Hurricane Harvey “Lonely Deaths”

Hurricane Harvey is responsible for killing at least 47 people in Texas. According to a story last week in the New York Times, at least several of these people died alone.

“Some victims lived alone and died solitary deaths,” read the article. “They called and texted loved ones with reassuring messages as the storm took hold, only to be found lifeless the next day.”

In the United States, there is not a formal medical phrase to describe the situation of dying alone, though it has often been referred to as “lonely death.” A few years back a popular newspaper article appeared about a 72-year-old New York City man named George Bell, who died alone in a Jackson Heights apartment, “splashed with trash and balled-up, decades-old lottery tickets that had failed to deliver.”

The proportion of Americans living alone has increased steadily since the 1920s, from about 5 percent at that time, to 27 percent in 2013. And the number of elderly living alone has increased too. A 2014 Washington Post article reported that studies have repeatedly found that “Americans prefer privacy in living arrangements, and that increasing economic resources are often used to purchase this privacy in the form of living alone.”

The same article described the case of 81-year-old Stan Piotrowski, who lives alone in Tudor City, an enclave with a very high proportion of single dwellers. “At this point in my life, I wouldn’t want to live with anybody,” he told the Washington Post. “I want to do what I want to do. If I want to sleep late, I can sleep late.”

This proud, go-it-alone attitude can help to ensure a lonely death, a situation that was observed first-hand in Hurricane Harvey. At least several of those who died alone in the storm were men in Galveston County, on the coast of Texas. A 54-year-old man, a 59-year-old man and an 83-year-old man were each found alone in their houses after the storm, drowned.

Galveston attracts outdoorsy, headstrong, “loner-type folks,” Erin Barnhart, the county medical examiner, explained to the New York Times. “Presumably they were attempting to ride out the storm,” said Barnhart. She said that in previous hurricanes in Galveston people didn’t leave and they survived, which may have left some residents feeling invincible. “They think they can handle it,” she said.

Barnhart explained just how a lonely death situation could have developed with Harvey: “There may have been a stubborn old man who said, ‘I’ve lived my life and if this is it, this is it.’”

Lonely deaths in large natural disasters appear to be common enough and are often when the phenomenon comes to light. In the 1995 Chicago heat wave, “the dangerous side of elderly people living alone was illustrated,” reported the Washington Post. About 750 people died during the heat wave. Many of them were poor elderly residents who could not afford air conditioning and did not open their windows or sleep outside for fear of crime. The good news: the deaths prompted local officials to work to try and battle the problem of senior isolation and lonely death with age-friendly programs and networks.

“When another heat wave struck Chicago in 1999,” the Washington Post reported, “the city reduced deaths by offering free transportation to cooling centers, making phone calls to check on elderly residents and sending city workers on door-to-door patrols to check on single people.”

The first appearance of the term lonely death actually occurred in 1995, the same year as the Chicago heat wave. The event happened not in the United States, but in Japan. The Great Hanshin earthquake of 1995 killed 6,433 people, many of them in the coastal city of Kobe. Roughly a quarter of a million homes were either completely or partially destroyed in the earthquake. Municipalities provided temporary homes for people, but the housing was allotted on an individual basis, not at the community level. This created problems.

“Many people found they were no longer with their familiar neighbors after moving,” explains a Wikinews post on the topic. “This caused serious problems among people, especially the elderly.” Since 2000, about 200 of these displaced peoples have been found dead—and alone—in their temporary homes. A Japanese word was coined for the situation: kodokushi. The literal translation in Japanese is “death in solitude.”

In 2008 in Tokyo, more than 2,200 people over 65 died lonely deaths, according to statistics from the city’s Bureau of Social Welfare and Public Health. The deaths most often involve men in their 50s and the nation’s rapidly increasing elderly population. Today, roughly 1 in 5 Japanese is over 65; by 2030 it will be 1 in 3. With senior citizens increasingly living away from family and a nationwide shortage of nursing homes, many elderly are now living alone. “There is a kind of myth that older people in Japan are living in three-generational families, but that’s not so anymore,” Takako Sodei, a gerontologist with Ochanomizu University in Tokyo, told me in 2010 when I reported on the topic for TIME.

In America, the phrase most often used to describe the Japanese phenomenon of kodokushi is lonely death. And as more and more Americans choose to live alone, and also live in areas that are prone to natural disasters, such as along the coast, which are increasingly vulnerable to large devastating storms and floods thanks to sea level rise and climate change, the phenomenon of lonely death is likely to increase.

One of the people who died alone in Hurricane Harvey was 89 year old Agnes Stanley, a longtime volunteer for a conservation group in Houston. She died in her one-story brick home, the New York Times reported, and was found floating in four feet of floodwater. “We don’t know what happened,” her son told reporters.

And there still may be other Hurricane Harvey lonely deaths out there, waiting to be discovered.

“The search for the dead is far from complete,” reported the New York Times article, “as volunteers and relief workers move door to door and sift through the wreckage.”