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

Typhoon exposure increases prevalence, incidence, and disability-adjusted life years (DALYs) related to mental disorders.

• Both main effect and year-on-year difference models were used to quantify these relationships.
• Multinational panel data were analyzed using structural equation modelling (SEM).
• The study integrated the Cumulative Disadvantage Model with Structural Causal Influence analysis.
• The findings were based on the Social Determinants of Health theoretical framework.

The strongest impact of typhoon exposure on mental health burden was found in the 25-34 age group.

• The study examined heterogeneity by age across multiple subgroups.
• Pronounced heterogeneity by age and socioeconomic status was observed across countries.
• Multidimensional subgroup heterogeneity models were used to identify age-specific effects.

High income, education, Human Development Index (HDI), and public health investment were associated with greater resilience to typhoon-related mental health impacts.

• Macro-level social structural variables examined included gross national income, HDI, Gini coefficient, government health expenditure, out-of-pocket health spending, educational attainment, and life expectancy.
• These variables were assessed as moderators in the typhoon–mental health relationship.
• High income, education, HDI, and public health investment were linked to greater resilience.

Low income, high out-of-pocket (OOP) health spending, and high inequality were associated with vulnerability to typhoon-related mental health burdens.

• The Gini coefficient was used as a measure of inequality in the analysis.
• Out-of-pocket health spending was identified as a key vulnerability indicator.
• These factors were quantified as moderators using structural equation modelling with multinational panel data.

Secondary disaster frequency and the number of people affected acted as mediators in the pathway from typhoon exposure to mental disorders.

• The mediation pathway was characterized as running from 'typhoon' to 'social stress' to 'mental disorders.'
• Structural equation modelling (SEM) was used to quantify these mediating roles.
• This represents the first integration of multinational panel data with SEM to quantify mediating roles of social determinants in the typhoon–mental health relationship.

Improving socioeconomic conditions, lowering OOP costs, reducing inequality, and increasing public health investment can strengthen psychological resilience and disaster response capacity.

• The findings provide empirical evidence for global disaster response policy.
• The study underscores the importance of advancing universal health coverage and optimizing resource allocation.
• Targeted mental health interventions for vulnerable populations are recommended in the context of climate change.