Study Shows Maternal Mental Health Affected When Exposed to Multiple Hurricanes

This post was written by University Communications intern, and NC State student, Erin Ferrare.

Women who have to deal with multiple hurricanes during pregnancy have an increased risk of psychological distress, according to a study published earlier this year. Specifically, the study found that pregnant women who are exposed to two or more extreme weather events are more likely than other pregnant women to develop mood and anxiety disorders, incident-related mental disorders, and severe mental illness.

The topic is of particular interest following Hurricane Helene, which was just one of the major hurricanes women in North Carolina have been exposed to since 2016. While there is research on maternal mental health after being exposed to one hurricane, there is limited data on women who have been exposed to more than one.

“Our research highlights a critical gap: while we know the mental health impacts of single disasters, we’re only beginning to understand the effects of recurrent exposure especially in vulnerable groups like pregnant women,” says Jen Runkle, corresponding author of the study and senior research scholar at NC State’s North Carolina Institute for Climate Studies (NCICS). “For those living in disaster-prone areas, the effects aren’t just one-time – our study brings a nuanced perspective, showing that recurring events compound mental health impacts, pushing for policies that address the cumulative stress of multiple disasters.”

The study – which was published in June 2024 in PLOS Mental Health – drew on data from the UNC Sheps Center which showed daily emergency department (ED) visits for pregnant Medicaid patients between the ages of 18 and 44. The ED visit data ranged from Oct. 1, 2015, to Sept. 1, 2020, which is of particular interest to researchers since four major hurricanes moved through North Carolina during that timeframe: Matthew (2016), Florence (2018), Michael (2018), and Dorian (2019).

The results of the study found a cumulative mental health burden of multiple and recurring hurricane exposure on pregnant populations, including a 158% increase in maternal disorders diagnosed during pregnancy; a 151% increase in perinatal mood and anxiety disorders; and a 135% increase in severe mental illness ED visits for pregnant Medicaid beneficiaries impacted by two or more storms. 

Researchers also found that women residing in counties with low access to maternal care services who experienced two or more storms were over 200% more likely to experience a mental health related ED visit.

“Our findings emphasize the need for policy shifts to support mental health care accessibility in disaster-prone areas,” says Runkle. “This includes integrating rapid mental health response teams that work directly in affected communities and ensuring continuity of care for vulnerable groups like low-income pregnant women. Mental health screenings and interventions must be integrated into disaster response for pregnant women and children – these groups face significant psychological effects, yet they are often overlooked in current policies.”

The paper, “Examining recurrent hurricane exposure and psychiatric morbidity in Medicaid-insured pregnant populations” was published in the journal PLOS Mental Health in June 2024. The paper was co-authored by Kelsey Herbst, Trey Williamson, and Carl J. Schreck, who works alongside Runkle at NCICS.