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dc.contributor.authorKishore, Nishant
dc.contributor.authorMarqués, Domingo
dc.contributor.authorMahmud, Ayesha S
dc.contributor.authorKiang, Mathew Vinhhoa
dc.contributor.authorRodriguez, Irmary
dc.contributor.authorFuller, Arlan F.
dc.contributor.authorEbner, Peggy
dc.contributor.authorSorensen, Cecilia
dc.contributor.authorRacy, Fabio De Castro Jorge
dc.contributor.authorLemery, Jay
dc.contributor.authorMaas, Leslie
dc.contributor.authorLeaning, Jennifer
dc.contributor.authorIrizarry, Rafael A.
dc.contributor.authorBalsari, Satchit Siddharth
dc.contributor.authorBuckee, Caroline O'Flaherty
dc.date.accessioned2018-07-27T20:20:01Z
dash.embargo.terms2018-12-13
dc.date.issued2018
dc.identifierQuick submit: 2018-07-26T13:12:39-0400
dc.identifier.citationKishore, Nishant, Domingo Marqués, Ayesha Mahmud, Mathew V. Kiang, Irmary Rodriguez, Arlan Fuller, Peggy Ebner, et al. 2018. “Mortality in Puerto Rico after Hurricane Maria.” New England Journal of Medicine 379 (2) (July 12): 162–170. doi:10.1056/nejmsa1803972.en_US
dc.identifier.issn0028-4793en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37309252
dc.description.abstractBACKGROUND Quantifying the effect of natural disasters on society is critical for recovery of public health services and infrastructure. The death toll can be difficult to assess in the aftermath of a major disaster. In September 2017, Hurricane Maria caused massive infrastructural damage to Puerto Rico, but its effect on mortality remains contentious. The official death count is 64. METHODS Using a representative, stratified sample, we surveyed 3299 randomly chosen households across Puerto Rico to produce an independent estimate of all-cause mortality after the hurricane. Respondents were asked about displacement, infrastructure loss, and causes of death. We calculated excess deaths by comparing our estimated post-hurricane mortality rate with official rates for the same period in 2016. RESULTS From the survey data, we estimated a mortality rate of 14.3 deaths (95% confidence interval [CI], 9.8 to 18.9) per 1000 persons from September 20 through December 31, 2017. This rate yielded a total of 4645 excess deaths during this period (95% CI, 793 to 8498), equivalent to a 62% increase in the mortality rate as compared with the same period in 2016. However, this number is likely to be an underestimate because of survivor bias. The mortality rate remained high through the end of December 2017, and one third of the deaths were attributed to delayed or interrupted health care. Hurricane-related migration was substantial. CONCLUSIONS This household-based survey suggests that the number of excess deaths related to Hurricane Maria in Puerto Rico is more than 70 times the official estimate. (Funded by the Harvard T.H. Chan School of Public Health and others.)en_US
dc.language.isoen_USen_US
dc.publisherNew England Journal of Medicine (NEJM/MMS)en_US
dc.relation.isversionofdoi:10.1056/NEJMsa1803972en_US
dash.licenseLAA
dc.titleMortality in Puerto Rico after Hurricane Mariaen_US
dc.typeJournal Articleen_US
dc.date.updated2018-07-26T17:12:41Z
dc.description.versionVersion of Recorden_US
dc.relation.journalNew England Journal of Medicineen_US
dash.depositing.authorIrizarry, Rafael A.
dash.embargo.until2018-12-13
dc.date.available2018
dc.identifier.doi10.1056/NEJMsa1803972*
dash.authorsorderedfalse
dash.contributor.affiliatedFuller, Arlan
dash.contributor.affiliatedRacy, Fabio De Castro Jorge
dash.contributor.affiliatedKishore, Nishant
dash.contributor.affiliatedBuckee, Caroline
dash.contributor.affiliatedKiang, Mathew
dash.contributor.affiliatedLeaning, Jennifer
dash.contributor.affiliatedMahmud, Ayesha
dash.contributor.affiliatedBalsari, Satchit
dash.contributor.affiliatedIrizarry, Rafael


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