Medical
  • Articles
  • November 2024

RGA Brief: Four considerations for mortality following natural disasters

By
  • Dr. Georgiana Willwerth-Pascutiu
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In Brief

Although natural disasters are typically viewed as property and casualty insurance issues, some studies suggest their long-term health impacts may deserve greater attention from life and health insurers. The potential lingering effects necessitate a holistic approach to assess direct and indirect mortality and morbidity associated with natural disasters.

Key takeaways

  • Natural disasters impact property and casualty insurance and result in direct mortality, yet some studies suggest they are associated with substantial indirect mortality that is not accurately captured and quantified.
  • Several factors are being evaluated by the insurance industry and others to determine how far the reach of natural disasters may extend, including the role that climate change plays in their severity and frequency, and their impacts on mental health and vulnerable populations.
  • Estimates vary as to the extended morbidity and mortality effects of natural disasters – what they may impact and for how long, or whether there is a valid correlation.

 

In October 2024, torrential rain brought over a year's worth of precipitation to several areas in southeastern Spain. Ongoing rain exasperated the situation in other parts of the country. More than 200 people died, and the financial impact is expected to be staggering. Storms such as these across the globe often produce similar results.

Natural disasters in their various forms – hurricanes, floods, earthquakes, wildfires, droughts, and more – are typically viewed as property and casualty (P&C) insurance issues because the associated deaths generally do not significantly influence long-term mortality trends. But some studies suggest the toll is more widespread and their effects may linger well after houses and businesses are rebuilt.

For example, a recent study published in Nature1 analyzing tropical cyclones in the US – encompassing hurricanes and tropical storms – determined that the health impacts from these natural disasters may be underestimated, as primarily direct mortality is reported with an average of 24 deaths per event. But indirect mortality may be closer to 7,000 per storm.

A typical surveillance approach scans records for specific mentions that link deaths to an extreme weather event. While this process can capture direct mortality from causes such as electrocution or drowning, it may overlook a substantial number of deaths from other sources, including food and water contamination, disrupted access to medical care, and mental health disorders. Additional studies suggest that excess mortality can be documented for at least 60 days following a weather-related event.

The Nature study extends indirect effects to several years after an event, seeking to connect the dots between the data gaps in this area. Other studies offer similar conclusions, but it is important to note that measuring the extended effects of catastrophes is challenging. Consider this: A 2023 study published in The BMJ, based on data from 35 countries, demonstrated that mortality risks among populations exposed to floods increased during the first 25 days following a flood and returned to baseline values at around 60 days.2 Questions arise as to true correlation for some mortality-related outcomes, especially those developing well after a climate-related event.

No definitive finding is possible at this point, and life and health insurers should monitor and analyze additional data from areas where the ramifications of natural disasters are suggested to impact long-term morbidity and mortality. This article provides a brief look at four of them.

1. Climate change

Life and health insurers may have yet to experience a substantial documented impact from climate change, but the frequency and severity of climate events may alter this.3 The global number of reported climate- and weather-related disasters increased fivefold from 1970 to 2019.4

Temperatures continue to rise above historic norms, with 2023 having been the warmest year on record, resulting in not only extreme heat, but also heat waves. Droughts and floods reside at opposing sides of the meteorological spectrum, yet they are the most widely felt weather-related issues worldwide.

Indications are that the ongoing effects of climate change will increase the frequency and severity of natural disasters. Climate science projections suggest an approximate 10% to 15% increase in the number of storms per year by 2050.5 This will potentially have a negative impact on the population’s health.

2. Mental health

A natural disaster can wreak havoc on property, but it can also take an emotional toll. Following disasters, mental health problems tend to increase among people with no history of mental illness and those at risk, according to the Centers for Disease Control and Prevention (CDC).6 These issues may be short-lived or prolonged and may not display immediately after a disaster.

Some of the more common psychological diagnoses include post-traumatic stress disorder (PTSD), anxiety, and depression.

Symptoms are more likely to linger in children due to parental stress, disruptions to their routine, or separation from caregivers.7 First responders also are not immune to mental health consequences resulting from their high level of exposure to the illnesses, injuries, and death wrought by natural disasters.

For insurers, the presence of these psychological factors may trigger an increase in disability claim filings.

3. Vulnerable populations

In the wake of a natural disaster, residents can be left without power, food, water, and shelter. Certain populations may be more susceptible to the full ramifications of these hardships. For example, the Nature study suggested that 99% of infant deaths associated with tropical cyclones occur more than 21 months later.1 

Those with lower incomes could have greater difficulty securing access to healthcare and medical needs due to the physical location of the facilities or the lack of financial means for non-covered costs.

Some studies propose that exposure to pollutants and toxicants stirred up or leaked during natural disasters is more likely to impact communities of color.8 Other studies suggest Black populations affected by catastrophes are three times more at risk of death compared to Caucasian communities.1

4. Secondary impacts

Storm surges – such as those from hurricanes, tropical storms, and floods – can have a negative impact on health well after the weather has cleared, according to some reports. The CDC notes that water’s intrusion onto land and the time it takes to recede can heighten the risk of waterborne diseases by up to 50%. The subsequent allergens, mold, and contaminated water can cause or exacerbate respiratory illnesses.6

Conclusion

Several studies suggest, to varying degrees, that the impact of natural disasters may extend beyond their direct effects. Still, it can be challenging to determine a direct correlation between the aftereffects and the event itself, as well as the full scope of any collateral symptoms.

As severe environmental events become more common, accurate reporting and attribution is needed combined with a more holistic approach toward assessing direct and indirect mortality and morbidity associated with natural disasters.


RGA experts are eager to engage with clients to better understand and tackle the industry’s most pressing challenges together. Contact us to discuss and to learn more about RGA's capabilities, resources, and solutions.

 

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Meet the Authors & Experts

Georgiana Pascutiu
Author
Dr. Georgiana Willwerth-Pascutiu
Vice President and Medical Director, Global Medical

References

  1. Nature, October 2, 2024. https://www.nature.com/articles/s41586-024-07945-5
  2. The BMJ, Mortality risks associated with floods in 761 communities worldwide: time series study, October 4, 2023. https://www.bmj.com/content/383/bmj-2023-075081
  3. The Geneva Association, Climate Change: What does the future hold for health and life insurance?, February 2024. https://www.genevaassociation.org/sites/default/files/2024-02/cch-report_web-270224.pdf
  4. World Meteorological Association. https://wmo.int/
  5. World Economic Forum, Quantifying the Impact of Climate Change on Human Health, January 2024. https://www3.weforum.org/docs/WEF_Quantifying_the_Impact_of_Climate_Change_on_Human_Health_2024.pdf
  6. Centers for Disease Control and Prevention, Mental Health, and Stress-Related Disorders. https://www.cdc.gov/climate-health/php/effects/mental-health-disorders.html
  7. American Psychiatric Association. https://www.psychiatry.org/patients-families/climate-change-and-mental-health-connections/affects-on-mental-health
  8. Union of Concerned Scientists and Texas Environmental Justice Advocacy Services, Double Jeopardy in Houston, August 22, 2016. https://www.ucsusa.org/resources/double-jeopardy-houston#.WdVku1tSyUl