Flooding is one of the most disruptive and costliest climate-related disasters and presents an escalating threat to population health due to climate change and urbanization patterns. Previous studies have investigated the consequences of flood exposures on only a handful of health outcomes and focus on a single flood event or affected region. To address this gap, we conducted a nationwide, multi-decade analysis of the impacts of severe floods on a wide range of health outcomes in the United States by linking a novel satellite-based high-resolution flood exposure database with Medicare cause-specific hospitalization records over the period 2000- 2016. Using a self-matched study design with a distributed lag model, we examined how cause-specific hospitalization rates deviate from expected rates during and up to four weeks after severe flood exposure. Our results revealed that risk of hospitalization was consistently elevated during and for at least four weeks following severe flood exposure for nervous system diseases (3.5 %; 95 % confidence interval [CI]: 0.6 %, 6.4 %), skin and subcutaneous tissue diseases (3.4 %; 95 % CI: 0.3 %, 6.7 %), and injury and poisoning (1.5 %; 95 % CI: -0.07 %, 3.2 %). Increases in hospitalization rate for these causes, musculoskeletal system diseases, and mental health-related impacts varied based on proportion of Black residents in each ZIP Code. Our findings demonstrate the need for targeted preparedness strategies for hospital personnel before, during, and after severe flooding.

翻译：洪水是最具破坏性和最昂贵的气候相关灾害之一，且由于气候变化和城市化模式，其对人群健康构成的威胁日益加剧。以往研究仅探讨了洪水暴露对少数健康结局的影响，并聚焦于单一洪水事件或受影响区域。为填补这一空白，我们通过将基于卫星的新型高分辨率洪水暴露数据库与2000-2016年期间Medicare病因特异性住院记录相关联，对美国严重洪水对广泛健康结局的影响进行了全国性、跨数十年的分析。采用自匹配研究设计结合分布式滞后模型，我们分析了严重洪水暴露期间及之后四周内病因特异性住院率如何偏离预期水平。结果显示，在严重洪水暴露期间及至少之后四周内，神经系统疾病（3.5%；95%置信区间[CI]：0.6%，6.4%）、皮肤及皮下组织疾病（3.4%；95% CI：0.3%，6.7%）以及损伤与中毒（1.5%；95% CI：-0.07%，3.2%）的住院风险持续升高。这些病因、肌肉骨骼系统疾病及心理健康相关影响的住院率增幅因各邮政编码区黑人居民比例而异。我们的研究结果凸显了在严重洪水发生前、中、后为医院人员制定针对性防范策略的必要性。