RATIONALE: In the weeks and months following a disaster, acute illness and injuries requiring hospital admission increase. It is not known whether disaster exposure is associated with increased risk for hospitalization in the years after a disaster. OBJECTIVE: We examined the extent to which disaster exposure is associated with hospitalization two years after Hurricane Sandy. The analyses fill a clinical gap in our understanding of long-term physical health consequences of disaster exposure by identifying older adults at greatest risk for hospitalization two years after disaster exposure. METHOD: Survey data from a longitudinal panel study collectedbefore and after Hurricane Sandy were linked with Medicare inpatient files in order to assess the impact of Hurricane Sandy on hospital admissions two years following the hurricane. RESULTS: We found that people who reported experiencing a lot of fear and distress in the midst of Hurricane Sandy were at an increased risk of being hospitalized two years after the hurricane [Hazard Ratio = 1.75; 95% CI (1.12-2.73)]. Findings held after controlling for pre-disaster demographics, social risks, chronic conditions, hospitalizations during the year before the hurricane, and decline in physical functioning. CONCLUSIONS: These findings are the first to show that disaster exposure increases the risk for hospital admissions two years after a disaster. Controlling for known risk factors for hospitalization, older adults who experience high levels of fear and distress during a disaster are more likely to be hospitalized two years following the disaster than older adults who do not have this experience.