Impact of Tropical Cyclones on Violent Injury Emergency Department Visits by Women in North Carolina

Violence against women and girls represents a major public health problem with persistent social and health consequences. Elevated risk of violence is present during periods of social, economic, and environmental stress, all of which are increased during hurricane events. Qualitative studies document increases in violence against women following extreme weather, but validated, methodologically consistent quantitative evidence remains limited. This study examines the relationship between hurricane exposure and violence against women and girls in North Carolina. Using multiple definitions of binary exposure classifications from precipitation exceedance and wind gust data from Hurricanes Florence (2018) and Helene (2024) highlights multiple spatial definitions of storm exposure. Violence-coded emergency department visits among women serve as outcome measures in exposed zones. This study finds that hurricane exposure is associated with delayed excess visits at 12 weeks in most definitions of violence-related emergency department presentations among women and girls in North Carolina, an effect that is significant under conditions of extreme precipitation exposure.