This pioneering research, published in the open-access journal PLOS Medicine on March 12th, 2026, represents the first comprehensive national-level investigation into how power disruptions affect health outcomes in the aging population. Prior localized studies, such as those centered in New York State, suggested correlations between outages and hospital visits, but lacked the broad scope and data robustness to establish a definitive nationwide impact. McBrien’s team harnessed an extensive dataset encompassing power outage events across 2,161 U.S. counties during the year 2018 combined with detailed hospitalization records of 23 million Medicare beneficiaries.

Employing a sophisticated case-crossover design, the investigators meticulously analyzed daily emergency hospitalizations for cardiovascular and respiratory conditions in relation to county-level power outage durations. Their findings clearly showed that outages exceeding eight hours were associated with immediate and subsequent spikes in hospital admissions among older adults. Notably, respiratory hospitalizations peaked on the very day of the power failure, while cardiovascular cases manifested predominantly the following day. This temporal lag underscores the complex physiological and environmental mechanisms triggered by electrical interruptions.

One plausible explanation for the surge in respiratory emergencies during outages lies in the sudden loss of air quality control measures, such as air purifiers and humidifiers, as well as the inability of ventilators and other respiratory support devices to function properly without power. Additionally, the lack of heating or air conditioning can exacerbate asthma, chronic obstructive pulmonary disease (COPD), and other respiratory ailments, especially in vulnerable elderly individuals. On the cardiovascular front, the delayed increase in hospital admissions may reflect the physiological stress and strain induced by temperature fluctuations, interrupted medication regimens, or the loss of electrically powered medical devices like pacemakers’ monitoring systems.

Quantitatively, the study estimates that in 2018 alone, power outages were responsible for an additional 4,246 hospitalizations among the elderly due to these two primary causes. This figure starkly reveals the public health burden imposed by an increasingly unstable electrical grid. As climate change intensifies, so too does the likelihood of further deteriorations in grid resilience, threatening to exacerbate these health consequences unless urgent actions are taken.

From a policy standpoint, the implications are clear and multifaceted. Strengthening the reliability and robustness of the U.S. electric grid emerges as a critical public health intervention. Upgrades that reduce the frequency and duration of outages could literally save thousands of lives each year. Moreover, targeted support for vulnerable populations is necessary, including widespread access to backup power solutions such as generators and battery storage systems tailored to medical device usage. Equipping older adults with preparedness tools—ranging from power banks for essential communication devices to generators for air conditioners and oxygen concentrators—could mitigate the immediate health crises triggered by outages.

The study further suggests that future research should delve into individual-level data to refine understanding of risk factors and health outcomes tied to power failures. The county-level analysis, while comprehensive, necessarily aggregates data, potentially obscuring more granular personal vulnerabilities and environmental factors. Detailed individual tracking could uncover which subsets of the elderly population—by comorbidities, socioeconomic status, or geographic location—are most at risk, facilitating more targeted interventions.

The research team emphasizes the convergence of climate change and an aging infrastructure as a perfect storm contributing to this emerging health challenge. As harsh weather events grow in intensity—ranging from hurricanes and heatwaves to wildfires—the electrical grid faces unprecedented stress, leading to more frequent and longer-lasting interruptions. This study underscores the urgency of integrating health considerations into climate adaptation planning, particularly with respect to infrastructure modernization.

Heather McBrien and her co-authors convey a cautionary message, pointing out the paradox of escalating health risks due to climate exacerbations occurring alongside the rollback of critical regulatory protections in the United States. They highlight that while the scientific evidence accumulates showing widespread downstream effects of climate change—including increased hospitalizations and mortality—political and regulatory frameworks have sometimes moved in directions that undermine public health safeguards.

Taken together, these findings serve as a clarion call to public health officials, policymakers, and utility providers. Proactive measures to ensure a resilient grid are not merely matters of convenience or economic efficiency but are essential components of safeguarding the health and well-being of millions, especially society’s most vulnerable members. Integrating health risk assessments into energy policy could foster smarter investments in infrastructure that prioritize both environmental sustainability and human health outcomes.

This landmark study lays important groundwork for a deeper understanding of how energy insecurity translates into health emergencies. It also spotlights critical opportunities for innovation in technologies and preparedness strategies aimed at protecting the elderly during power disruptions. As the global community confronts the intertwined challenges of aging populations and climate change, interdisciplinary approaches such as this research exemplify the cutting edge of health adaptation science.

In an era where the electric grid is increasingly fragile, and climate change relentlessly punishing, the health risks posed by power outages to older adults are no longer hypothetical but urgent and quantifiable. The study by McBrien and colleagues advances not only our knowledge but also our imperative to act to protect public health through resilient infrastructure, adaptive healthcare, and informed regulatory frameworks. It is a timely and vital contribution to the nexus of climate, energy, and health scholarship.

Subject of Research: People

Article Title: The association between power outages and cardiovascular and respiratory hospitalizations among US Medicare beneficiaries in 2018: A case-crossover study

News Publication Date: March 12, 2026

Web References: http://dx.doi.org/10.1371/journal.pmed.1004923

References: McBrien H, Mork D, Do V, Kioumourtzoglou M-A, Casey JA (2026) The association between power outages and cardiovascular and respiratory hospitalizations among US Medicare beneficiaries in 2018: A case-crossover study. PLoS Med 23(2): e1004923. https://doi.org/10.1371/journal.pmed.1004923

Image Credits: McBrien H, et al., 2025, PLOS Medicine, CC-BY 4.0

Keywords

Power outages, cardiovascular hospitalizations, respiratory hospitalizations, older adults, Medicare, climate change, electric grid resilience, public health, emergency hospitalizations, aging population, health disparities, infrastructure maintenance.

Conventional assessments of aging have long struggled with a critical limitation: conflating early developmental factors—such as prenatal nutrition and childhood conditions—with actual biological aging processes. The new Pace of Aging method elegantly disentangles these confounding effects, providing a clearer window into the dynamic physiological changes that accumulate throughout adulthood and into later life. This advancement addresses a central dilemma in gerontology, enabling researchers to parse lifelong biological trajectories from the shadows of early environmental imprints.

Dr. Arun Balachandran, the study’s lead author and a postdoctoral researcher at the Columbia Aging Center, explains that the team’s revamped approach not only sharpens scientific insight but also substantially elevates public health utility. Unlike earlier models focused primarily on biomedical interventions, the recalibrated Pace of Aging framework is uniquely designed to evaluate the longitudinal impact of social policies and population-wide public health measures. Dr. Daniel Belsky, associate professor of Epidemiology and a key collaborator on the project, underscores this innovative pivot, emphasizing the method’s capacity to reveal how social determinants, environments, and individual lifestyle choices sculpt aging trajectories at scale.

The research draws on rich, high-fidelity data from two major longitudinal cohorts: the U.S. Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). These datasets encompass tens of thousands of adults aged 50 and above, enabling the researchers to capture comprehensive biological and functional markers collected via in-home assessments over multiple timepoints spanning a decade. By incorporating biomarkers such as C-reactive protein, Cystatin-C, and glycated hemoglobin alongside physiological measures including diastolic blood pressure, waist circumference, lung function, grip strength, gait speed, and balance, the Pace of Aging metric paints a multidimensional portrait of aging dynamics.

The analytical framework leverages data from dried blood spots coupled with physical and performance tests, repeated over an average eight-year follow-up. This longitudinal design permits the calculation of individualized aging velocities, precisely differentiating fast agers from slow agers within populations that are conventionally regarded as homogenous by chronological age. Notably, the study’s 19,045 participants were tracked through 2016 with extended health outcome surveillance through 2022, allowing robust linkage between biological aging pace and eventual incidence of morbidity, disability, and mortality.

Findings demonstrate that the newly calibrated Pace of Aging score exhibits strong predictive validity, consistently forecasting the onset of chronic diseases, cognitive decline, and early death, above and beyond chronological age. This predictive power opens novel avenues for early identification of at-risk subgroups, potentially guiding timely preventive interventions. Intriguingly, the research highlights pronounced disparities in aging rates within demographic strata. For example, individuals with lower educational attainment exhibited accelerated biological aging, illuminating a critical nexus between socioeconomic factors and healthspan trajectories.

Originally formulated using longitudinal data from the Dunedin Study—a birth cohort followed from young adulthood into midlife—the Pace of Aging tool’s newly expanded applicability now transcends individual cohorts to embrace population-based studies. This adaptability extends the framework’s relevance not only to biomedical researchers but also to policymakers charged with crafting social programs that influence aging outcomes at the population level. The capacity to monitor aging pace in real-world contexts marks a crucial leap toward evidence-based healthspan extension strategies.

Beyond the biomedical domain, this research intersects meaningfully with sociology and economics by elucidating how major life events and transitions—including retirement, caregiving responsibilities, and bereavement—interface with biological aging processes. This cross-disciplinary insight equips policymakers with metrics attuned to the social complexity underpinning aging, enhancing the precision of interventions aimed at improving quality of life and reducing health disparities among older adults.

Dr. Belsky emphasizes that the differences uncovered by this approach are not mere statistical artifacts but meaningful divergences with tangible health consequences. People identified as aging faster biologically were substantially more prone to developing disease and disability, and experienced earlier mortality despite sharing the same chronological age as their slower-aging peers. This distinction underscores the profound limitations of chronological age as a proxy and the necessity of incorporating biological aging metrics in health assessments.

The collaborative nature of this study—encompassing experts across institutions including Columbia University, University of London, Stanford University, the National Institute on Aging, and the Norwegian Institute for Public Health—reflects the complexity and breadth of expertise required to pioneer such an encompassing approach. These partnerships highlight a global commitment to advancing aging research that translates seamlessly from theoretical biology to practical public health solutions.

Financial backing from prestigious funders like the National Institutes of Health, the Russell Sage Foundation, and the Robert N. Butler Columbia Aging Center underscores the significance of this work within the scientific and health policy communities. With strong institutional support, the Pace of Aging method is positioned to become a core tool in aging research and an essential basis for guiding future health interventions that foster longer, healthier lives.

The Columbia University Mailman School of Public Health, the home institution behind this breakthrough, boasts nearly a century of leadership in population health research and education. Their multidisciplinary faculty’s commitment to addressing complex health challenges around the globe infuses this work with robust scientific rigor and a vision for impactful public health reform. By harnessing their expertise and global reach, the Pace of Aging method is primed to influence how societies worldwide understand and manage the aging process.

In sum, the development of this refined Pace of Aging measure represents a landmark achievement in aging science. By separating the influences of early life from ongoing biological change and validating a predictive link to critical health outcomes, this research equips scientists, clinicians, and policymakers with a powerful new lens. This methodological innovation has the potential not only to transform population health surveillance but also to drive the development of pioneering interventions that can slow aging, reduce health inequities, and ultimately extend the healthy years of life for millions across the globe.

Subject of Research: Biological and population-level measurement of aging processes; development and validation of a novel Pace of Aging metric.

Article Title: Pace of Aging analysis of healthspan and lifespan in older adults in the US and UK

News Publication Date: May 27, 2025

Web References:
https://www.nature.com/articles/s43587-025-00866-6

References:
Belsky, D. W., Balachandran, A., Pei, H., Shi, Y., Beard, J., Cohen, A., Eckstein Indik, C., Ryan, C., Furuya, A., Kothari, M., Zhang, Y., Caspi, A., Moffitt, T., Domingue, B., Ferrucci, L., Skirbekk, V. (2025). Pace of Aging analysis of healthspan and lifespan in older adults in the US and UK. Nature Aging. DOI:10.1038/s43587-025-00866-6

Keywords: Health and medicine, aging, biological aging, public health, longitudinal studies, biomarkers, population health, healthspan, lifespan, social determinants of health