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Effect of Insurance-Related Factors on the Association between Flooding and Mental Health Outcomes

1
Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol BS1 6EH, UK
2
NIHR Health Protection Research Unit in Evaluation of Interventions, University of Bristol, Bristol BS8 2BN, UK
3
Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK
4
NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
5
Public Health England, London SE1 8UG, UK
6
Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
*
Author to whom correspondence should be addressed.
Group members: Thomas David Waite, Charles R Beck, Angie Bone, Richard Amlôt, Sari Kovats, Ben Armstrong, Giovanni Leonardi, G James Rubin and Isabel Oliver.
Int. J. Environ. Res. Public Health 2019, 16(7), 1174; https://doi.org/10.3390/ijerph16071174
Received: 5 March 2019 / Revised: 27 March 2019 / Accepted: 29 March 2019 / Published: 2 April 2019
(This article belongs to the Section Mental Health)
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Abstract

Floods are a significant public health problem linked with increased psychological morbidity. We aimed to investigate the effect of insurance-related factors on the association between flooding and probable mental health outcomes. We performed a secondary analysis of cross-sectional survey data from the English National Study of Flooding and Health (NSFH) collected two years after an initial flooding event in 2013-14. Our analysis focused on 851 respondents who experienced flooding or disruption. Multivariable logistic regression models were run for each exposure group. Among those whose homes had been flooded, not having household insurance was associated with increased odds of all outcomes compared to those with household insurance, significantly so for post-traumatic stress disorder (PTSD) (aOR 4.31, 95% CI 1.31–14.20). Those who reported severe stress due to insurance issues had increased odds of probable depression (aOR 11.08, 95% CI 1.11–110.30), anxiety (aOR 4.48, 95% CI 1.02–19.70) and PTSD (aOR 7.95, 95% CI 2.10–30.1) compared to those reporting no/mild stress. The study suggests there is increased psychological morbidity amongst the uninsured and those who report feeling severe stress as a result of insurance issues associated with flooding. Services should be prepared to support communities through insurance processes, to reduce probable mental health morbidity following a flood event. View Full-Text
Keywords: mental health; flooding; natural disasters; insurance mental health; flooding; natural disasters; insurance
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Mulchandani, R.; Smith, M.; Armstrong, B.; English National Study of Flooding and Health Study Group; Beck, C.R.; Oliver, I. Effect of Insurance-Related Factors on the Association between Flooding and Mental Health Outcomes. Int. J. Environ. Res. Public Health 2019, 16, 1174.

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