The English national cohort study of flooding and health: cross-sectional analysis of mental health outcomes at year one
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BACKGROUND: In winter 2013/14 there was widespread flooding in England. Previous studies have described an increased prevalence of psychological morbidity six months after flooding. Disruption to essential services may increase morbidity however there have been no studies examining whether those experiencing disruption but not directly flooded are affected. The National Study of Flooding and Health was established in order to investigate the longer-term impact of flooding and related disruptions on mental health and wellbeing. METHODS: In year one we conducted a cross sectional analysis of people living in neighbourhoods affected by flooding between 1 December 2013 and 31 March 2014. 8761 households were invited to participate. Participants were categorised according to exposure as flooded, disrupted by flooding or unaffected. We used validated instruments to screen for probable psychological morbidity, the Patient Health Questionnaire (PHQ 2), Generalised Anxiety Disorder scale (GAD-2) and Post Traumatic Stress Disorder (PTSD) checklist (PCL-6). We calculated prevalence and odds ratios for each outcome by exposure group relative to unaffected participants, adjusting for confounders. RESULTS: 2126 people (23%) responded. The prevalence of psychological morbidity was elevated amongst flooded participants ([n = 622] depression 20.1%, anxiety 28.3%, PTSD 36.2%) and disrupted participants ([n = 1099] depression 9.6%, anxiety 10.7% PTSD 15.2%). Flooding was associated with higher odds of all outcomes (adjusted odds ratios (aORs), 95% CIs for depression 5.91 (3.91-10.99), anxiety 6.50 (3.77-11.24), PTSD 7.19 (4.33-11.93)). Flooded participants who reported domestic utilities disruption had higher odds of all outcomes than other flooded participants, (aORs, depression 6.19 (3.30-11.59), anxiety 6.64 (3.84-11.48), PTSD 7.27 (4.39-12.03) aORs without such disruption, depression, 3.14 (1.17-8.39), anxiety 3.45 (1.45-8.22), PTSD 2.90 (1.25-6.73)). Increased floodwater depth was significantly associated with higher odds of each outcome. Disruption without flooding was associated with borderline higher odds of anxiety (aOR 1.61 (0.94-2.77)) and higher odds of PTSD 2.06 (1.27-3.35)) compared with unaffected participants. Disruption to health/social care and work/education was also associated with higher odds of psychological morbidity. CONCLUSIONS: This study provides an insight into the impact of flooding on mental health, suggesting that the impacts of flooding are large, prolonged and extend beyond just those whose homes are flooded.
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Researchers tend to conceptualize mental health solely as mental illness and mental problems, administering surveys using validated instruments that assess mental health problems such as generalized anxiety disorder, PTSD, and psychological distress following an extreme weather event.
“Researchers tend to conceptualize mental health solely as mental illness and mental problems, administering surveys using validated instruments that assess mental health problems and issues like: generalized anxiety disorder (using the general anxiety disorder, GAD-2 questionnaire), PTSD (PCL-6 checklist), and psychological distress (via the general health questionnaire, GHQ-12) following an ext”
From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [52]
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Experimental — accuracy not yet measuredThe links between extreme weather events and mental health effects are well established.
“Within the disaster mental health literature, the links between extreme weather events and mental health effects are well established (see for example [51–59]).”
From Climate change and mental health: risks, impacts and priority actions (2018) · cites this paper as [52]
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- Authors
- Waite, T. D., Chaintarli, K., Beck, C. R., Bone, A., Amlôt, R., Kovats, S., Reacher, M., Armstrong, B., Leonardi, G., Rubin, G. J., & Oliver, I.
- Affiliations
- Public Health England (GB)
- London School of Hygiene & Tropical Medicine (GB)
- King's College London (GB)
- Corresponding author
- Oliver, Isabel
- ORCID
- Venue
- BMC Public Health
- Published
- 2017-01-28
- Volume
- 17
- Issue
- 1
- Pages
- 129-129
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC5273816
- OpenAlex
- W2582095624
- Cited by
- 126
- References
- 13
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 16 · 2023: 21 · 2022: 13 · 2021: 10 · 2020: 18 · 2019: 14 · 2018: 11 · 2017: 6
- FWCI
- 16.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Physical Sciences › Environmental Science › Global and Planetary Change › Flood Risk Assessment and Management
- Keywords
- floods, mental health, psychological morbidity, depression, anxiety, post-traumatic stress disorder, service disruption, household welfare, flood exposure, generalized anxiety disorder, depression prevalence, anxiety prevalence, disaster mental health
- MeSH terms
- Adult, Anxiety, Cross-Sectional Studies, Depression, England, Female, Humans, Male, Mental Health, Middle Aged, Stress Disorders, Post-Traumatic, Cohort Studies, Comorbidity, Prevalence, Odds Ratio, Floods
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