Routine high-tide flooding in coastal communities could lead to thousands of deaths among older adults by the end of the century, according to a new study co-authored by Florida State University researcher Mathew Hauer.

Published in The Lancet Planetary Health, the study projects that without significant adaptation, premature deaths among adults aged 65 and older linked to high-tide flooding could increase 43-fold by 2100.

Unlike storm surges from major hurricanes, high-tide flooding happens regularly and is often viewed as a nuisance rather than a danger. But researchers found even shallow flooding on roads can delay emergency medical care for older adults during time-sensitive emergencies such as cardiac arrest.

“When we think about climate change threatening people’s lives, we picture hurricanes and heat waves,” Hauer said. “What we found is that the routine, ankle-deep flooding people have learned to live with is on track to kill more older adults than storm surge does in these same coastal areas. It’s a quiet, cumulative form of climate mortality, and until now nobody had put a national number on it.”

The research team, which included Hauer from the FSU College of Social Sciences and Public Policy’s Department of Sociology and Center for Demography and Population Health, found that flooding creates significant traffic disruptions that obstruct emergency medical access. This is particularly dangerous for time-sensitive conditions where every minute of delay significantly reduces survival rates.

Researchers identified three major findings:

• A growing crisis: By 2100, the model projects nearly 10,000 additional deaths annually among older adults in coastal U.S. regions.
• Economic impact: The monetized damages associated with these premature deaths could reach $1.1 trillion by the end of the century.
• The 8-minute threshold: Seniors living in areas with more than an 8.85-minute drive to the nearest hospital are especially vulnerable to these flood-induced delays.

The findings are a wake-up call for the Sunshine State, which stands at the epicenter of the issue.

The study identified Florida as the nation’s most vulnerable state because of its large older population and extensive low-lying coastline.

“Simple things like raising roadways, better sited-hospitals, and other changes could make a significant impact on reducing this anticipated mortality. An ounce of prevention today is worth a pound of cure tomorrow.”

– Mathew Hauer, FSU associate professor and study co-author

By 2060, Florida could account for 24% to 38% of all high-tide flooding deaths in the coastal contiguous U.S., with an estimated 360 to 1,590 annual fatalities.

“Florida has twin threats of an older population and a large, low-lying coastal zone,” Hauer said. “So, the demography, the geography and climate change all combine to account for a large percentage of these anticipated deaths.”

Researchers said the projected death toll could be significantly reduced through infrastructure improvements and planning. Implementing protective measures, such as elevating roads or building new healthcare facilities in accessible locations, could reduce premature deaths by 57%.

The researchers recommend three critical steps for coastal communities:

• Protect road networks that are essential for emergency medical access.
• Increase accessibility by building more critical care facilities in at-risk coastal areas.
• Manage the retreat of vulnerable populations to areas with better infrastructure and healthcare access.

The study concluded that the economic costs associated with these deaths exceed many other climate-related impacts, making healthcare infrastructure a priority for policymakers.

“The deaths show up when an ambulance can’t get through and the adaptive infrastructure to prevent these are things we already know how to do,” Hauer said. “Simple things like raising roadways, better sited-hospitals, and other changes could make a significant impact on reducing this anticipated mortality. An ounce of prevention today is worth a pound of cure tomorrow.”

The study was funded by the U.S. Environmental Protection Agency and included collaborators from Arizona State University, Industrial Economics and the International Food Policy Research Institute.

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An associate professor in the College of Social Sciences and Public Policy is the first Florida State University faculty member to receive an early career award for her work in population health from the Interdisciplinary Association for Population Health Science (IAPHS).

Patricia Homan was awarded the Milbank Quarterly Early Career Award in Population Health at the IAPHS Conference in September.

“This is a huge honor, and I am thrilled to receive this recognition,” Homan said. “This would not have been possible without the wonderful mentorship and support I’ve received at FSU, which has enabled me to thrive as an early career scholar. I am especially grateful for my colleagues and leaders in the Department of Sociology, Public Health Program, and the College of Social Sciences and Public Policy, who have made FSU such a special place to teach, research and serve.”

Homan is an associate professor in the Department of Sociology, director of research & strategic initiatives for the Public Health Program, a faculty associate at the Pepper Institute on Aging and Public Policy, and a research affiliate at the Center for Demography and Population Health.

The award recognizes significant contributions to population health science by an individual who has received a Ph.D., M.D., or a comparable graduate degree within the past 10 years. It emphasizes contributions from multiple disciplines to address population health issues. The winner receives a $3,000 honorarium and up to $1,500 to cover conference attendance expenses.

Homan’s research focuses on developing theories and measurements for structural sexism, structural racism, and other forms of structural oppression, and examining how these forces shape health in the United States. Before joining the College of Social Sciences and Public Policy in 2018, Homan earned a doctorate in sociology from Duke University.

Homan’s other awards include the 2022 National Institutes of Health Matilda White Riley Early Stage Investigator Award, the 2022 Early Career Gender Scholar Award from Sociologists for Women in Society South, the 2021 American Sociological Association (ASA) Sex & Gender Section Distinguished Article Award, and the 2019 Roberta G. Simmons Outstanding Dissertation Award from the ASA Medical Sociology Section.

For more information about the College of Social Sciences and Public Policy, visit cosspp.fsu.edu.

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