Independent Report Highlights Excess Mortality from Hurricane Maria

damaged building surrounded by water and downed power lines

As commissioned by the Governor of Puerto Rico, the George Washington University Milken Institute School of Public Health (GW SPH) published an independent report assessing the excess number of deaths due to Hurricane María. In completing the assessment, the GWU research team implemented three studies with specific yet complementary methodologies. The GWU research team gathered  specific data based on past mortality patterns in relation to projected forward mortality rates in normal circumstances. Consequently, the difference between the current and predicted numbers is “the estimate of excess mortality due to the hurricane.” In order to account for external variables in the post-hurricane information environment, the team conducted a two-part study examining both the certification process and the quality of death certificate data. The entire scientific research process, including communication assessment methodology, instruments, and analytical framework, was conducted under the guidance of the CDC and the World Health Organization (WHO).

The final report highlights the following key findings:

  • Mortality in Puerto Rico has been slowly declining from 2010 on, but increased markedly in the period after September 2017, most dramatically under the displacement scenario accounting for migration after the hurricane.
  • Every social stratum and age group was affected by excess mortality, however, risk of death was higher and persistent for populations living in low socioeconomic development municipalities.
  • The lack of training on death certificate completion resulted in some reluctance to relate deaths to hurricanes, including concern about the subjectivity of this determination and about liability.
  • At the time of the hurricane, numerous agency communication personnel had inadequate training in crisis and emergency risk communication, nor were they trained regarding their role in a disaster.

Significantly, the report findings suggest that “[t]he inadequate preparedness and personnel training for crisis and emergency risk communication, combined with numerous barriers to accurate, timely information and factors that increased rumor generation, ultimately decreased the perceived transparency and credibility of the Government of Puerto Rico.” The list of specific recommendations for improving upon the reported weaknesses includes establishing strategic objectives in policy-making and risk communication guidelines, developing a federal and state level preparedness and response capacity, instituting mortality-based monitoring and analysis, and improving upon risk communication processes.

The full report including applicable data and methodology can be accessed here.

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