The English National Cohort Study of Flooding and Health: the change in the prevalence of psychological morbidity at year two

Abstract

BackgroundThe longer term impact of flooding on health is poorly understood. In 2015, following widespread flooding in the UK during winter 2013/14, Public Health England launched the English National Study of Flooding and Health. The study identified a higher prevalence of probable psychological morbidity one year after exposure to flooding. We now report findings after two years.MethodsIn year two (2016), a self-assessment questionnaire including flooding-related exposures and validated instruments to screen for probable anxiety, depression and post-traumatic stress disorder (PTSD) was sent to all participants who consented to further follow-up. Participants exposure status was categorised according to responses in year one; we assessed for exposure to new episodes of flooding and continuing flood-related problems in respondents homes. We calculated the prevalence and odds ratio for each outcome by exposure group relative to unaffected participants, adjusting for confounders. We used the McNemar test to assess change in outcomes between year one and year two.ResultsIn year two, 1064 (70%) people responded. The prevalence of probable psychological morbidity remained elevated amongst flooded participants [n = 339] (depression 10.6%, anxiety 13.6%, PTSD 24.5%) and disrupted participants [n = 512] (depression 4.1%, anxiety 6.4%, PTSD 8.9%), although these rates were reduced compared to year one. A greater reduction in anxiety 7.6% (95% confidence interval [CI] 4.6–9.9) was seen than depression 3.8% (95% CI 1.5–6.1) and PTSD: 6.6% (95% CI 3.9–9.2). Exposure to flooding was associated with a higher odds of anxiety (adjusted odds ratio [aOR] 5.2 95%, 95% CI 1.7–16.3) and depression (aOR 8.7, 95% CI 1.9–39.8) but not PTSD. Exposure to disruption caused by flooding was not significantly associated with probable psychological morbidity. Persistent damage in the home as a consequence of the original flooding event was reported by 119 participants (14%). The odds of probable psychological morbidity amongst flooded participants who reported persistent damage, compared with those who were unaffected, were significantly higher than the same comparison amongst flooded participants who did not report persistent damage.ConclusionsThis study shows a continuance of probable psychological morbidity at least two years following exposure to flooding. Commissioners and providers of health and social care services should be aware that the increased need in populations may be prolonged. Efforts to resolve persistent damage to homes may reduce the risk of probable psychological morbidity.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5236-9) contains supplementary material, which is available to authorized users.

The English National Cohort Study of Flooding & Health: psychological morbidity at three years of follow up

“…It is important to note that the crude mental health prevalence presented are not exactly comparable to those presented at year two of this study, in the previously published paper by Jermacane et al [10]. In Jermacane et al, 2018, individuals who had responded to some, but not all mental health questions, were included in the denominator data, but in the present study those subjects were excluded, in line with the approach of Waite et al [9] for year one data.…”

“…The original cohort comprised of 2126 participants, with 1408 providing consent for follow-up [9]. At year two, of the 1408 contacted a total of 1064 responded [10]. 1361 participants were contacted at year three.…”

“…The NSFH has previously identified a significant adverse impact on mental health, both at one and 2 years post-flooding, in those whose homes were flooded and whose lives were otherwise disrupted by flooding, compared with those unaffected [9,10]. The NSFH also identified that adverse outcomes are associated with secondary stressors [11], such as insurance-related issues [12], and with displacement from home without warning [13].…”

The Morbidities Experienced during and after the 2017 Flood in Port Harcourt

“…Floods stand as the most common and critical catastrophic event occurring in most parts of the world [1], which have resulted in loss of human lives and sources of livelihood, prolonged health impact, damage and deterioration of the environment, as well as retardation to development and economic losses [2,3]. Flooding is the most frequent global natural hazard, in terms of occurrence, with incidence and impact on the increase worldwide with a trend that is set to continue to increase in frequency and intensity due to climate change accompanied by rising sea levels and more frequent and extreme precipitation [4,5].…”

Beyond Climate Change and Health: Integrating Broader Environmental Change and Natural Environments for Public Health Protection and Promotion in the UK

“…As part of the HPRU in Environmental Change and Health Theme 1 research, we have explored the health and well-being consequences of flood exposures in the UK [39] and found that the seasonality of a number of foodborne pathogens can be influenced by weather, particularly temperature [40]. We have also reviewed the seasonality of over 2000 distinct infectious diseases reported in the UK [41] and the co-occurrence of weather conditions with human infection cases of individual pathogens provides Atmosphere 2018, 9, 245 6 of 22 some indication that these might be related.…”