Hurricanes keep killing people long after they hit land, new research shows.

Over the past few decades, hurricanes and other tropical storms in the U.S. were associated with up to 33.4% higher death rates from several major causes in subsequent months, according to a study published Tuesday in the Journal of the American Medical Association. According to the study, subsequent causes of death from hurricanes included injuries, infectious and parasitic diseases, respiratory and cardiovascular diseases, and neuropsychiatric disorders.

The study shows how far-reaching and varied the hidden costs to life could be from climate-related disasters and climate change, according to the Columbia Mailman School of Public Health in New York City, which led the study.

“In the U.S., tropical cyclones, such as hurricanes and tropical storms, have a devastating effect on society, yet a comprehensive assessment of their continuing health impacts had been lacking,” said study co-author Marianthi-Anna Kioumourtzoglou, an assistant professor of environmental health sciences at the Columbia Mailman School of Public Health, in a statement

“Our study is a first major step in better understanding how cyclones may affect deaths, which provides an essential foundation for improving resilience to climate-related disasters across the days, weeks, months and years after they wreak destruction.”

After collecting 33.6 million U.S. death records from 1988 to 2018, the researchers used a statistical model to calculate how death rates changed following tropical cyclones when compared to equivalent periods in other years.

“Tropical cyclone” is an umbrella term that meteorologists use to include all hurricanes and tropical storms. A hurricane becomes a tropical storm when its sustained wind speed reaches 74 mph. 

Deadly year for weather disasters: 2021 storms cause most deaths in US since Hurricane Maria in 2017

The JAMA study reveals the potential hidden deadly cost of climate-related disasters, scientists say.

“Recent tropical cyclone seasons – which have yielded stronger, more active, and longer-lasting tropical cyclones than previously recorded – indicate that tropical cyclones will remain an important public health concern,” said study lead author Robbie Parks, a postdoctoral research scientist at the Mailman School of Public Health.

With 31 named storms in 2020 and 21 in 2021, the past two Atlantic hurricane seasons were among the three most active on record, according to data from the National Oceanic and Atmospheric Administration. Hurricane records go back to the mid-1800s.

Tropical cyclones were most frequent in eastern and southeastern coastal counties of the U.S., the study said.

Parks added that “our results show that tropical cyclones in the U.S. were associated with increases in deaths for several major causes of death, speaking to the ‘hidden burden’ of climate-related exposures and climate change.”