Effect of insurance-related factors on the association between flooding and mental health outcomes

English National Study of Flooding Health Study Group

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


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.

Original languageEnglish
Article number1174
JournalInternational Journal of Environmental Research and Public Health
Issue number7
Publication statusPublished - 1 Apr 2019

Bibliographical note

Funding Information:
Funding: This work was supported by the National Institute for Health Research Health Protection Research Units (NIHR HPRU) in Evaluation of Interventions at the University of Bristol, in partnership with Public Health England (PHE), the NIHR HPRU Emergency Preparedness and Response at King’s College London in partnership with PHE and the NIHR HPRU in Environmental Change and Health at the London School of Hygiene and Tropical Medicine in partnership with PHE. The views expressed are those of the authors and not those of the NHS, the NIHR, the Department of Health and Social Care or PHE.

Publisher Copyright:
© 2019 by the authors. Licensee MDPI, Basel, Switzerland.


  • Flooding
  • Insurance
  • Mental health
  • Natural disasters


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