AMNA NAWAZ: Welcome to the "News Hour."

The devastating toll from Hurricane Helene keeps growing.

Authorities say at least 120 people have died across six states, and officials fear that number could grow even larger.

Many more people are still missing and unaccounted for.

GEOFF BENNETT: In North Carolina, communities are in crisis, with many roads closed, slowing the delivery of food, water and other desperately needed aid.

And some places in Florida are now trying to recover from their third big hit in less than two years.

Special correspondent Christopher Booker has our report.

CHRISTOPHER BOOKER: For residents on Florida's Big Bend, it's been a year like no other.

The small community of Keaton Beach took an almost direct hit from Hurricane Helene.

It was the third hurricane since last summer to strike this stretch of the Gulf Coast.

Where we're standing, all that's left is what?

SHANNON MILLINOR, Florida Resident: Just the pylons on the house.

CHRISTOPHER BOOKER: Just the pylons.

SHANNON MILLINOR: Yes, that's it.

CHRISTOPHER BOOKER: Where is the rest of the house?

SHANNON MILLINOR: Over there in the canal, across the canal.

CHRISTOPHER BOOKER: Shannon Millinor lost his entire home to the estimated 15 feet of storm surge.

He was born and raised in this area and says many in this close-knit community are reeling.

SHANNON MILLINOR: They're just devastated.

We pretty much know everybody down here.

Just everybody was -- that lived here full time just thought that they were going to come home.

And now they have nothing, just like we do.

Everything is closed and everything.

CHRISTOPHER BOOKER: While people in Florida have started to clean up, the aftermath of Hurricane Helene continues to wreak havoc across almost the entire Southeast.

In Western North Carolina, rescue teams are still searching for victims, as floodwaters have submerged entire neighborhoods.

The state's Governor Roy Cooper called the disaster an unprecedented tragedy.

GOV.

ROY COOPER (D-NC): Today, we did an aerial overview to see the damage here in Western North Carolina, and it is extensive and devastating.

We know that it's going to require significant resources both in the short term and the long term.

CHRISTOPHER BOOKER: Among those rescued over the weekend was nurse Janetta Barfield.

JANETTA BARFIELD, North Carolina Resident: And even before the officer got to me, the water was all the way up to my chest inside my car.

CHRISTOPHER BOOKER: Floodwaters and damaged roads left some of the hardest-hit areas of North Carolina completely cut off.

Many residents in the mountain city of Asheville remain without running water or cell service.

But a lucky few have managed to find power.

CARRIE OWENBY, North Carolina Resident: We did not have cell service for the first, like, three days here, but it's just coming back and everybody's wanting to get their devices started, so we can just let our family know that we're safe.

CHRISTOPHER BOOKER: In Georgia, playground equipment sat partially underwater.

In Atlanta, 11 inches of rain fell over 48 hours, the most the city has ever seen over two days.

And in Eastern Tennessee, a bridge collapsed into a river.

In all, more than a million people across the Southeast are without power.

President Biden addressed the devastation today.

JOE BIDEN, President of the United States: I'm here to tell every single survivor in these impacted areas that we will be there with you as long as it takes.

CHRISTOPHER BOOKER: Helene roared a shore in the Big Bend last Thursday as a Category 4 hurricane with winds of 140 miles per hour and record-breaking storm surge.

This storm underlines a complicated mix of questions for the people who live here.

First, should they rebuild?

And, if they do, what will that look like?

And then can they afford what were already the highest home insurance rates in the country?

From 2017 to 2022, Florida homeowners saw a 45 percent increase in premiums, leaving many unable to afford insurance altogether.

Cedar Key, a Big Bend island town of about 700 people, was also one of the hardest hit.

Officials estimated a quarter of the homes were destroyed.

Sue Colson is the mayor.

She says the storm will fundamentally change the place she's called home for 30 years.

SUE COLSON, Mayor of Cedar Key, Florida: We have to learn.

We cannot fight nature and we cannot build the Titanic that will never sink.

That's insane.

And we still think we can do it.

We can do better at building.

We can do better at the codes.

But then maybe we need to rethink where we place things.

Maybe we shouldn't build a food market at the bottom of the hill, where it's always getting damaged.

CHRISTOPHER BOOKER: Does a storm like this force the question as to whether a community like Cedar Key can continue in the era of these big storms?

SUE COLSON: Oh, no.

That's so silly.

That's a silly question.

We have never not been inhabited.

It's a prime place to live.

It's a prime place to exist.

The problem is, we have to learn how to work with nature, not fight it, not think we can overbuild it.

CHRISTOPHER BOOKER: About 40 miles up the coast in Steinhatchee, residents were salvaging what they could from Maddie's, the town's only grocery store.

During past big storms, the water never even reached its door, but Helene's surge nearly touched the ceiling, ruining practically everything and blanketing the store with mud.

CRYSTAL MROZ, Florida Resident: It's truly amazing how powerful water is.

CHRISTOPHER BOOKER: Crystal Mroz is the store's manager.

This is your third hurricane in 13 months.

CRYSTAL MROZ: Yes, and I fear there's another one.

I hope not.

I mean, we can't take another one.

This is the worst I have ever seen this place.

And we have gotten beaten by hurricanes a lot, and I have never seen one like this.

I mean, I have had friends who have completely lost their house.

CHRISTOPHER BOOKER: While plenty of storms have hit the Big Bend throughout history, experts say the recent ones have been the most intense.

RYAN TRUCHELUT, Meteorologist, WeatherTiger: There is some element of just very, very bad luck in this part of the country.

But on the other hand I do think that there's a climate change fingerprint to this.

CHRISTOPHER BOOKER: Ryan Truchelut, a meteorologist based in Tallahassee, says warmer and rising waters in the Gulf of Mexico, driven by climate change, are providing extra fuel for these storms.

RYAN TRUCHELUT: I don't believe that we're going to be cooling off the sea surface temperatures any time soon.

So whenever the Big Bend faces a hurricane risk in the future, I do think we have shifted the risk profile towards a greater proportion of storms approaching being able to sustain major hurricane intensity.

CHRISTOPHER BOOKER: Back in Keaton Beach, Shannon Millinor says, despite those risks, he and many of his neighbors plan on staying put.

SHANNON MILLINOR: It's our little paradise.

We -- it's where we live.

We enjoy -- we fish all the time.

That's what we do.

People got their own stuff they do if they don't live on the coast.

And we have got our stuff we do here.

We will rebuild and we will continue on.

CHRISTOPHER BOOKER: For the "PBS News Hour," I'm Christopher Booker in Florida's Big Bend.