Cumulative disaster exposure and hypertension among mothers who survived Hurricane Katrina

As climate change intensifies, hurricanes and weather-related disasters have been increasingly frequent and severe, impacting regions like the U.S. Gulf Coast with repeated hurricanes. While acute and short-term health impacts are well-described, impacts on longer-term and chronic conditions such as hypertension remain underexplored. This study examines the association between repeated hurricane exposure and hypertension risk in survivors. We used data from the Resilience in Survivors of Katrina project, a longitudinal (2003-2018) cohort of predominantly Black, low-income mothers affected by Hurricane Katrina. A sample of 505 women who were not hypertensive pre-Katrina was analyzed. Cumulative exposure was defined as the number of hurricanes experienced post-Katrina, assessed at several survey waves over 12 years. Logistic regression estimated associations between hurricane exposure and hypertension in 2016-18, with mediation analyses exploring the indirect effect via psychological distress (PD). In adjusted models, exposure to two hurricanes was associated with a 61% increase in hypertension odds (OR = 1.61, 95% CI: 1.00, 2.63) and exposure to three or more with 87% increased odds (OR = 1.87, 95% CI: 1.01, 3.47), relative to exposure to only one hurricane. The indirect effect from hurricane exposure to hypertension via PD was statically significant (95% CI: 1.01, 1.09). Findings highlight a novel link between cumulative disaster exposure and hypertension, with PD as a potential mediator. This suggests that repeated exposure to hurricanes not only impacts mental health but may also contribute to adverse physical health outcomes. Addressing both mental and physical health in disaster response, especially for vulnerable populations, is crucial.