INTRODUCTION:Hurricane Mitch was an event described as one of the most damaging recent natural disasters in our hemisphere. This study examined its effects on a community of 5,000 residents in northern Honduras. METHODS:Survey responses of 110 attendants at an ambulatory clinic 4 months after the event were analyzed. Correlates were established between demographic and housing characteristics and morbidity and mortality. RESULTS:The availability of food, water, and medical care decreased significantly immediately after the hurricane, but by four months afterward returned to baseline values. Residents reported emotional distress correlated with the loss of a house or intrafamilial illness or mortality. Diarrheal illnesses more commonly were found in households with poor chronic access to medical care. The use of cement block housing correlated with availability of food or running water, with access to medical care and vaccinations, and with a reduced frequency of diarrhea or headaches in the immediate post-hurricane phase. CONCLUSIONS:Improvements in housing construction appear to be the most effective preventive measure for withstanding the effects of future hurricanes in tropical regions similar to northern Honduras.