Mental health burdens, typhoon and structural health inequities: evidence from a global perspective

Against the backdrop of accelerating climate change and more frequent extreme weather events, typhoon disasters have become a major challenge to mental health. Based on the Social Determinants of Health theory and integrating the Cumulative Disadvantage Model with Structural Causal Influence analysis, this study evaluates how typhoon exposure affects the burden of mental health disorders and how these effects vary with social structural differences.

To investigate the mechanisms linking typhoon exposure to the burden of mental health disorders, and to quantify the moderating roles of macro-level social structural variables.

By constructing both main effect and year-on-year difference models, combined with structural equation modelling and multinational panel data, this research quantifies the moderating roles of macro-level social variables, including gross national income, Human Development Index, Gini coefficient, government health expenditure, out-of-pocket health spending, educational attainment, and life expectancy.

Typhoons were found to increase prevalence, incidence, and disability-adjusted life years (DALYs) related to mental disorders, with the strongest impact in the 25-34 age group. High income, education, HDI, and public health investment were linked to greater resilience, while low income, high OOP, and high inequality indicated vulnerability. Secondary disaster frequency and the number of people affected acted as mediators, forming a pathway from 'typhoon' to 'social stress' to 'mental disorders.'

Typhoon impacts on mental health are shaped by both direct exposure and structural inequalities. Improving socioeconomic conditions, lowering OOP costs, reducing inequality, and increasing public health investment can strengthen psychological resilience and disaster response capacity.