Deaths in Puerto Rico after Hurricane Maria Far Higher than Official Count

An article published in The New England Journal of Medicine sheds light on the displacement, disruption of services, and fatalities that occurred in the aftermath of Hurricane Maria in Puerto Rico. The article, “Mortality in Puerto Rico after Hurricane Maria, estimates there were more than 4,600 fatalities from the storm, approximately 70 times greater than the official death count of 64.

A randomized survey of 3,299 Puerto Rican households taken in early 2018 collected information about each household member, including those who had moved in or out, died, or were born in 2017. Households were asked questions about members’ age, sex, migration due to the hurricane, deaths after the hurricane, neighborhood deaths, and access to services and utilities.

The survey found significant levels of displacement and disruption in services. More than 8% of people in surveyed households were displaced due to the hurricane; either leaving their household (2.8%) or moving in with another household (5.5%) after the hurricane. Fifty-two percent of those who left their households moved elsewhere in Puerto Rico, while 41% left for the U.S. mainland.

On average, households reported 84 days without electricity, 68 days without water, and 41 days without cellular phone coverage between the hurricane’s landfall in September, 2017 and the end of December, 2017. Households in remote regions tended to be without electricity and water for a much longer period, indicating that “households either recovered services relatively quickly or not for several months.” The report notes that many households were still without water and electricity at the time the survey was conducted in January and February of 2018.

The survey also found 31% of households reported disruptions in medical services: 14.4% of households were unable to access medications, 9.5% were unable to access respiratory equipment requiring electricity, 8.6% faced closed medical facilities, and 6.1% reported an absent doctor. 

The researchers weighted their survey results based on the total population of Puerto Rico to derive an estimate of total deaths following the hurricane between September 20 and December 31,2017. This estimate was then compared to the total deaths recorded in Puerto Rico for the same period in 2016. The authors found a 62% increase in the mortality rate, or an excess of 4,645 deaths attributable to the storm and its after-effects. This estimate is more than 70 times greater than the official Hurricane Maria death count of 64 people in Puerto Rico.   

“Mortality in Puerto Rico after Hurricane Maria” is available at: