A new study commissioned by the Puerto Rican government estimates Hurricane Maria killed 2,975 people on the island, far more people than the 64 originally counted.
The report, conducted by researchers at George Washington University's Milken Institute School of Public Health, found the risk of death was 45 percent higher for "populations living in low socioeconomic development municipalities" and men 65 years or older, ABC News reported.
The researchers came to the 2,975 estimate by assessing how much "excess mortality" there was following the Category 5 hurricane, which devastated the island's infrastructure and resources in 2017.
The study assessed historical death patterns from 2010 to 2017 and then weighed that figure compared to the number of deaths between September 2017 through February 2018, CBS News reported.
"Overall, we estimate that 40 percent of municipalities experienced significantly higher mortality in the study period than in the comparable period of the previous two years," the report says.
Puerto Rico's government originally estimated there were 64 deaths due to Maria, a statistic that has been widely disputed by a number of studies that have estimated a range between 1,427 and 4,600 deaths attributable to the storm.
"The official government estimate of 64 deaths from the hurricane is low primarily because the conventions used for causal attribution only allowed for classification of deaths attributable directly to the storm, e.g., those caused by structural collapse, flying debris, floods and drownings," the new report says.
"During our broader study, we found that many physicians were not oriented in the appropriate certification protocol," the report adds. "This translated into an inadequate indicator for monitoring mortality in the hurricane's aftermath."
The report also found that those physicians in Puerto Rico who authorize death certificates are often inadequately trained in how to properly do so.
Puerto Rico only recently regained most of its electricity after the storm caused the second-largest blackout in history. The island is still suffering from the consequences of Hurricane Maria as it gears up for another hurricane season.