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Objectives. To understand changes in behavioral health services utilization and expenditures before and after natural disaster with an adult Medicaid population affected by the Baton Rouge, Louisiana–area flood (August 2016). Methods. We examined de-identified behavioral health claims data for Medicaid-insured adults in the affected region for 10 months before and after flooding (October 2015–June 2017). This constituted 273 233 provider claims for 22 196 individuals. Claims data included patient gender, behavioral health diagnoses, treatment dates, and costs. We made adjustments for Medicaid expansion by using monthly enrollment data. Results. Overall, most male patient behavioral health care visits were for substance use disorders (33.6%) and most female patient behavioral health care visits were for depression-related disorders (30%). Both diagnostic categories increased after the flood by 66% and 44%, respectively. Expansion accounted for a 4% increase in claims. Postflood claims reflected 8% to 10% higher costs. Conclusions. Greater amounts of behavioral health care services were sought in all 10 months of the postflood study period. We observed gender differences in use of services and diagnoses. Behavioral health care services following natural disasters must be extended longer than traditionally expected, with consideration for specific population needs.

Abstract There has been a growing interest in understanding whether and how people adapt to extreme weather events in a changing climate. This article presents one of the first empirical analyses of adaptation to flooding on a global scale. Using a sample of 97 countries between 1985 and 2010, we investigate the extent and pattern of flood adaptation by estimating the effects of a country's climatological risk, recent flood experiences, and socioeconomic characteristics on its flood‐related fatalities. Our results provide mixed evidence on adaptation: countries facing greater long‐term climatological flooding risks do not necessarily adapt better and suffer fewer fatalities; however, after controlling for the cross‐country heterogeneity, we find that more recent flooding shocks have a significant and negative effect on fatalities from subsequent floods. These findings may suggest the short‐term learning dynamics of adaptation and potential inefficacy of earlier flood control measures, particularly those that promote increased exposure in floodplains. Our findings provide important implications for climate adaptation policy making and climate modeling.

<p>Devastating floods in southeast Queensland in 2011 were the combination of flash flooding in the Lockyer Valley with riverine flooding in the Brisbane metropolitan area. While there is considerable information about the immediate impact on those affected, there is less understanding of the long-term health effects that follow such events. This study explored the perceptions of health effects and support received by people affected by the 2011 southeast Queensland flood six years after the event. A cross-sectional survey of 327 people was conducted in areas affected by the floods. The questionnaire sought information about the ongoing social, economic, demographic and self-declared physical and mental health effects. The data were analysed through comparison of those unaffected with those directly affected by the floods. Residents whose households were flooded were more likely to score their health negatively than non-affected residents and had higher reported rates of trauma, injury and mental illness. Twenty-six per cent of this group reported that they still experience some adverse health effects from the floods. Managing the long-term health implications of a flood-affected population is an important public policy task. Dissatisfaction with recovery operations and perceived injustices associated with insurance and compensation arrangements may aggravate health consequences. Early recognition and intervention may assist with reducing secondary effects.</p>

This study discusses the flooding related consequences of climate change on most populous Canadian cities and flow regulation infrastructure (FRI). The discussion is based on the aggregated results of historical and projected future flooding frequencies and flood timing as generated by Canada-wide hydrodynamic modelling in a previous study. Impact assessment on 100 most populous Canadian cities indicate that future flooding frequencies in some of the most populous cities such as Toronto and Montreal can be expected to increase from 100 (250) years to 15 (22) years by the end of the 21st century making these cities highest at risk to projected changes in flooding frequencies as a consequence of climate change. Overall 40–60% of the analyzed cities are found to be associated with future increases in flooding frequencies and associated increases in flood hazard and flood risk. The flooding related impacts of climate change on 1072 FRIs located across Canada are assessed both in terms of projected changes in future flooding frequencies and changes in flood timings. Results suggest that 40–50% of the FRIs especially those located in southern Ontario, western coastal regions, and northern regions of Canada can be expected to experience future increases in flooding frequencies. FRIs located in many of these regions are also projected to experience future changes in flood timing underlining that operating rules for those FRIs may need to be reassessed to make them resilient to changing climate.

Objectives. To assess the environmental justice implications of flooding from Hurricane Harvey in Greater Houston, Texas, we analyzed whether the areal extent of flooding was distributed inequitably with respect to race, ethnicity, and socioeconomic status, after controlling for relevant explanatory factors.Methods. Our study integrated cartographic information from Harvey’s Inundation Footprint, developed by the US Federal Emergency Management Agency, with sociodemographic data from the 2012–2016 American Community Survey. Statistical analyses were based on bivariate correlations and multivariate generalized estimating equations.Results. The areal extent of Harvey-induced flooding was significantly greater in neighborhoods with a higher proportion of non-Hispanic Black and socioeconomically deprived residents after we controlled for contextual factors and clustering.Conclusions. Results provide evidence of racial/ethnic and socioeconomic injustices in the distribution of flooding and represent an importa...

La gestion intégrée des risques d’inondation (GIRI) fait appel à la coordination de tous les niveaux et secteurs du gouvernement et de la société civile. Afin de favoriser la responsabilisation et l’appropriation des plans de GIRI par les communautés, l’implication des acteurs non gouvernementaux et des citoyens est de plus en plus valorisée. D’abord, l’émergence des approches participatives est exacerbée par l’optimisme face à la possibilité d’améliorer substantiellement la qualité et la portée des décisions, de gérer les conflits, de faciliter l'implantation des mesures non structurelles et de renforcer les capacités sociales au sein des communautés. Toutefois, certains avancent que l'intégration des non-experts dans le processus décisionnel brime l'impartialité de la procédure technocratique et que leur manque d’intérêt et de compétences limite la portée des démarches participatives. Des lacunes dans la représentativité des parties prenantes affectées et concernées au sein des instances peuvent aussi biaiser les aboutissants de la participation. De plus, la réticence des autorités à partager le pouvoir décisionnel limite l’institutionnalisation des approches participatives, tandis que la rigidité de l’appareil gouvernemental freine les élans participatifs des collectivités. Considérant l’intérêt grandissant des chercheurs, des décideurs et de la société civile envers les approches participatives dans le contexte de la gestion des inondations, cet article propose une synthèse de la littérature pour démêler les principales retombées et les limites de la participation. , In order to promote community accountability for flood risks, the involvement of non-governmental actors and citizens is increasingly valued. The emergence of participatory approaches is consolidated by optimism about the possibility of improving the quality and scope of decisions, managing conflicts, facilitating the implementation of non-structural measures and strengthening social capacity within communities. However, some argue that the integration of non-experts undermines the impartiality of the decision-making process and that their lack of interest and expertise limits the scope of participatory approaches. Moreover, the authorities’ reluctance to share decision-making power limits the institutionalization of participatory approaches, whereas the rigidity of the governmental framework hampers participatory impulses within communities. Lack of stakeholder representativeness within the decision-making framework may also bias the outcome of participation. In addition, the reluctance of the authorities to share decision-making power limits the institutionalization of participatory approaches, while the rigidity of the government apparatus hinders the participatory momentum of communities. Considering the growing interest of researchers, policymakers and civil society in participatory approaches in the context of flood management, this article provides a synthesis of the literature to unravel the major benefits and limitations of participation.