Linking precipitation-driven flooding events to acute respiratory illness in New York city

Authors

• Laura T. Cabrera-Rivera, University of Puerto Rico, Medical Sciences Campus
• Andrew Delgado, Icahn School of Medicine at Mount Sinai
• Andrew Maroko, Icahn School of Medicine at Mount Sinai
• Suresh A. Sethi, Brooklyn College
• Vishal Midya, Icahn School of Medicine at Mount Sinai
• Maanal Chowdhury, The City University of New York
• Brett F. Branco, Brooklyn College
• Ilias Kavouras, The City University of New York
• Ismail Nabeel, Icahn School of Medicine at Mount Sinai

Abstract

Background: Human-induced climate change is increasing extreme precipitation events, potentially affecting respiratory health and healthcare access in urban areas. This study examined the relationship between precipitation-driven flooding events and emergency department (ED) visits for acute respiratory illnesses in New York City (NYC) communities. Methods: We conducted a retrospective ecological study across 14 postal ZIP codes in New York City's five boroughs from October 2020 to November 2022. Using NYC Micronet sensor network data, we analyzed ED visits for influenza-like illness and pneumonia (n=53,534), categorizing flooding events as minor (<1.5 inches), moderate (1.5-2.5 inches), or major (>2.5 inches). Associations between flooding exposure and ED visits were analyzed using Poisson mixed effects models with a 6-day lag, controlling for socioeconomic status and COVID-19 rates. Results: Precipitation-driven flooding was associated with an average 2.8% decrease in respiratory ED visits after 6 days (IRR 0.972, 95% CI 0.955-0.989). Minor flooding showed a 2.4% reduction in visits, while moderate and major flooding were associated with 17.9% and 12.9% reductions, respectively. These associations remained significant after controlling for confounders. Conclusions: Acute urban flooding events were associated with decreased respiratory ED visits, suggesting possible disruptions to healthcare access or deferred care. These findings affect climate change adaptation and infrastructure planning to ensure continued healthcare accessibility during extreme weather events.

Publication Title

Journal of Climate Change and Health

Recommended Citation

Cabrera-Rivera, L., Delgado, A., Maroko, A., Sethi, S., Midya, V., Chowdhury, M., Branco, B., Kavouras, I., & Nabeel, I. (2026). Linking precipitation-driven flooding events to acute respiratory illness in New York city. Journal of Climate Change and Health, 29 https://doi.org/10.1016/j.joclim.2026.100697