Violent deaths following disasters: A retrospective analysis

Negative mental health outcomes associated with disaster exposure can increase risks of interpersonal and self-directed violence. However, the link between disaster exposure and increased incidence in violent deaths is not clearly established.

The objective of this work is to assess the incidence of violent deaths in non-disaster and disaster periods across five distinct disaster events.

This study uses an ecological, quasi-experimental design to assess violent deaths in pre-disaster and disaster periods across five U.S. states (e.g., North Carolina, Oregon, Oklahoma, Wisconsin, and Colorado) with federally declared disasters resulting from natural hazards (e.g., flood, wildfire, tropical cyclone, storms). Deaths recorded in the National Violent Death Reporting System were used to describe violent deaths with injuries occurring three-months prior to and after disaster onset. Poisson regression with population offsets and fixed effects was used to calculate incidence rate ratios for disaster affected and unaffected counties within the same state, comparing violent death rates in disaster periods with non-disaster periods.

Most of all deaths were White (80.75%), male (76.87%), and unmarried (65.03%); the median age of decedents was 41.5 years (IQR: 28-55). Overall, the incidence of violent deaths was consistent between disaster and non-disaster periods for both affected (IRR: 0.985; 95% CI: 0.760-1.276) and unaffected counties (IRR: 1.062; 95% CI: 0.975-1.158). Rate ratios were heterogenous but not significant across individual disasters, with only non-suicide and all-cause violent deaths increasing significantly following severe storms and flooding in Wisconsin for counties ineligible for public assistance.

The results of this study are consistent with the heterogenous findings on violent deaths and disasters throughout literature. As disasters become more frequent and severe, it is important to further consider the relationship between disaster impacts and negative mental health outcomes, including violent deaths.