The long-term physical and psychological health impacts of flooding: A systematic mapping

Zhong, Shengliang; Yang, Lianping; Toloo, Ghasem Sam; Wang, Zhe; Tong, Shilu; Sun, Xiaojie; Crompton, David; FitzGerald, Gerard; Huang, Cunrui

doi:10.1016/j.scitotenv.2018.01.041

Cited by 86 publications

(66 citation statements)

References 88 publications

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“…21 In addition to immediate injury and death from flood water, longer-term impacts on health include spread of infectious disease and mental illness, both of which are exacerbated by the destruction of infrastructure, homes, and livelihoods. 22,23 The second component of this new indicator maps extreme rainfall events, as a proxy indicator of flood risk. In the 2015 Lancet Countdown report by Watts and coworkers, 1 flood risk was estimated for 2090 by defining a flood event as a 5 day precipitation total exceeding the 10 year rainfall level (a level of rainfall only expected once every 10 years) in the reference period.…”

Section: Indicator 15: Health Effects Of Extremes Of Precipitation (mentioning

confidence: 99%

The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

et al. 2018

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Decreasing labour productivity, increased capacity for the transmission of diseases such as dengue fever, malaria, and cholera, and threats to food security provide early warning of compounding negative health and nutrition effects if temperatures continue to rise. Adaptation, planning, and resilience for health Global inertia in adapting to climate change persists, with a mixed response from national governments since the signing of the Paris Agreement in 2015. More than half of global cities surveyed expect climate change to seriously compromise public health infrastructure, either directly, with extremes of weather disrupting crucial services, or indirectly, through the overwhelming of existing services with increased burdens of disease (indicator 2.2). Globally, spending for climate change adaptation remains well below the $100 billion per year commitment made under the Paris Agreement. Within this annual spending, only 3•8% of total development spending committed through formal UN Framework Convention on Climate Change (UNFCCC) mechanisms is dedicated to human health (indicator 2.8). This low investment in Panel 1: Progress towards the recommendations of the 2015 Lancet Commission on health and climate change In 2015, the Lancet Commission made ten policy recommendations. Of these ten recommendations, the Lancet Countdown is measuring progress on the following: Recommendation 1: invest in climate change and public health research Since 2007, the number of published articles on health and climate change in scientific journals has increased by 182% (indicator 5.2). Recommendation 2: scale up financing for climate-resilient health systems Spending on direct health adaptation as a proportion of total adaptation spending increased in 2017 to 4•8% (£11•68 billion), which is an increase in absolute and relative terms from the previous year (indicator 2.7). Health-related adaptation spending (including disaster response and food and agriculture) was estimated at 15•2% of total adaptation spend. Although this national-level spending is increasing, climate financing for mitigation and adaptation remains well below the US$100 billion per year committed in the Paris Agreement (indicator 2.8). Recommendation 3: phase out coal-fired power Coal consumption remains high, but continued to decline in 2017, a trend which is largely driven by China's decreased reliance and continued investment in renewable energy (indicators 3.2 and 3.3). The Powering Past Coal Alliance (an alliance of 23 countries including the UK, Italy, Canada, and France) was launched at the 23rd Conference of the Parties to the UN Framework Convention on Climate Change (UNFCCC) in December, 2017 (COP23), committing to phase out coal use by 2030 or earlier. Recommendation 4: encourage city-level low-carbon transition to reduce urban pollution In 2017, a new milestone was reached, with more than 2 million electric vehicles on the road, and with global per-capita electricity consumption for road transport increasing by 13% from 2013 to 2015 (indicator 3.6). C...

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Section: Indicator 15: Health Effects Of Extremes Of Precipitation (mentioning

confidence: 99%

The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

et al. 2018

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“…Flooding can have a range of effects on people’s health, both physical and psychological 1–5. Given projections that both the frequency and severity of flooding events will continue to increase in the future,6–9 populations living in flood-susceptible areas may be exposed to multiple flooding events.…”

Section: Introductionmentioning

confidence: 99%

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health

et al. 2019

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ObjectiveTo assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6 months post-flooding.DesignCross-sectional analysis of data from the English National Study of Flooding and Health.SettingCumbria, England.ParticipantsQuestionnaires were sent to 2500 residential addresses at 6 months post-flooding; 590 people responded.OutcomesProbable depression was assessed using the Patient Health Questionnaire, probable anxiety using the Generalised Anxiety Disorder scale and probable PTSD using the short-form PTSD checklist (PCL-6). HRQoL was assessed using the EQ-5D-5L. Mental health outcomes were analysed using logistic regression; HRQoL dimensions using ordinal regression; and summary index/Visual Analogue Scale scores using linear regression.ResultsOne hundred and nineteen participants had been flooded, over half of whom were experiencing a repeat flooding event (54%; n=64). Mental health outcomes were elevated among flooded compared with unaffected participants (adjusted OR for probable depression: 7.77, 95% CI: 1.51 to 40.13; anxiety: 4.16, 95% CI: 1.18 to 14.70; PTSD: 14.41, 95% CI: 3.91 to 53.13). The prevalence of depression was higher among repeat compared with single flooded participants, but this was not significant after adjustment. There was no difference in levels of anxiety or PTSD. Compared with unaffected participants, those flooded had lower EQ-5D-5L index scores (adjusted coefficient: −0.06, 95% CI: −0.12 to −0.01) and lower self-rated health scores (adjusted coefficient: −6.99, 95% CI: −11.96 to −2.02). There was, however, little difference in HRQoL overall between repeat and single flooded participants.ConclusionsInterventions are needed to help minimise the impact of flooding on people’s mental health and HRQoL.

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“…Few studies have focused on the long-term prevalence of mental health problems in those affected by flooding, with systematic mapping reviews by Zhong et al, 2018 and Fernandez et al, 2015 highlighting the lack of studies conducted on this topic two or more years post-flooding [1,17]. Our paper assessed the prevalence of probable mental health outcomes 3 years after a flooding event.…”

Section: Discussionmentioning

confidence: 98%

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

et al. 2020

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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.

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The long-term physical and psychological health impacts of flooding: A systematic mapping

Cited by 86 publications

References 88 publications

The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health

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

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