Study shows higher death toll among PuertoRicans related to HurricaneMaria than reported following the 2017 disaster BMJ_Open
. This focus on deaths occurring in the territory resulted in an underestimation of the death toll by approximately 14.7%, which we estimate occurred in the USA. In contrast, Kishore surveyed a representative sample of households, asking survivors to account for the whereabouts of all people who lived in their community prior to the hurricane irrespective of the location of the occurrences of death among community members .
An additional contribution of the study is the use of a research design to credibly estimate the excess mortality of displaced and migrant populations during this period, while carefully accounting for population displacement following the disaster.
Finally, because we use the deaths of persons who are identified as Puerto Rican in their death certificate, our analysis does not allow us to disentangle the excess mortality of displaced populations as opposed to longer-term migrants or second or third-generation individuals of such ancestry.
This analysis suggests the need for not only equitable disaster preparedness but also the importance of cross-jurisdiction data sharing.These already vulnerable populations may face a number of additional hurdles on relocation, such as healthcare disruptions and psychological stressors, which may exacerbate health impacts of the disaster. Receiving jurisdictions would, thus, benefit from an improved understanding of both the dynamics of postdisaster displacement and its consequences.
Already important efforts exist among jurisdictions in the USA, such as the State and Territorial Exchange of Vital Events of the National Association for Public Health Statistics Information Systems, to facilitate vital records for use by other state-level and territorial public health organisations. However, more coordination is required to speed the flow of data to gain a more comprehensive understanding of the scale of disasters in other countries.
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