{"doi":"10.1136/ip-2022-044709","title":"Hurricane Florence and suicide mortality in North Carolina: a controlled interrupted time-series analysis","abstract":"BACKGROUND: Natural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in September 2018, may have impacted suicide deaths in North Carolina (NC). METHODS: We used publicly available NC death records data to estimate associations between Hurricane Florence and monthly suicide death rates using a controlled, interrupted time series analysis. Hurricane exposure was determined by using county-level support designations from the Federal Emergency Management Agency. We examined effect modification by sex, age group, and race/ethnicity. RESULTS: 8363 suicide deaths occurred between January 2014 and December 2019. The overall suicide death rate in NC between 2014 and 2019 was 15.53 per 100 000 person-years (95% CI 15.20 to 15.87). Post-Hurricane, there was a small, immediate increase in the suicide death rate among exposed counties (0.89/100 000 PY; 95% CI -2.69 to 4.48). Comparing exposed and unexposed counties, there was no sustained post-Hurricane Florence change in suicide death rate trends (0.02/100 000 PY per month; 95% CI -0.33 to 0.38). Relative to 2018, NC experienced a statewide decline in suicides in 2019. An immediate increase in suicide deaths in Hurricane-affected counties versus Hurricane-unaffected counties was observed among women, people under age 65 and non-Hispanic black individuals, but there was no sustained change in the months after Hurricane Florence. CONCLUSIONS: Although results did not indicate a strong post-Hurricane Florence impact on suicide rates, subgroup analysis suggests differential impacts of Hurricane Florence on several groups, warranting future follow-up.","journal":"Injury Prevention","year":2022,"id":278329,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9411,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":6027,"name":"Brian W. Pence","orcid":"0000-0001-7321-9538","position":1,"is_corresponding":false},{"id":950454,"name":"Kate Vinita Fitch","orcid":"0000-0002-4410-4608","position":2,"is_corresponding":false},{"id":950865,"name":"Monica E Swilley-Martinez","orcid":null,"position":3,"is_corresponding":false},{"id":434805,"name":"Andrew L. Kavee","orcid":null,"position":4,"is_corresponding":false},{"id":950866,"name":"Samantha Dorris","orcid":null,"position":5,"is_corresponding":false},{"id":950867,"name":"Toska Cooper","orcid":null,"position":6,"is_corresponding":false},{"id":105707,"name":"Alexander P. Keil","orcid":"0000-0002-0955-6107","position":7,"is_corresponding":false},{"id":366445,"name":"Bradley N. Gaynes","orcid":"0000-0002-8283-5030","position":8,"is_corresponding":false},{"id":528723,"name":"Timothy S. Carey","orcid":"0000-0001-6539-5021","position":9,"is_corresponding":false},{"id":673681,"name":"David B. Goldston","orcid":"0000-0001-7182-6553","position":10,"is_corresponding":false},{"id":597588,"name":"Shabbar I. Ranapurwala","orcid":"0000-0002-3944-3912","position":11,"is_corresponding":false},{"id":449337,"name":"Vanessa Miller","orcid":"0000-0003-3537-649X","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T00:28:43.133347Z","pmid":"36600665","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}