Abstract
Background: Northern New South Wales in Australia is a “hotspot” for natural disaster declarations with recent extensive flooding in early 2017. With limited knowledge about how climate change affects mental health and resilience, robust local assessments are required to better understand long-term impact, particularly in communities prone to extreme weather events.Methods: Six months post-flood, a cross-sectional survey of adults living in the region during the flood was conducted to quantify associations between flood impact and psychological morbidity (post-traumatic stress (PTSD), anxiety, depression, suicidal ideation) for different exposure scenarios, and respondent groups. We adopted a community-academic partnership approach and purposive recruitment to increase participation from marginalized groups.Results: Of 2,180 respondents, almost all (91%) were affected by some degree of flood-related exposure at an individual and community level (ranging from suburb damage to home or business inundated). Socio-economically marginalized respondents were more likely to have their homes inundated and to be displaced. Mental health risk was significantly elevated for respondents: whose home/business/farm was inundated [e.g., home inundation: PTSD adjusted odds ratio (AOR) 13.72 (99% CI 4.53–41.56)]; who reported multiple exposures [e.g., three exposures: PTSD AOR 6.43 (99% CI 2.11–19.60)]; and who were still displaced after 6 months [e.g., PTSD AOR 24.43 (99% CI 7.05–84.69)].Conclusion: The 2017 flood had profound impact, particularly for respondents still displaced and for socio-economically marginalized groups. Our community-academic partnership approach builds community cohesion, informs targeted mental health disaster preparedness and response policies for different sectors of the community and longer-term interventions aimed at improving community adaptability to climate change.
Highlights
There is compelling evidence and wide consensus that anthropogenic activities are causing climate change, leading to more frequent extreme weather events with adverse consequences for public health, disproportionately so for the poorest populations [1, 2]
As espoused by the Sendai Framework, this project aims to understand the interplay of factors that may contribute to local disaster risk and adaptive capacity to inform risk reduction policies
Over one-fifth (22%) of respondents reported being still distressed about the flood, 16% with probable anxiety, 15% probable post-traumatic stress disorder (PTSD), 15% probable depression and 7% suicidal ideation
Summary
There is compelling evidence and wide consensus that anthropogenic activities are causing climate change, leading to more frequent extreme weather events with adverse consequences for public health, disproportionately so for the poorest populations [1, 2]. The Sendai Framework advocates a community-centered preventive approach to disaster risk It recommends that government agencies be multi-sectoral and inclusive in designing and implementing policies by engaging all relevant stakeholders, including women, children, seniors, people with pre-existing health conditions, people with low socio-economic status and Indigenous communities. In this way, understanding and managing disaster risk encompasses all dimensions of exposure, vulnerability, and capacity of individuals and communities in formulating regional and local risk reduction policies [8]. With limited knowledge about how climate change affects mental health and resilience, robust local assessments are required to better understand long-term impact, in communities prone to extreme weather events
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