Natural disasters trigger complex chains of events within human societies¹. Immediate deaths and damage are directly observed after a disaster and are widely studied, but delayed downstream outcomes, indirectly caused by the disaster, are difficult to trace back to the initial event^1,2. Tropical cyclones (TCs)—that is, hurricanes and tropical storms—are widespread globally and have lasting economic impacts^3,4,5, but their full health impact remains unknown. Here we conduct a large-scale evaluation of long-term effects of TCs on human mortality in the contiguous United States (CONUS) for all TCs between 1930 and 2015. We observe a robust increase in excess mortality that persists for 15 years after each geophysical event. We estimate that the average TC generates 7,000–11,000 excess deaths, exceeding the average of 24 immediate deaths reported in government statistics^6,7. Tracking the effects of 501 historical storms, we compute that the TC climate of CONUS imposes an undocumented mortality burden that explains a substantial fraction of the higher mortality rates along the Atlantic coast and is equal to roughly 3.2–5.1% of all deaths. These findings suggest that the TC climate, previously thought to be unimportant for broader public health outcomes, is a meaningful underlying driver for the distribution of mortality risk in CONUS, especially among infants (less than 1 year of age), people 1–44 years of age, and the Black population. Understanding why TCs induce this excess mortality is likely to yield substantial health benefits.

自然灾害会引发人类社会内部复杂的事件链¹.灾难发生后直接观察到的直接死亡和损害并被广泛研究，但由灾难间接引起的延迟下游结果很难追溯到初始事件^1,2。热带气旋 （TC），即飓风和热带风暴，在全球范围内广泛分布，并产生持久的经济影响^3,4,5，但其对健康的全面影响仍然未知。在这里，我们对 1930 年至 2015 年间所有 TC 的 TC 对美国本土 （CONUS） 人类死亡率的长期影响进行了大规模评估。我们观察到超额死亡率的强劲增加，每次地球物理事件后持续 15 年。我们估计，平均 TC 产生 7,000-11,000 例超额死亡，超过了政府统计数据中报告的 24 例直接死亡的平均数^6,7。跟踪 501 次历史风暴的影响，我们计算出 CONUS 的 TC 气候带来了未记录的死亡负担，这解释了大西洋沿岸较高死亡率的很大一部分，大约相当于所有死亡人数的 3.2-5.1%。这些发现表明，以前被认为对更广泛的公共卫生结果不重要的 TC 气候是 CONUS 死亡风险分布的有意义的潜在驱动因素，尤其是在婴儿（小于 1 岁）、1-44 岁人群和黑人人群中。了解 TC 为何会导致这种超额死亡率可能会产生巨大的健康益处。