Escobar Carias, M., Johnston, D., Knott, R., et al, 2022, Health Economics

Read: Flood disasters and health among the urban poor

Understanding community vulnerabilities to floods and their health impacts, to support better risk reduction measures.

Floods are the single most common type of disaster in Indonesia, and their frequency and intensity is set to increase over time. Despite recognition that the people at highest risk of flooding tend to be extremely poor, little is known about how these frequent shocks impact on their health, especially their mental health. PhD researcher Michelle Escobar Carías and her team at Monash University’s Centre for Health Economics shed new light on the health burden following flood exposure.

‘While floods are the most common type of disaster in Indonesia, there is a lot we don’t know, such as whether floods affect urban poor living in formal housing differently from those in informal settlements, or what the effects are on child mental health,’ explains Escobar. ‘Our research shows that each flood event further depletes the physical and mental health of Indonesian adults and children, but especially the poorest of the poor’.

The research uses two longitudinal datasets of low-income groups. The Indonesia Family Life Survey (IFLS) allowed the study of the impacts of flood events on the urban poor living in formal neighbourhoods; while RISE survey data allowed examination amongst the poor living in informal settlements. ‘We measured changes in physical and mental health status following a flood, while controlling for other events and policies that could have occurred at the provincial or settlement level, respectively.

‘We found that not only do the urban poor experience significant increases in acute morbidities and depressive symptoms following floods, but that these negative mental health effects are detectable for up to five years post-flood’, says Escobar. The team finds children’s mental health is even more affected than adults, with a 78 per cent increase in emotional difficulties almost one-year post-shock.

The urban poor have the lowest means to cope with disasters, while at the same time having limited access to mental health services. ‘We find that part of the lasting RISE demonstration site Batua, Makassar, pre-upgrade mental health effects could be caused by financial stress caused by floods, through higher medical bills, the acquisition of debt, and the depletion of household assets’.

For Escobar, the findings are a useful tool for public health authorities to improve the surge capacity of health centres post-flood. She also points out, ‘the connection between the financial burden caused by flood exposure and the mental health effects point to the need for financial aid instruments that local authorities could consider to reduce or prevent these negative health effects’.