Access to hardened infrastructure and hurricane mortality

I just happen to be working on a review of hurricane's socio-economic impacts right now, and since there seems to be widespread interest in these things at the moment, I'm just going to post some of the more interesting/important papers as I go. The figure from this 1993 paper is compelling (although I think a brace would be clearer than the arrow).

Risk factors for mortality in the Bangladesh cyclone of 1991
C. Bern, J.Sniezek, G.M. Mathbor, M.S. Sidiqi, C. Ronsmans, A.M.R. Chowdhury, A.E. Choudhury, K. Islam, M. Bennish, E. Noji, & R.l.Glass

Abstract: Cyclones continue to pose a dangerous threat to the coastal populations of Bangladesh, despite improvements in disaster control procedures. After 138 000 persons died in the April 1991 cyclone, we carried out a rapid epidemiological assessment to determine factors associated with cyclone-related mortality and to identify prevention strategies. A nonrandom survey of 45 housing clusters comprising 1123 persons showed that mortality was greatest among under-10-year-olds (26%) and women older than 40 years (31%). Nearly 22% of persons who did not reach a concrete or brick structure died, whereas alpersons who sought refuge in such structures survived. Future cyclone-associated mortality in Bangladesh could be prevented by more effective warnings leading to an earlier response, better access to designated cyclone shelters, and improved preparedness in high-risk communities. In particu- lar, deaths among women and under-10-year-olds could be reduced by ensuring that they are given special attention by families, neighbours, local authorities, and especially those in charge of early warnings and emergency evacuation.

From the results:

Type of housing and shelter-seeking activity were directly related to the risk of dying in the cyclone (Fig. 2). No deaths occurred among the 27 individuals (2%) who lived in pukka houses or remained in pukka public buildings for the duration of the cyclone. However, 1094 individuals (98%) were not in a safe shelter prior to the cyclone warning. In response to the warning, which most respondents reported hearing 3-6 hours prior to the storm surge, only 40 individuals (4%) sought and reached safe shelter.When the flood waters first reached the area 10-60 minutes before the storm surge, 151 persons (13%) were insafeshelter.In all, 385 persons (33%) had reached safe shelter by the moment of impact of the storm surge; none of these persons died In con- trast, of 736 persons at risk, 162 (22%; P < 0.0001) drowned in the flood waters.

Of 736 persons at risk at the time of the cyclone impact, 285 were swept away in the storm surge; of these, 112 (39%) died. Another 179 per- sons were able to float on some object, generally the thatch roof of their house; of these, 27 (15%) died. Mortality was 22% among those who sought high ground to escape the storm surge, and 11% among those who took refuge in trees.