Objectives. To quantify temporal changes in mental health and substance use emergency department utilization following Hurricane Helene (September 2024) in Western North Carolina and identify disparities across vulnerable populations. Methods. We conducted a cross-sectional analysis using emergency department surveillance data from Western North Carolina counties. We calculated incidence rate ratios (IRRs) with 95% confidence intervals (CIs) by comparing 3 recovery periods (immediate, early, short-term) with their corresponding calendar dates in 2023. Results. Alcohol-related visits increased across all periods (immediate: IRR = 1.35; 95% CI = 1.14, 1.60; early: IRR = 1.47; 95% CI = 1.31, 1.65; short-term: IRR = 1.36; 95% CI = 1.21, 1.52). Anxiety disorders increased across all periods, mood disorders increased during early recovery, schizophrenia visits increased during short-term recovery (IRR = 1.19; 95% CI = 1.02, 1.40), and opioid-related visits showed marginally significant increases during short-term recovery (IRR = 1.21; 95% CI = 1.00, 1.45). Counties with higher elderly populations showed amplified alcohol and anxiety effects; counties with higher uninsured or covered by Medicaid rates showed lower utilization. Conclusions. Hurricane Helene was associated with sustained increases in alcohol- and anxiety-related emergency department visits. Disparities across age and insurance status highlight differential vulnerability and access patterns requiring targeted interventions. (Am J Public Health. Published online ahead of print April 16, 2026:e1-e4. https://doi.org/10.2105/AJPH.2026.308456).
Sugg et al. (Thu,) studied this question.