The Risk of Non-Communicable Diseases after being Exposed to the Urban Flood; A Literature Review and Meta-Analysis

Renny Nurhasana(1*), Risky Kusuma Hartono(2)

(1) Urban Studies Program, School of Strategic and Global Studies Universitas Indonesia, Central Jakarta, Indonesia
(2) Department of Public Health, Sekolah Tinggi Ilmu Kesehatan Indonesia Maju, South Jakarta, Indonesia
(*) Corresponding Author


Background: Risk mapping for the various types of non-communicable diseases (NCDs), which lead to the cause of death due to the impact of the urban flood, is rarely conducted. The study aimed to conduct a Systematic Literature Review (SLR) and meta-analysis of the risk of various NCDs after the community experienced the urban flood disaster. Methods: The data was taken from PubMed, ScienceDirect, Taylor and Francis, and ProQuest from June 2010 to June 2020 by searching for the words of flood and NCDs that only occurred in urban areas. This study refers to the guideline that is widely used to conduct meta-analysis research, namely PRISMA. The procedure was started by searching, screening, and validating the original articles through meta-analysis using R Studio. Result: Twenty-six original articles were selected for SLR, and only two articles were not eligible for meta-analysis. Mental illness (0.53, 95% CI, 0.33-0.68), heart problems (0.39, 95% CI -0.11-0.73), and respiratory problems (0.53, 95% CI, 0.02-0.82) are the NCDs categories occurring after the community, predominantly female and the community aged >40 years, was exposed to the urban flood. This risk magnitude finding complements the previous studies that only did a literature review. The heterogeneous result (tau^2 p-value>0.05) and bias effects of publication (Egger test p-value>0.05) indicated that immediate assistance for victims is essential to prevent the onset of NCDs. Conclusion: Without early prevention and urban planning, the urban flood disaster can contribute to mental illness, heart problems, and respiratory problems.


cardiovascular disease;mental disorders;meta-analysis;non-communicable diseases;urban flood

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Alderman, K., Turner, L. R., & Tong, S. (2012). Floods and human health: a systematic review. Environment International, 47, 37–47.

Alderman, K., Turner, L. R., & Tong, S. (2013). Assessment of the health impacts of the 2011 summer floods in Brisbane. Disaster Medicine and Public Health Preparedness.

Amri MR, Yulianti G, Yunus R, Wiguna S, Adi AW, Ichwana AN, Randongkir RE, S. R. (2016). Risiko bencana indonesia. Badan Nas Penanggulangan Bencana Jakarta.

Ashraf S, Luqman M, Iftikhar M, Ashraf I, H. Z. (2017). Understanding Flood Risk Management in Asia: Concepts and Challenges. In: Flood Risk Management. InTech.

Below R, Wirtz A, G.-S. D. (2009). Disaster category classification and peril terminology for operational purposes.

Bich TH, Quang LN, Ha LTT, Hanh TTD, G.-S. D. (2011). Impacts of flood on health: epidemiologic evidence from Hanoi, Vietnam. Glob Health Action, 4, 6356.

Birkett MA. (2011). The Trier Social Stress Test protocol for inducing psychological stress. JoVE (Journal Vis Exp), (56), e3238.

Chen Y, Zhou H, Zhang H, Du G, Z. J. (2015). Urban flood risk warning under rapid urbanisation. Environ Res, 139, 3–10.

Cheng M, Wen S, jian Zhou H, Lian-fang B, Li J, X. L. (2013). Evaluation of headache and regional cerebral flood flow in patients with migraine. Clin Nucl Med, 38(11), 874–877.

Chung, M. C., Jalal, S., & Khan, N. U. (2014). Posttraumatic stress disorder and psychiatric comorbidity following the 2010 flood in Pakistan: Exposure characteristics, cognitive distortions, and emotional suppression. Psychiatry (New York).

Coughlin, S. S. (2011). Post-traumatic Stress Disorder and Cardiovascular Disease. The Open Cardiovascular Medicine Journal, 5, 164–170.

Dai W, Chen L, Tan H, Wang J, Lai Z, Kaminga AC, Li Y, L. A. (2016). Association between social support and recovery from post-traumatic stress disorder after flood: A 13-14 year follow-up study in Hunan, China Chronic Disease epidemiology. BMC Public Health, 16(1), 1–10.

Dai W, Kaminga AC, Tan H, Wang J, Lai Z, Wu X, L. A. (2017). Long-term psychological outcomes of flood survivors of hard-hit areas of the 1998 Dongting Lake flood in China: Prevalence and risk factors. PLoS One, 12(2), 1–14.

Dai, W., Wang, J., Kaminga, A. C., Chen, L., Tan, H., Lai, Z., … Liu, A. (2016). Predictors of recovery from post-traumatic stress disorder after the dongting lake flood in China: A 13-14 year follow-up study. BMC Psychiatry, 16(1), 1–10.

Doocy S, Daniels A, Murray S, K. T. (2013). The Human Impact of Floods: a Historical Review of Events 1980-2009 and Systematic Literature Review. PLoS Curr.

Eiffert, S., Noibi, Y., Vesper, S., Downs, J., Fulk, F., Wallace, J., … Winquist, A. (2016). A Citizen-Science Study Documents Environmental Exposures and Asthma Prevalence in Two Communities. Journal of Environmental and Public Health, 2016.

Equator Network. (2019). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Retrieved 17 July, 2020, from

Fernandez A, Black J, Jones M, Wilson L, Salvador-Carulla L, Astell-Burt T, B. D. (2015). Flooding and mental health: A systematic mapping review. PLoS One, 10(4), 1–20.

Fewtrell L, K. D. (2008). An attempt to quantify the health impacts of flooding in the UK using an urban case study. Public Health, 122(5), 446–451.

Fontalba-Navas, A., Lucas-Borja, M. E., Gil-Aguilar, V., Arrebola, J. P., Pena-Andreu, J. M., & Perez, J. (2017). Incidence and risk factors for post-traumatic stress disorder in a population affected by a severe flood. Public Health, 144, 96–102.

French, C. E., Waite, T. D., Armstrong, B., Rubin, G. J., Beck, C. R., & Oliver, I. (2019). Impact of repeat flooding on mental health and health-related quality of life: A cross-sectional analysis of the English National Study of Flooding and Health. BMJ Open.

Graham H, White P, Cotton J, M. S. (2019). Flood-and Weather-Damaged Homes and Mental Health: An Analysis Using England's Mental Health Survey. Int J Environ Res Public Health, 16(18), 2356.

Hanger S, Linnerooth-Bayer J, Surminski S, Nenciu-Posner C, Lorant A, Ionescu R, P. A. (2018). Insurance, Public Assistance, and Household Flood Risk Reduction: A Comparative Study of Austria, England, and Romania. Risk Anal, 38(4), 680–693.

Hu P, Zhang Q, Shi P, Chen B, F. J. (2018). Flood-induced mortality across the globe: Spatiotemporal pattern and influencing factors. Sci Total Environ, 647, 171–182.

Hu S, Tan H, Cofie R, Zhou J, Yang T, Tang X, L. A. (2015). Recovery from post-traumatic stress disorder after a flood in China: A 13-year follow-up and its prediction by degree of collective action. BMC Public Health.

Hu, S., Tan, H., Cofie, R., Zhou, J., Yang, T., Tang, X., & Liu, A. (2015). Recovery from post-traumatic stress disorder after a flood in China: A 13-year follow-up and its prediction by degree of collective action. BMC Public Health, 15(1), 1–7.

Huang P, Tan H, Liu A, Feng S, C. M. (2010). Prediction of posttraumatic stress disorder among adults in flood district. BMC Public Health, 10, 2–9.

Husky MM, Alvarez V, Tapia G, Oprescu F, Navarro-mateu F, Kovess-masfety V, Ea LDP, B. U. De. (2020). Mental disorders and medical conditions associated with causing injury or death : A population-based study. Psychiatry Res, 287 (June, 112899.

Jahan S. (2015). Assessment of flood-related mental illness in Bangladesh. Queensland University of Technology.

Jimenez, A. M., Collins, T. W., & Grineski, S. E. (2013). Intra-ethnic disparities in respiratory health problems among hispanic residents impacted by a flood. Journal of Asthma.

Kim Y Do, Tak YH, Park MH, K. B. (2020). Improvement of urban flood damage estimation using a high-resolution digital terrain. J Flood Risk Manag, 13(S1).

Laplante DP, Hart KJ, O'Hara MW, Brunet A, K. S. (2018). Prenatal maternal stress is associated with toddler cognitive functioning: The Iowa Flood Study. Early Hum Dev, 116 (Novem, 84–92.

Li X, Huang X, Tan H, Liu A, Zhou J, Y. T. (2010). A study on the relationship between posttraumatic stress disorder in flood victim parents and children in Hunan, China. Aust N Z J Psychiatry, 44(6), 543–550.

Lieberman-Cribbin W, Liu B, Schneider S, Schwartz R, T. E. (2017). Self-reported and FEMA flood exposure assessment after Hurricane Sandy: association with mental health outcomes. PLoS One, 12(1), e0170965.

Lieberman-Cribbin, W., Liu, B., Schneider, S., Schwartz, R., & Taioli, E. (2017). Self-reported and FEMA flood exposure assessment after Hurricane Sandy: association with mental health outcomes. PLoS One, 12(1), e0170965.

Lin, C. Y., Chen, T. C., Dai, C. Y., Yu, M. L., Lu, P. L., Yen, J. H., & Chen, Y. H. (2015). Serological investigation to identify risk factors for post-flood infectious diseases: A longitudinal survey among people displaced by Typhoon Morakot in Taiwan. BMJ Open.

Lowe D, Ebi KL, F. B. (2013). Factors increasing vulnerability to health effects before, during and after floods. Int J Environ Res Public Health, 10(12), 7015–7067.

Luu C, von Meding J, M. M. (2019). Analysing Vietnam's national disaster loss database for flood risk assessment using multiple linear regression-TOPSIS. Int J Disaster Risk Reduct, 40 (March), 101153.

Maclean, J. C., Popovici, I., & French, M. T. (2016). Are natural disasters in early childhood associated with mental health and substance use disorders as an adult? Social Science and Medicine, 151(2016), 78–91.

Martin, N. C., Felton, J. W., & Cole, D. A. (2016). Predictors of Youths' Posttraumatic Stress Symptoms Following a Natural Disaster: The 2010 Nashville, Tennessee, Flood. Journal of Clinical Child and Adolescent Psychology.

Matsubara, C., Murakami, H., Imai, K., Mizoue, T., Akashi, H., Miyoshi, C., & Nakasa, T. (2016). Prevalence and Risk Factors for Post-Traumatic Stress Reaction among Resident Survivors of the Tsunami That Followed the Great East Japan Earthquake, 11 March, 2011. Disaster Medicine and Public Health Preparedness.

Mazzoleni, M., Bacchi, B., Barontini, S., Di Baldassarre, G., Pilotti, M., & Ranzi, R. (2014). Flooding hazard mapping in floodplain areas affected by piping breaches in the Po River, Italy. Journal of Hydrologic Engineering, 19(4), 717–731.

McCallum, I., Liu, W., See, L., Mechler, R., Keating, A., Hochrainer-Stigler, S., … Moorthy, I. (2016). Technologies to Support Community Flood Disaster Risk Reduction. International Journal of Disaster Risk Science, 7(2), 198–204.

McLean, M. A., Cobham, V. E., Simcock, G., Kildea, S., & King, S. (2019). Toddler temperament mediates the effect of prenatal maternal stress on childhood anxiety symptomatology: The QF2011 Queensland flood study. International Journal of Environmental Research and Public Health.

Miller JD, H. M. (2017). The impacts of urbanisation and climate change on urban flooding and urban water quality: A review of the evidence concerning the United Kingdom. J Hydrol Reg Stud, 12, 345–362.

Mordeno, I. G., & Cue, M. P. (2015). Examining the Latent Structure of Acute Stress Disorder Symptoms in Filipino-Victims of a Flashflood Disaster. Community Mental Health Journal, 51(5), 613–620.

Mulchandani, R., Smith, M., Armstrong, B., Beck, C. R., Oliver, I., Davidwaite, T., … James Rubin, G. (2019). Effect of insurance-related factors on the association between flooding and mental health outcomes. International Journal of Environmental Research and Public Health.

Munro, A., Kovats, R. S., Rubin, G. J., Waite, T. D., Bone, A., Armstrong, B., … Oliver, I. (2017). Effect of evacuation and displacement on the association between flooding and mental health outcomes: a cross-sectional analysis of UK survey data. The Lancet Planetary Health, 1(4), e134–e141.

Mustafa A, Bruwier M, Archambeau P, Erpicum S, Pirotton M, Dewals B, T. J. (2018). Effects of spatial planning on future flood risks in urban environments. J Environ Manage, 225, 193–204.

Nagayoshi Y, Yumoto S, Sakaguchi K, Shudo C, Takino S, Hashiyama M, Kai Y, Kuroda Y, Kawano H, O. H. (2015). Heart attacks triggered by huge mudslides in mountain regions and severe flooding in inhabited areas. J Cardiol, 65(2), 117–120.

Nakamura, M., Tanaka, F., Nakajima, S., Honma, M., Sakai, T., Kawakami, M., … Makita, S. (2012). Comparison of the incidence of acute decompensated heart failure before and after the major tsunami in northeast Japan. American Journal of Cardiology.

Natgeo. (2018). Urban Area. Retrieved 1 April 2018, from

O'Donovan A, Hughes BM, Slavich GM, Lynch L, Cronin M-T, O'Farrelly C, M. K. (2010). Clinical anxiety, cortisol and interleukin-6: Evidence for specificity in emotion– biology relationships. Brain Behav Immun, 24(7), 1074–1077.

Ohl CA, T. S. (2000). Flooding and human health. BMJ, 321(7270), 1167–1168.

Othman, A. Z., Dahlan, A., Borhani, S. N., & Rusdi, H. (2016). Posttraumatic Stress Disorder and Quality of Life among Flood Disaster Victims. Procedia - Social and Behavioral Sciences, 234, 125–134.

Paterson DL, Wright H, H. P. (2018). Health Risks of Flood Disasters. Clin Infect Dis, 67(9), 1450–1454.

Pattison I, L. S. (2012). The link between land-use management and fluvial flood risk: A chaotic conception? Prog Phys Geogr, 36(1), 72–92.

Poku-boansi M, Amoako C, Owusu-ansah JK, B. P. (2020). What the state does but fails : Exploring smart options for urban flood risk management in informal Accra, Ghana. City Environ Interact, 5, 100038.

Puechlong, C., Weiss, K., Le Vigouroux, S., & Charbonnier, E. (2020). Role of personality traits and cognitive emotion regulation strategies in symptoms of post-traumatic stress disorder among flood victims. International Journal of Disaster Risk Reduction, 50, 101688.

Reifels, L., Bassilios, B., Spittal, M. J., King, K., Fletcher, J., & Pirkis, J. (2015). Patterns and predictors of primary mental health service use following bushfire and flood disasters. Disaster Medicine and Public Health Preparedness, 9(3), 275–282.

Rossati A. (2017). Global Warming and Its Health Impact. Int J Occup Environ Med, 8(1), 7–20.

Ryan B, Franklin RC, Burkle FM, Aitken P, Smith E, Watt K, L. P. (2015). Identifying and Describing the Impact of Cyclone, Storm, and Flood Related Disasters on Treatment Management, Care and Exacerbations of Non-communicable Diseases and the Implications for Public Health. PLoS Curr.

Ryan BJ, Franklin RC, Burkle FM, Smith EC, Aitken P, L. P. (2019). Determining key influences on patient ability to successfully manage non-communicable disease after natural disaster. Prehosp Disaster Med, 43(3), 241–250.

Satoh J, Yokono K, Ando R, Asakura T, Hanzawa K, Ishigaki Y, Kadowaki T, Kasuga M, Katagiri H, K. (2019). Diabetes care providers’ manual for disaster diabetes care. Diabetol Int, 10(3), 153–179.

Saulnier DD, Brolin Ribacke K, von S. J. (2017). No Calm After the Storm: A Systematic Review of Human Health Following Flood and Storm Disasters. Prehosp Disaster Med, 32(5), 568–579.

Saulnier DD, Hanson C, Ir P, Mölsted Alvesson H, von S. J. (2018). The Effect of Seasonal Floods on Health: Analysis of Six Years of National Health Data and Flood Maps. Int J Environ Res Public Health, 15(4).

Shao W, Xian S, Lin N, S. M. (2017). A sequential model to link contextual risk, perception and public support for flood adaptation policy. Water Res, 122, 216–225.

Sofia, G., Roder, G., Dalla Fontana, G., & Tarolli, P. (2017). Flood dynamics in urbanised landscapes: 100 years of climate and humans' interaction. Scientific Reports, 7, 40527.

Stanaway JD, Afshin A, Gakidou E, Lim SS, Abate D, Abate KH, Abbafati C, Abbasi N, … Murray CJL. (2018). Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Stu. Lancet, 392(10159), 1923–1994.

van den Bosch, M., & Sang, Å. O. (2017). Urban natural environments as nature-based solutions for improved public health–A systematic review of reviews. Environmental Research, 158, 373–384.

Van Voorst, R. (2016). Formal and informal flood governance in Jakarta, Indonesia. Habitat International, 52, 5–10.

Vanasse, A., Cohen, A., Courteau, J., Bergeron, P., Dault, R., Gosselin, P., … Chebana, F. (2016). Association between floods and acute cardiovascular diseases: A population-based cohort study using a geographic information system approach. International Journal of Environmental Research and Public Health, 13(2), 1–12.

Waite, T. D., Chaintarli, K., Beck, C. R., Bone, A., Amlôt, R., Kovats, S., … Oliver, I. (2017). The English national cohort study of flooding and health: cross-sectional analysis of mental health outcomes at year one. BMC Public Health.

Walker JT. (2018). The influence of climate change on waterborne disease and Legionella: a review. Perspect Public Health, 138(5), 282–286.

Wei, Q., Zhang, X., Yi, W., Pan, R., Gao, J., Duan, J., … Su, H. (2020). Association between floods and hospital admissions for schizophrenia in Hefei, China: The lag effects of degrees of floods and time variation. Science of the Total Environment, 698, 134179.

Weiss K. (2020). Role of personality traits and cognitive emotion regulation strategies in symptoms of post-traumatic stress disorder among flood victims. Int J Disaster Risk Reduct, 101688.

Wesli W, Sirojuzilam S, Matondang AR, L. S. (2013). The Effect of Land Use and Community Participation on Flood Control at North Aceh District. Indones J Geogr, 45(2), 171–186.

WHO. (2011). The Worldwide Rise of Chronic Noncommunicable Diseases: A Slow-Motion Catastrophe.

Wing OEJ, Bates PD, Smith AM, Sampson CC, Johnson KA, Fargione J, M. P. (2018). Estimates of present and future flood risk in the conterminous United States. Environ Res Lett, 13(3), 34023.

Wolfram F, L. T. (2019). A simulation study of the HIFU ablation process on lung Tumours, showing consequences of atypical acoustic properties in flooded lungs. Z Med Phys, 29(1), 49–58.

Yoda, T., Yokoyama, K., Suzuki, H., & Hirao, T. (2017). Relationship Between Long-term Flooding and Serious Mental Illness After the 2011 Flood in Thailand. Disaster Medicine and Public Health Preparedness, 11(3), 300–304.

Zeligman, M., McElroy-Heltzel, S. E., Davis, E. B., Dispenza, F., Davis, D. E., & DeBlaere, C. (2019). Posttraumatic Growth and Trauma in Flood Survivors: Contributions of Attitudes Toward God. Journal of Mental Health Counseling.


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