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

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.