Observation and modeling of fertility loss attributable to natural disasters from 1990-2021

Natural disasters have increasingly threatened population health, but their global impacts on fertility remain uncertain. This study aims to quantify global fertility loss attributable to natural disasters and its socioeconomic disparities.

We conducted a two-stage analysis using disaster records from the Emergency Events Database (EM-DAT) and total fertility rate (TFR) and net reproductive rate (NRR) data from the Global Burden of Disease (GBD) 2021 database. First, we used country-year panel data to assess exposure-response functions. Second, we estimated spatiotemporal distributions and inequalities of global, regional, and national fertility losses attributable to natural disasters.

Here we show that, globally, floods and storms contribute to annual TFR losses of 103.79 and 38.75 per 100,000 women of childbearing age. Flood-attributable TFR loss is most pronounced in South Asia, particularly in low-SDI and low-income countries, whereas storm-attributable TFR loss is greater in high-SDI and middle-income countries. For NRR, epidemics, storms, floods, and earthquakes contribute to losses of 35.26, 32.36, 31.96, and 24.53 per 100,000 women of childbearing age annually. South Asia shows the highest NRR losses attributable to floods, storms, and earthquakes, whereas Sub-Saharan Africa shows the highest epidemic-attributable NRR loss. Epidemic- and flood-attributable NRR losses are higher in low-SDI and low-income countries, whereas earthquake- and storm-attributable NRR losses are higher in middle- to high-SDI and income countries.

Floods, storms, earthquakes, and epidemics contribute to significant fertility loss worldwide, with geographical and socioeconomic disparities. Regions prone to these disasters should implement local-specific reproductive health strategies to maintain sustainable demographic structures.