{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:41:24Z","timestamp":1792604484276,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Extreme weather has major implications for state and national health care systems; however, statistics examining weather-related injuries and fatalities are limited.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the frequency and regional distribution of major disaster events (MDEs) in the US.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This ecologic cross-sectional study of MDEs occurring between January 1, 2006, and December 31, 2021, evaluated US data on all injuries and fatalities included in the National Oceanic and Atmospheric Administration National Centers for Environmental Information Storm Events Database. The data analysis was performed between February 22, 2023, and April 1, 2024.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Major disaster events defined as an environmental event that caused either at least 50 injuries or at least 10 deaths.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>All MDEs were evaluated using descriptive statistics for event type, property damage, and rural or urban classification according to the National Centers for Health Statistics Urban-Rural Classification Scheme for Counties. The location of events according to Administration for Strategic Preparedness and Response (ASPR) region and hospital bed capacity of ASPR regions were also examined.<\/jats:p><\/jats:sec>Results<\/jats:title>Between 2006 and 2021, 11\u202f159 storm events caused 42\u202f254 injuries and 9760 deaths. Major disaster events accounted for 209 weather events (1.9%) but caused 19\u202f463 weather-associated injuries (46.1%) and 2189 weather-associated deaths (22.4%). The majority of MDEs were caused by extreme heat (86 [41.1%]) and tornadoes (67 [32.1%]). While a larger proportion of MDEs occurred in urban areas (151 [75.1%]) vs rural areas (50 [24.9%]), rural MDEs caused a median of 9 (IQR, 2-16) deaths per event vs 4 (IQR, 0-14) deaths per event in urban areas. The majority of MDEs occurred in either ASPR region 4 (51 [24.5%]) or region 9 (45 [21.6%]). Certain event types, such as fires, wind, and hurricanes or storms, were geographically concentrated, while extreme heat and floods affected regions across the US equally. Urban counties had disproportionately greater hospital bed capacity than rural counties relative to population and MDE distributions.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>The findings of this ecologic study indicate that while MDEs accounted for a small proportion of all weather events, they were associated with a disproportionate number of injuries and fatalities. Integrating these data into county, state, and regional hazard vulnerability analyses is crucial to ensuring preparedness and mitigating climate risk.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.29826","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T15:32:43Z","timestamp":1724686363000},"page":"e2429826","source":"Crossref","is-referenced-by-count":12,"title":["Extreme Weather Injuries and Fatalities, 2006 to 2021"],"prefix":"10.1001","volume":"7","author":[{"given":"Caroline Q.","family":"Stephens","sequence":"first","affiliation":[{"name":"Division of Pediatric Surgery, UCSF Benioff Children\u2019s Hospitals, and Department of Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Newton","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, UCSF Benioff Children\u2019s Hospitals, and Department of Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Kappy","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine, Children\u2019s National Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline G.","family":"Melhado","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery, UCSF Benioff Children\u2019s Hospitals, and Department of Surgery, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Fallat","sequence":"additional","affiliation":[{"name":"Hiram C. Polk Jr Department of Surgery, Division of Pediatric Surgery, University of Louisville School of Medicine, and Norton Children\u2019s Hospital, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"issue":"1","key":"zoi240911r3","doi-asserted-by":"publisher","first-page":"122","DOI":"10.3346\/jkms.2014.29.1.122","article-title":"Scientific framework for research on disaster and mass casualty incident in Korea: building consensus using Delphi method.","volume":"29","author":"Kim","year":"2014","journal-title":"J Korean Med Sci"},{"issue":"11","key":"zoi240911r12","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/PEC.0000000000001650","article-title":"Pediatric injuries treated at a level 1 trauma center after an F5 tornado.","volume":"34","author":"Watts","year":"2018","journal-title":"Pediatr Emerg Care"},{"issue":"12","key":"zoi240911r13","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083038","article-title":"Injuries and post-traumatic stress following historic tornados: Alabama, April 2011.","volume":"8","author":"Niederkrotenthaler","year":"2013","journal-title":"PLoS One"},{"issue":"6","key":"zoi240911r14","doi-asserted-by":"publisher","first-page":"746","DOI":"10.1016\/j.annemergmed.2017.06.042","article-title":"All-cause hospital admissions among older adults after a natural disaster.","volume":"71","author":"Bell","year":"2018","journal-title":"Ann Emerg Med"},{"issue":"10","key":"zoi240911r15","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2022.3633","article-title":"Disparities in spatial access to emergency surgical services in the US.","volume":"3","author":"McCrum","year":"2022","journal-title":"JAMA Health Forum"},{"issue":"2","key":"zoi240911r16","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1016\/j.injury.2017.01.008","article-title":"Disparities in access to trauma care in the United States: a population-based analysis.","volume":"48","author":"Carr","year":"2017","journal-title":"Injury"},{"issue":"1","key":"zoi240911r23","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1177\/0739456X16628605","article-title":"Assessing the quality of rural hazard mitigation plans in the southeastern United States.","volume":"37","author":"Horney","year":"2017","journal-title":"J Plann Educ Res"},{"issue":"1","key":"zoi240911r25","doi-asserted-by":"publisher","first-page":"2470","DOI":"10.1038\/s41467-023-38084-6","article-title":"Spatiotemporal distribution of power outages with climate events and social vulnerability in the USA.","volume":"14","author":"Do","year":"2023","journal-title":"Nat Commun"},{"issue":"2","key":"zoi240911r26","doi-asserted-by":"publisher","first-page":"221","DOI":"10.23907\/2017.023","article-title":"Medicolegal death scene investigations after natural disaster- and weather-related events: a review of the literature.","volume":"7","author":"Rocha","year":"2017","journal-title":"Acad Forensic Pathol"},{"key":"zoi240911r1","volume-title":"The Fifth National Climate Assessment","author":"Hayden","year":"2023"},{"key":"zoi240911r2","doi-asserted-by":"crossref","DOI":"10.7930\/NCA5.2023.RiB","volume-title":"Fifth National Climate Assessment","author":"Crimmins","year":"2023"},{"key":"zoi240911r11","first-page":"905","article-title":"Wildfire burn patients: a unique population.","volume-title":"J Burn Care Res","author":"Stokes","year":"2021"},{"key":"zoi240911r18","volume-title":"CASPER: Community Assessment for Public Health Emergency Response (CASPER) Toolkit","author":"Centers for Disease Control and Prevention","year":"2019","edition":"3rd ed"},{"key":"zoi240911r20","volume-title":"Rural America at a Glance: 2021 Edition","author":"Dobis","year":"2021"},{"key":"zoi240911r24","volume-title":"Fifth National Climate Assessment","author":"Jay","year":"2023"},{"key":"zoi240911r4","unstructured":"Storm Events Database. 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