The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability

Background: While most prior research has focused on extreme heat, few assessed the immediate health effects of winter storms and associated power outages (PO), although severe storms have become more frequent. This study evaluates the joint and independent health effects of winter storms and PO, snow versus ice-storm, effects by time window (peak timing, winter/transitional months) and the impacts on critical care indicators including numbers of comorbidity, procedure, length of stay and cost. Methods: We use distributed lag nonlinear models to assess the impacts of winter storm/PO on hospitalizations due to cardiovascular, lower respiratory diseases (LRD), respiratory infections, food/water-borne diseases (FWBD) and injuries in New York State on 0–6 lag days following storm/PO compared with non-storm/non-PO periods (references), while controlling for time-varying factors and PM_2.5. The storm-related hospitalizations are described by time window. We also calculate changes in critical care indicators between the storm/PO and control periods. Results: We found the joint effects of storm/PO are the strongest (risk ratios (RR) range: 1.01–1.90), followed by that of storm alone (1.02–1.39), but not during PO alone. Ice storms have stronger impacts (RRs: 1.04–3.15) than snowstorms (RRs: 1.03–2.21). The storm/PO-health associations, which occur immediately, and some last a whole week, are stronger in FWBD, October/November, and peak between 3:00–8:00 p.m. Comorbidity and medical costs significantly increase after storm/PO. Conclusion: Winter storms increase multiple diseases, comorbidity and medical costs, especially when accompanied by PO or ice storms. Early warnings and prevention may be critical in the transitional months and afternoon rush hours.