Hurricane Evacuations Are Becoming More Challenging—Physically and Psychologically

As Hurricane Milton approaches Florida, people in recently storm-stricken areas grapple with the physical and mental health tolls of evacuating and seeking shelter

Street view of debris from Hurricane Helene

Debris from Hurricane Helene lines a street in the Redington Beach section of St. Petersburg, Fla., on October 8, 2024, ahead of Hurricane Milton’s expected landfall. Milton regained power on October 8 to become a Category 5 storm with maximum sustained winds of 165 mph (270 kph) as it barreled towards west-central coast of Florida and is forecast to make landfall late October 9, according to the National Hurricane Center.

Bryan R. Smith/AFP via Getty Images

Editor’s Note (10/9/24): Hurricane Milton made landfall on October 9 around 8:30 P.M. EDT near Siesta Key, Fla. At the time, Milton was a Category 3 storm, with sustained winds of about 120 mph.

Hurricane Milton is hurtling toward the western coast of Florida, and thousands of people are fleeing their homes for inland counties—or even other states. Fifteen counties, which include the populous Tampa Bay area, have issued mandatory evacuation orders for those living in high-risk storm surge and flood zones. Traffic has been massively congested, and some gas stations report running out of fuel.

“When I looked at [Hurricane Milton] on Saturday, I thought, ‘Oh my gosh, this has got to be a joke.’ We just don’t see it that often in the Tampa area, where you’ve got something that is obviously going to be very strong,” says Lindsay Peterson, a research assistant professor at the University of South Florida, who studies disaster planning for older adults and long-term care facilities. Peterson evacuated her own home in South Tampa earlier this week. “I know a lot of people now are frightened. They didn’t leave, and now they feel like they can’t get out because the roads are crowded and people are fighting at the gas station over gas.”


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The Category 4 storm is approaching on the heels of Hurricane Helene, which struck Florida and ripped through five more states two weeks ago, killing more than 200 people. Many people, still trying to recover their lives amid the aftermath, are now bracing for this new system—which may bring storm surges twice as high to the Tampa Bay area.

“Our ground is completely saturated,” says Claire Knox, a professor and director of the Master of Emergency and Crisis Management program at the University of Central Florida, “and now you’re having this massive system that’s going to bring anywhere from eight to 12 feet of storm surge on the west coast [of Florida], probably about five to seven on the [state’s] east coast.”

Scientific American spoke with Knox and Peterson about what the challenges and considerations of climate-related evacuations are—and how the agonizing decisions and risks often involved can affect people’s physical and mental health.

[An edited transcript of the interview follows.]

What factors are considered for hurricane evacuation orders?

KNOX: There are a lot of things in play. FEMA [the Federal Emergency Management Agency], in partnership with two other agencies, has a tool called HURREVAC in which emergency responders can look at nearby hazards, potential evacuation zones, different scenarios, different categories of the hurricane, anticipated time of landfall. All those go into play, and the tool will help make assessments: What's your clearance time? How many hours is it going to take to evacuate different [storm surge and flood] zones, different populations? You want to get your more socially vulnerable, your coastal areas, individuals in mobile homes and camp sites out first.

That plan is then communicated to the elected officials. The mayor of that jurisdiction has the final word. The emergency manager is just an adviser—they are just providing the information and the details to those elected officials, and it’s up to them to heed that information or wait. There are a lot of legal challenges. There are a lot of political pressures.

PETERSON: It’s a huge area along the west Florida coast that has been issued evacuation orders—that’s millions of people. The possible problem is that most of us in this area may not be terribly affected. So when this is all over, people will ask whether it was necessary. What’s happening now is: they’re evacuating a lot of people, and many of those people need to be evacuated; some of them don’t. But we just don’t know that right now—it’s better to be prepared than act too late.

Why might some people be unable to evacuate—or choose not to?

KNOX: What we find in our research is that individuals are more likely to evacuate if [a disaster was] in their recent history. When we saw record evacuations during Hurricane Irma in 2017, that was on the back end of Hurricane Harvey, which had just hit Texas. The massive flooding was on national news. It was on people’s mind, and that was one of the reasons why we saw record evacuation for Hurricane Irma—6.5 million evacuees. Helene was recent and is on people’s mind, seeing the devastation in North Carolina and throughout the Big Bend of Florida. Based on research, there’s a better chance those individuals will take these evacuation orders more seriously.

People’s perception of risk is really interesting. Someone may say, ‘Oh, we weren’t impacted by a storm two years ago, four years ago, 10 years ago.’ Well, we’ve had a lot of development and land use changes in Florida. That will change the way the water flows and interacts with the land. That was something we saw, unfortunately, with new developments in the west coast of Florida during Hurricane Ian [in 2022]; the water had no place to go, so it went into homes. Also, that person is a lot older than they were 10 years ago, and so they have different needs. A lot of times, people don’t place those components into their decision-making process.

In our research, we’ve found one of the best determinants of whether a person will decide to heed any type of mandatory evacuation is if their neighbor or their friends are leaving. That social network is still really important in that decision-making process. So with social media, we’ve gotten so disconnected from each other, and so a lot of times we don’t think about checking on our neighbor. I’ve seen resiliency efforts to build social capital back into our society, and I think that’s really important, especially during a crisis.

How are these climate emergencies affecting people’s health—physically and psychologically? How might this influence people’s decisions to evacuate?

PETERSON: There’s a mental component to evacuating. As the time gets closer, if you haven’t evacuated and need to, I think there’s a bit of panic that sets in. That interferes with thinking clearly. And there’s also a lot of denial. There’s this odd feeling that if you stay, somehow your home is protected, and we see this in many older adults. It’s not rational, but I think people feel they want to be able to possibly do something, if necessary, at the last minute. But there’s really very little anybody can do. There’s just a lot of unrealistic thinking that enters in, especially because this is something people don’t do a lot. You also think about the meaning of a home for people, and it’s huge for everybody—but it’s really huge as you get older. A house may be some people’s last home ever. Everything they ever will own in their life is in that house. It’s very hard to leave it behind.

You’ve also just got the practical problems of some people not having anywhere else to go, not knowing where to go, being afraid of going to a shelter or not having figured out beforehand where the shelters are. Especially if someone’s taking care of somebody who’s vulnerable, it’s hard to make that move to leave because you’re afraid of whether that person would be okay in a shelter. People might be afraid to go because they’re caring for someone with dementia or autism; maybe someone is just very anxious or sensitive. For someone with cognitive or mental issues, shelters are very difficult places. They’re noisy, chaotic. If you’re taking care of someone who has a medical condition where they need electricity or some kind of specific medical care, there are special needs shelters for those people. Some will pick you up and bring you there, but you may need to prearrange and let them know. All of that takes a lot of preplanning—mentally and physically.

What should people know as they evacuate?

KNOX: We tell people go tens of miles, not hundreds of miles. That relieves the congested roads, that allows resources to stay in place. Ideally, you shouldn’t have to leave your county. You should go to a shelter. We see that more than 50 percent of people would rather shelter with friends and family in a home versus going into a shelter, versus going to a hotel. What we found during Hurricane Irma is that people were driving past empty shelters. You had individuals going from Miami three or four counties up, and those shelters there were then overwhelmed. In a recent survey of hurricane Irma, more than 50 percent of people went to a different state. Now, there are different reasons for that—it could be family. But ideally, you want to just get out of the immediate flood zones and storm surge areas; you want to go more inland.

FloridaDisaster.org, run by the Division of Emergency Management, has a list of special needs shelters. It will let you know where in your county those shelters are available. Per Florida state statute, the vast majority of our schools are designated shelters. The office of emergency management for every county in Florida have websites that have all the listings. You’re also seeing that information communicated via multiple social media platforms. We’ve seen use of Nextdoor, Facebook, Instagram, Twitter, in addition to traditional media.

What are ways evacuation procedures can be more accessible to people who may not have the means to go to a hotel or relatives they can stay with?

KNOX: There are new partnerships with the private sector. There’s a list of major hotel chains that the governor released that are doing very discounted rates. They’re also allowing pets into their hotels, or they’re waiving the pet fee to get people to go. If you use a certain code, Uber has free rides to the shelters. We see partnerships also with Airbnbs that are doing discounted rates.

How can emergency responses improve?

PETERSON: I think for everybody, wherever you are across the country, it’s a matter of paying more attention to the risks. We have more and more people moving into new areas. In California, areas that are subject to wildfires that maybe weren’t populated in the past are populated now. You’ve got people moving into areas that could be subject to a flash flood. The climate dangers are increasing. Our populations are growing—and the population of vulnerable people is growing. Everybody’s got a part in it. People, scientists and public safety officials, all the way up to the top, need to be thinking about what’s happening, looking at the frequencies and projecting out where the dangers are going to be in the future—and making plans for that.

Lauren J. Young is an associate editor for health and medicine at Scientific American. She has edited and written stories that tackle a wide range of subjects, including the COVID pandemic, emerging diseases, evolutionary biology and health inequities. Young has nearly a decade of newsroom and science journalism experience. Before joining Scientific American in 2023, she was an associate editor at Popular Science and a digital producer at public radio’s Science Friday. She has appeared as a guest on radio shows, podcasts and stage events. Young has also spoken on panels for the Asian American Journalists Association, American Library Association, NOVA Science Studio and the New York Botanical Garden. Her work has appeared in Scholastic MATH, School Library Journal, IEEE Spectrum, Atlas Obscura and Smithsonian Magazine. Young studied biology at California Polytechnic State University, San Luis Obispo, before pursuing a master’s at New York University’s Science, Health & Environmental Reporting Program.

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