Secondary stressors are associated with probable psychological morbidity after flooding: a cross-sectional analysis

Elizabeth L. Tempest, English National Study on Flooding and Health Study Group, Ben Carter, Charles R. Beck, G. James Rubin

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Abstract

Background: The impact of flooding on mental health is exacerbated due to secondary stressors, although the mechanism of action is not understood. We investigated the role of secondary stressors on psychological outcomes through analysis of data collected one-year after flooding, and effect modification by sex.

Methods: We analysed data from the English National Study on Flooding and Health collected from households flooded, disrupted and unexposed to flooding during 2013-14. Psychological outcomes were probable depression, anxiety and post-traumatic stress disorder (PTSD). Parsimonious multivariable logistic regression models were fitted to determine the effect of secondary stressors on the psychological outcomes. Sex was tested as an effect modifier using subgroup analyses.

Results: A total of 2006 people participated (55.5% women, mean age 60 years old). Participants reporting concerns about their personal health and that of their family (concerns about health) had greater odds of probable depression (adjusted odds ratio [aOR] 1.77, 95% CI 1.17-2.65) and PTSD (aOR 2.58, 95% CI 1.82-3.66). Loss of items of sentimental value was associated with probable anxiety (aOR 1.82, 95% CI 1.26-2.62). For women, the strongest associations were between concerns about health and probable PTSD (aOR 2.86, 95% CI 1.79-4.57). For men, the strongest associations were between 'relationship problems' and probable depression (aOR 3.25, 95% CI 1.54-6.85).

Conclusions: Concerns about health, problems with relationships and loss of sentimental items were consistently associated with poor psychological outcomes. Interventions to reduce the occurrence of these secondary stressors are needed to mitigate the impact of flooding on probable psychological morbidity.

Original languageEnglish
Pages (from-to)1042-1047
Number of pages6
JournalEuropean journal of public health
Volume27
Issue number6
Early online date26 Oct 2017
DOIs
Publication statusPublished - 1 Dec 2017

Keywords

  • secondary stressors
  • mental health
  • flooding

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