# Mental health burdens, typhoon and structural health inequities: evidence from a global perspective

## TL;DR

Typhoon disasters worsen mental health outcomes, especially for younger and less privileged groups, with social and economic factors playing a key role in resilience.

## Contribution

This study quantifies how social and economic structures moderate typhoon impacts on mental health using multinational panel data and structural equation modeling.

## Key findings

- Typhoons increase mental disorder prevalence, incidence, and DALYs, most strongly in the 25–34 age group.
- High income, education, and public health investment correlate with greater mental health resilience to typhoons.
- Low income, high out-of-pocket costs, and inequality increase vulnerability to typhoon-related mental health burdens.

## Abstract

Against the backdrop of accelerating climate change and more frequent extreme weather events, typhoon disasters have become a major challenge to mental health. Based on the Social Determinants of Health theory and integrating the Cumulative Disadvantage Model with Structural Causal Influence analysis, this study evaluates how typhoon exposure affects the burden of mental health disorders and how these effects vary with social structural differences.

To investigate the mechanisms linking typhoon exposure to the burden of mental health disorders, and to quantify the moderating roles of macro-level social structural variables.

By constructing both main effect and year-on-year difference models, combined with structural equation modelling and multinational panel data, this research quantifies the moderating roles of macro-level social variables, including gross national income, Human Development Index, Gini coefficient, government health expenditure, out-of-pocket health spending, educational attainment, and life expectancy.

Typhoons were found to increase prevalence, incidence, and disability-adjusted life years (DALYs) related to mental disorders, with the strongest impact in the 25–34 age group. High income, education, HDI, and public health investment were linked to greater resilience, while low income, high OOP, and high inequality indicated vulnerability. Secondary disaster frequency and the number of people affected acted as mediators, forming a pathway from ‘typhoon’ to ‘social stress’ to ‘mental disorders.’

Typhoon impacts on mental health are shaped by both direct exposure and structural inequalities. Improving socioeconomic conditions, lowering OOP costs, reducing inequality, and increasing public health investment can strengthen psychological resilience and disaster response capacity.

Main findings: This study reveals that typhoon disasters significantly exacerbate the mental health burden across multiple countries, with pronounced heterogeneity by age and socioeconomic status, and that their impacts are strongly moderated by social structure and institutional resources – addressing a key gap in quantifying structural inequality mechanisms in disaster mental epidemiology.Added knowledge: For the first time, this research integrates multinational panel data with multidimensional subgroup heterogeneity models and structural equation modelling (SEM) to quantify the moderating and mediating roles of social determinants of health in the typhoon – mental health relationship.Global health impact for policy and action: The findings provide empirical evidence for global disaster response policy, underscoring the importance of advancing universal health coverage, optimizing resource allocation, and delivering targeted mental health interventions for vulnerable populations in the context of climate change.