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

Abstract

Background: Flooding is expected to increase due to climate change, population growth and urban development. The longer-term mental health impacts of flooding are not well understood. In 2015, the English National Study of Flooding and Health was established to improve understanding of the impact of flooding on health and inform future public health action. Methods: We used 3 years of data from the English National Study of Flooding and Health. Participants who had consented to follow up were sent a questionnaire. Participants were classified into either "unaffected", "disrupted" or "flooded" according to their exposure. Logistic regression models were used to calculate adjusted odds ratios for probable depression, anxiety and post-traumatic stress disorder (PTSD) in each exposure group. The Wald test was used to assess the difference in probable mental health outcomes for those who did and did not experience "persistent damage" to their home. Conditional logistic regression was conducted to assess change in prevalence over the 3 years and to identify possible determinants of recovery. Results: Eight hundred nineteen individuals were included in the final analysis -119 were classified as unaffected, 421 disrupted and 279 flooded. Overall, 5.7% had probable depression, 8.1% had probable anxiety and 11.8% had probable PTSD, with higher prevalence in the flooded group compared with the unaffected group. After adjustment for potential confounders, probable mental health outcomes were higher in the flooded group compared to the unaffected group, significantly for probable depression (aOR 8.48, 95% CI 1.04-68.97) and PTSD (aOR 7.74, 95% CI 2.24-26.79). Seventy-seven (9.4%) participants reported experiencing persistent damage to their home, most commonly damp (n = 40) and visible mould (n = 26) in liveable rooms. Of the 569 participants who responded at all 3 years, a significant reduction in prevalence for all probable mental health outcomes was observed in the flooded group. Conclusions: Flooding can have severe long-lasting consequences on mental health in affected populations. If these problems are not identified and treated early, they may persist for years. Further research is necessary to develop and evaluate interventions to increase resilience in at risk populations and to ensure timely access to support services following flooding.

Climate Change and Mental Health: A Scoping Review

“…An Australian study qualitatively explored individuals’ experiences from rural communities, concluding that the threat of drought and flood are intertwined and contributed to decreased well-being from stress, anxiety, loss, and fear [ 42 ]. A cohort study from the UK looking at the long-term impact of flooding found psychological morbidity persisted for at least three years after the flooding event [ 43 ].…”

Monitoring the evolution of individuals’ flood-related adaptive behaviors over time: two cross-sectional surveys conducted in the Province of Quebec, Canada

“…Results presented here are in line with findings showing that floods have a major impact on psychological and physical well-being [ 11 , 21 , 23 , 60 – 62 ]. A longitudinal study in England showed high psychological morbidity in groups affected by flooding, even 2 to 3 years after exposure, particularly when it comes to depression and anxiety [ 63 – 65 ]. While our study design did not have a control group with which to compare, respondents who had experienced a flood reported high rates of physical and mental health issues.…”

“…Still, while short-term health impacts of flooding are well understood [ 11 , 13 ], long-term health effects, such as PTSD, depression, and anxiety, are not as well documented. Longitudinal data from England support the need to provide suitable treatment to flood victims in order to prevent chronic health issues from developing, because even over a three-year follow-up period, there was persistence of psychological morbidity [ 65 ]. While nearly half (48.7%) of the respondents in the present study reporting physical health impacts from flooding consulted a health professional, only 35.4% of those reporting mental health impacts did so.…”

Climate Change and Human Well-Being in the 2020s: Lessons From 2020

“…54 A study of floods in the United Kingdom found higher prevalence of mental health outcomes in those flooded, including depression, anxiety, and PTSD. 55 In a study of Houston's Hurricane Harvey, Blacks and the unemployed were much more likely than Whites or the employed to have PTSD. 56 A study of New Orleans' Hurricane Katrina found a legacy of damaged infrastructure throughout the city, 15 years after the disaster, 57 while a review of UK floods found infrastructure deterioration was a primary driver of urban flood risk.…”