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On July 28, 2022, eastern Kentucky experienced the state’s deadliest flood in recorded history. In response to ongoing mental health concerns from community members who survived the flood, local health department directors in affected communities requested technical assistance from the Kentucky Department for Public Health and the Centers for Disease Control and Prevention.
Methods
Two simultaneous Community Assessments for Public Health Emergency Response (CASPERs) were conducted 6 weeks after the flood. Four counties were assessed in each CASPER. EpiInfo7 was used to calculate the unweighted and weighted frequencies and percentages to estimate the number and percentage of households with a particular response in each CASPER.
Results
Approximately a third (30.5%) of households in CASPER 1 and approximately 40% of households in CASPER 2 reported experiencing ≥1 mental health problems. Individual-level mental health questions from a modified 3-stage CASPER found approximately 15% of persons in both CASPERs reported a Patient Health Questionnaire-2 (PHQ-2) score ≥3 and approximately 20% of persons in both CASPERs reported Generalized Anxiety Disorder-2 (GAD-2) score ≥3.
Conclusions
These findings indicated households experienced mental health problems after the flood. Depression and anxiety were prevalent among persons living in flood-affected areas. If ever needed, households preferred to receive mental health services in-person and locally.
Treatment interruptions in disaster victims are concerning, owing to an increase in natural disasters and the growing elderly population with chronic conditions. This study examined the temporal trends in treatment interruptions among victims of 2 recent major heavy rain disasters in Japan: West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020.
Methods
Data for this study were derived from the national standardized medical data collection system called the “Japan Surveillance in Post-Extreme Emergencies and Disasters.” Joinpoint regression analysis was performed to examine the daily trends in treatment interruptions reported soon after each disaster onset.
Results
A total of 144 and 87 treatment interruption cases were observed in the heavily affected areas of the West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020, respectively. In both disasters, a high number of treatment interruption cases were observed on the first day after the disaster. Joinpoint regression analysis showed that trends in the percentage of treatment interruptions differed between the 2 disasters at different disaster scales.
Conclusions
The findings suggest the importance of a prompt response to treatment interruptions in the immediate aftermath of a disaster and consideration of the specific characteristics of the disaster when planning for disaster preparedness and response.
Floods often displace people and exacerbate their access to finance, affecting the livelihood of daily wage workers in least-developed countries. In August 2017, Nepal experienced the heaviest rainfall in more than 60 years, severely flooding about 80 per cent of the land in the southern part of the country. Using the two-way fixed effects approach and an event study design, we evaluate the impact of severe flooding on the wages of agricultural workers. We show that the 2017 floods resulted in a 9–10 per cent decrease in cash wages among agricultural households while in-kind wages of agricultural laborers increased significantly after the floods, implying that in-kind wages helped mitigate the adverse effects of floods on cash wages. We also investigate changes in assistance, loan-seeking behavior, loan repayment, and collection behavior as mechanisms leading to the risk-mitigating behavior by farmers.
The frequency and severity of floods has increased in different regions of the world due to climate change. It is important to examine how adaptation measures impact the mental health of individuals affected by these disasters.
Objective
The goal of this scoping review was to document the existing studies on the impact of flood adaptation measures in affected populations to identify the best preventive strategies and limitations that deserve further exploration.
Methods
This study followed the PRISMA-ScR guidelines. Inclusion criteria focused on studies in English or French available in MEDLINE and Web of Science that examined the impact of adaptation measures on the mental health of flood victims. Literature reviews or non-study records were excluded from the analysis.
Results
A total of 857 records were obtained from the examined databases. After 2 rounds of screening, 9 studies were included for full-text analysis. Six studies sought to identify the factors that drive resilience in flood victims, whereas 3 studies analyzed the impact of external interventions on their mental health.
Conclusions
The limited number of studies demonstrates the need for public health policies to develop flood adaptation measures that can be used to support the mental health of flood victims.
Over the past century, average temperatures have risen a little over 1°C. This may not seem like much: after all, temperatures vary from one day to the next by much more than that, and we take it in our stride. However, over the past couple of decades we have become more aware of the rising incidence of what we call extreme events: heatwaves, droughts, wildfires, floods, severe storms. These are the signs of the times; signs, perhaps, that Mother Nature is not happy. Or is this all simply part of the natural unpredictability of the world we live in? In this chapter we look at recent extremes, along with the recent branch of climate science, Event Attribution, where we endeavour to assess any human contribution to these events. We illustrate both the nature of extreme events, and our growing understanding, with several detailed case studies.
This chapter uses medieval chronicles and annals to explore how river disasters were understood and remembered, and how people chose to tell stories about rivers. A focus on floods brings up issues of risk and resilience, and how floods were interpreted by medieval people. The chapter also focuses on how rivers are connected to other memorable and historic events and why they were such powerful stories. The chapter then turns to the ways that rivers were incorporated into monastic memory and to stories of foundation, and how holy sites were seen as revealed by God and the saints. The chapter ends with a case study focused on St. Sturm and the monastery of Fulda, with a focus on the role of rivers in the house’s history.
Edited by
Richard Williams, University of South Wales,Verity Kemp, Independent Health Emergency Planning Consultant,Keith Porter, University of Birmingham,Tim Healing, Worshipful Society of Apothecaries of London,John Drury, University of Sussex
This chapter introduces the notion of identifying primary and secondary stressors as a way of drawing attention to the many sources of stress that arise either as a consequence of disastrous events of long or short duration, or because they frame the context in which those disastrous events occur. The events that we include in this approach are broad in nature; they include emergencies of all kinds, major incidents, outbreaks of high consequence infectious diseases (HCIDs), terrorist attacks, and conflicts. We begin by outlining the context in which the circumstances that cause stress operate. Then we define primary and secondary stressors. This approach helps us to understand sources of stress in all kinds of adverse and disastrous events. We conclude that the sources of stress that we have researched in these differing emergencies differ, but also have much in common.
In 2022, Pakistan witnessed unprecedented flooding, submerging one-third of the country under-water, ruining millions of houses, taking lives, afflicted injuries, and displacing scores of people. Our study documents not only the public health problems that have arisen due to this natural calamity but also the state of health systems’ response.
Methods:
We conducted a qualitative study asking key questions around prevalent health problems, health-care seeking, government’s response, resource mobilization, and roadmap for the future. We purposively selected 16 key frontline health workers for in-depth interviews.
Results:
Waterborne and infectious diseases were rampant posing huge public health challenges. Disaster mitigation efforts and relief operations were delayed and not at scale to cover the entire affected population. Moreover, a weak economy, poverty, and insufficient livelihoods compounded the tribulations of floods. Issues of leadership and governance at state level resulted in disorganized efforts and response.
Conclusions:
Pakistan is famous for its philanthropy; however, lack of transparency and accountability, the actual benefits seldom reach the beneficiaries. Such climatic disasters necessitate a more holistic approach and a greater responsiveness of the health system. In addition to health services, the state must respond to financial, social, and infrastructural needs of the people suffering from the calamity.
In May 2023, the Italian region Emilia-Romagna was hit by intense rainfall, which caused extensive floods in densely populated areas. On May 4, 2023, a 12-month state of emergency was declared in the region with the activation of response and recovery plans. This field report provides an overview of the health response to the floods, paying particular attention to the measures put in place to ensure care for displaced populations and raising interesting points of discussion regarding the role of the health system during extreme weather events (EWEs). The considerations that emerge from this report underline the need for a primary care approach to disasters, especially when these occur in areas with a high prevalence of elderly resident population, and underscore the importance of integration of different levels of care.
Australian novelist George Turner’s 1987 novel The Sea and Summer is one of the world’s first climate fiction novels, although James Edmond’s 1911 story, ‘The Fool and His Inheritance’, is a precursor to the genre. The early emergence of Australian climate fiction is not surprising given the country’s vulnerability to anthropogenic climate change. This chapter investigates the 35-year history of Australian climate fiction through an analysis of six novels, contemplating how environment, history and culture shape the use of genre, form and theme. It examines slow violence and flooding in The Sea and Summer; the intertwining of colonisation, environmental destruction and dispossession in Alexis Wright’s The Swan Book (2013); the use of the uncanny to explore the impact of ‘settlement’ in Jennifer Mills’s Dyschronia (2018); the effect of a changing climate on generations in James Bradley’s Clade (2015); and the psychological ramifications of the 2019–20 bushfires, evident through motifs of missing bodies and an invisible menace in Richard Flanagan’s The Living Sea of Waking Dreams (2020) and Inga Simpson’s The Last Woman in the World (2021). These novels, which are shaped by their production in a country with a fragile environment and a history of colonisation, offer varying visions of hope and despair.
This is a case report of a huge hospital evacuation with 11 350 inpatients in the 2021 Zhengzhou flood in China, using a mixed methods analysis.
Methods:
The qualitative part was a content analysis of semi-structured interviews of 6 key hospital staff involved in evacuation management. The evacuation experience was reviewed according to the 4 stages of disaster management: prevention, preparation, response, and recovery.
Results:
Because of unprecedented torrential rain, the flood exceeded expectations, and there was a lack of local preventive measures. In preparation, according to the alert, the evacuation was planned to reduce the workload on inpatients and to accept the surge of medical needs by the flood. In response, the prioritization of critically ill patients and large-scale collaboration of hospital staff, rescue teams, and accepting branch made it possible to successfully transfer all 11 350 inpatients. In recovery, restoring medical services and a series of activities to improve the hospital’s vulnerability were carried out.
Conclusions:
A hospital evacuation is one of the strategies of the business continuity plan of a hospital. For the evacuation, leadership and collaboration were important. Challenges such as prolonged roadway flooding and the infrastructure issues were needed to be addressed throughout the evacuation process.
The impact of hurricane-related flooding on infectious diseases in the US is not well understood. Using geocoded electronic health records for 62,762 veterans living in North Carolina counties impacted by Hurricane Matthew coupled with flood maps, we explore the impact of hurricane and flood exposure on infectious outcomes in outpatient settings and emergency departments as well as antimicrobial prescribing. Declines in outpatient visits and antimicrobial prescribing are observed in weeks 0-2 following the hurricane as compared with the baseline period and the year prior, while increases in antimicrobial prescribing are observed 3+ weeks following the hurricane. Taken together, hurricane and flood exposure appear to have had minor impacts on infectious outcomes in North Carolina veterans, not resulting in large increases in infections or antimicrobial prescribing
Indoor mold after flooding poses health risks, including rare but serious invasive mold infections. The purpose of this study was to evaluate use of International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes for mold infection and mold exposure in Houston, Texas, during the year before and the year after Hurricane Harvey.
Methods:
This study used data from MarketScan, a large health insurance claims database.
Results:
The incidence of invasive mold infections remained unchanged in the year after Hurricane Harvey; however, the incidence of diagnosis codes for mold exposure nearly doubled compared with the year before the hurricane (6.3 vs 11.0 per 100 000 enrollees, rate ratio: 1.7, 95% confidence interval 1.0–3.1).
Conclusions:
Diagnosis codes alone may not be sufficiently sensitive to detect changes in invasive mold infection rates within this population and time frame, demonstrating the need for more comprehensive studies.
Wilfried Brutsaert (2022 Stockholm Water Prize Laureate) has revised and updated his classic textbook to take into account recent developments, while retaining the rigor and structure of the previous edition to introduce the fundamental principles of hydrology. New topics include the response of the global water cycle to climate change, the land surface energy budget closure, snow melt, groundwater trends and statistical surface variability with disturbed atmospheric boundary layers. Hydrologic phenomena are dealt with at the spatial and temporal scales at which they occur in nature. The physics and mathematics necessary to describe these phenomena are introduced and developed: readers will require a working knowledge of calculus and basic fluid mechanics. This classroom-tested textbook – based on the author's long-running course at Cornell - is invaluable for entry-level courses in hydrology directed at advanced undergraduate and graduate students in physical science and engineering. In addition, it is also a great reference text for practising scientists and engineers.
This article uses historical-ecological insights for a re-reading of two little-known mid-twentieth-century Australian plays, Oriel Gray’s The Torrents and Eunice Hanger’s Flood, which highlight developments relevant to the environmental disasters of today. In particular, the article focuses on the significance of key cultural assumptions embedded in the texts – and a revival of The Torrents in 2019 – including those to do with land use in a period of accelerating development. This approach offers new insights into the dominance of mining, irrigation, and dam-building activities within the Australian ethos, landscape, and economy. One of these insights is the framing of development as progressive. The article thus also examines how development projected as progressive takes place amid the continuing denial of prior occupation of the land by First Nations peoples and of knowledge systems developed over thousands of years. The intersectional settler-colonialist-ecocritical approach here seeks to capture the compounding ecosystem that is modern Australian theatre and its critique. The intention is not to apply revisionist critiques of 1950s plays but to explore the historical relationship between humans, colonialism, and the physical environment over time. Denise Varney is Professor of Theatre Studies in the School of Culture and Communication at the University of Melbourne. Her research is in modern and contemporary theatre and performance, with published work in the areas of ecocriticism, feminism, and Australian theatre. Her most recent book is Patrick White’s Theatre: Australian Modernism on Stage 1960–2018 (Sydney University Press, 2021).
This study aimed to evaluate a risk of flooding and landslides among home-care patients, to reveal an extent to which patients require support for evacuation, and to determine whether risk was accurately perceived among the patients.
Methods:
This is a cross-sectional study targeting the patients who were actively treated at the home-care clinic in Fukui Prefecture, Japan. We collected data on the patients’ sociodemographic and clinical characteristics. Additionally, we collected data on their risk of flooding and landslides through hazard maps and distributed a questionnaire to these patients regarding their risk awareness of flooding and landslides.
Results:
Of the 199 eligible home-care patients, 84.9% (169 of 199) were at risk of flooding and/or landslides, and 58.6% (99 of 169) of them needs support during evacuation. Furthermore, of those who were at risk of flooding and/or landslides, 46.0% (45 of 99) had accurate risk assessments. Factors that resulted in inadequate risk awareness of flooding and landslides included: not placing importance on evacuation, not using medical equipment, and living on the first floor.
Conclusions:
There was limited risk awareness of flooding and/or landslides among the home-care patients. The information of the risk factors regarding inadequate risk awareness of flooding and landslides should be used to sophisticate flooding and landslides evacuation strategy.
This chapter addresses insuring natural catastrophes in America. It provides an overview of the existing lines of insurance for natural catastrophe losses, such as homeowners insurance, commercial property insurance (including business interruption insurance), the National Flood Insurance Program, and earthquake insurance (including the California Earthquake Authority). Currently, most natural catastrophe losses are uninsured in America as a result of consumer ignorance regarding risk and private insurers’ general treatment of natural catastrophes as uninsurable correlated risks. Consequently, this chapter also includes a discussion of ways more natural catastrophe losses could be insured in America by considering the ways other developed countries throughout the world insure natural catastrophe losses.
Article 7.1 of the Paris Agreement establishes that parties should aim at enhancing adaptive capacity, strengthening resilience, and reducing vulnerability to climate change. While many climate hazards and vulnerabilities are beyond territorial control, a readiness to withstand and recover from them must be delivered locally. This chapter discusses climate-related vulnerability, adaptation, and resilience of the Greater Bay Area of China (GBA), an area that has been identified by the Chinese government as an engine of economic development but which has historically been vulnerable to flooding. After providing a contextual introduction to the GBA project, the chapter reviews key studies on past, current, and future climate trends focusing on meteorological, climatological, hydrological, and geophysical hazards. It then surveys adaptation policies and plans already implemented in GBA cities to assess what works and what does not and where the gaps are. Finally, the discussion focuses on the drivers and barriers for the uptake of technology for flood prevention and for the deployment of emergency responses. The aim of this discussion is to identify the opportunities and risks of technology in building future-ready local skills and citizen engagement for climate resilience. Given the ambitious plans for the GBA to contribute to the economic development of China, existing and projected vulnerabilities to climate hazards and their potential impact on the developed environment and physical infrastructure, business and industry, energy supply, financial services, human health, water resources, and biodiversity may not only hamper GBA plans but also put its businesses and citizens at risk. Technological innovation diminishes this vulnerability, but drivers and barriers to its uptake must be either identified and enhanced or removed accordingly.