Infrastructure failures and aging populations: Quantifying the spatial overlap of power outages and older adult vulnerability

Climate change is intensifying extreme weather events and power outages, posing life-threatening risks to older adults who depend on electricity for medical devices, temperature regulation, and daily care. No nationwide study has systematically examined where power-outage risks overlap with the vulnerabilities of older adults. This study quantifies spatial patterns of power outage exposure among older adults across the United States (U.S.) from 2014 to 2021. We analyzed county-level power outage data covering 3108 counties, integrated with demographic data on older adults living alone and nursing home resident characteristics. We measured three outage dimensions: duration, frequency, and intensity. Using spatial clustering methods, we identified geographic hotspots where high outage exposure coincides with vulnerable populations, including those requiring intensive care and minority nursing home residents. The southeastern U.S., particularly Texas, Louisiana, and Florida, experiences high-frequency outages alongside large concentrations of older adults and minority populations. During the study period, Texas generated 386 county-year observations showing clustering in which Hispanic nursing home residents faced frequent outage interruptions. In Florida, 155 county-year observations were characterized by high-intensity outages affecting disproportionately large numbers of customers coinciding with high proportions of older adults requiring intensive care. Counties with higher proportions of minority nursing home residents were consistently associated with greater outage intensity compared with predominantly White counties. Tropical cyclones and extreme heat amplified these disparities. These findings reveal systematic inequities in power-outage exposure that threaten vulnerable older adults. The spatial clusters represent priority areas for infrastructure investment, emergency preparedness, and backup power resources. As climate change intensifies extreme weather and strains electrical grids, targeted interventions in high-risk regions are urgently needed to protect aging populations from compounding health risks.