Shocks to the Mind:Mental Health and Behavioral Responses to Natural Disasters

• In Event: Human Behavior in Disasters

Abstract

Natural disasters are becoming increasingly frequent and severe in the United States, raising concerns not only about economic losses and physical damages but also about their broader impacts on population health. While a growing literature examines the economic and mortality effects of disasters, less is known about their consequences for mental and behavioral health at the population level. Existing studies typically focus on a single disaster event or a specific disaster type within a limited geographic area. This paper provides a comprehensive analysis of the mental and behavioral health impacts of natural disasters across the United States, examining multiple disaster types and a broad set of health outcomes.

Using nationwide county-level panel data from 2014 to 2019, this study combines information on major disaster declarations from the Federal Emergency Management Agency (FEMA) with health and behavioral indicators from the County Health Rankings dataset. The analysis focuses on four outcomes that capture mental and behavioral health conditions: frequent mental distress, insufficient sleep, excessive drinking, and adult smoking. To identify causal effects, I employ a staggered difference-in-differences framework based on the Callaway and Sant’Anna (2021) estimator, which accounts for variation in the timing of disaster exposure across counties and avoids biases associated with traditional two-way fixed effects models.

The results indicate that natural disasters significantly worsen several behavioral health outcomes. In particular, disasters lead to statistically significant increases in insufficient sleep and excessive drinking, suggesting that disaster exposure can disrupt daily routines and coping behaviors in affected communities. In contrast, the estimated effects on mental distress and smoking are smaller and statistically insignificant on average. However, the magnitude and direction of impacts vary substantially across disaster types. Hurricanes generate the largest negative effects across several outcomes, while floods are associated with increases in excessive drinking and insufficient sleep. Tornadoes and severe storms generally produce smaller and less consistent impacts.

Heterogeneity analyses reveal that disaster-related mental and behavioral health impacts are unevenly distributed across communities. Counties with a higher share of elderly residents experience larger increases in mental distress following disasters, while counties with lower elderly shares exhibit stronger behavioral responses such as increases in insufficient sleep and alcohol consumption. Moreover, counties with limited healthcare access—measured by Health Professional Shortage Area (HPSA) designation—experience larger adverse effects compared with counties that have greater provider availability. Similarly, low-income counties show stronger behavioral health responses than higher-income counties.

Overall, the findings highlight that natural disasters impose significant but uneven mental and behavioral health burdens. These results underscore the importance of incorporating mental health and behavioral health support into disaster response and recovery policies, particularly in vulnerable communities with limited healthcare access or socioeconomic disadvantages.

Authors

• Hyoshin Ki, University at Albany
  Presenting Author

• Hyeonwoo Do, University at Albany
  Non-Presenting Co-Author