A systematic review of human behaviour in and around floodwater

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Abstract

Flooding can have a major impact on people's safety and livelihood. Understanding people's flood-related behaviours may assist in the development of more effective strategies aimed at lessening the impact of floods including mortality and morbidity. This systematic review examined peer-reviewed literature published from January-1989 to April-2019 on human behaviour in and around floodwater to identify behaviour patterns as well as protective and risk factors. We extracted three main themes from a thematic analysis of included studies (N = 54): activities and risk-taking behaviours (n = 24); loss reduction, knowledge, and warnings (n = 37); and diet and hygiene (n = 4). This review had limitations which prevented definitive conclusions being made. What does seem apparent is the limited knowledge of the social psychological mechanisms that guide behavioural responses in a flood event. Further exploration of methods to improve preparedness, increase the likelihood of evacuation, and reduce ‘risky’ behaviour during floods is needed. Future studies should prioritise addressing these gaps to enhance the evidence-base for reducing the impact of floods including flood-related mortality and morbidity.

Introduction

Globally, flooding is one of the most common natural disasters [1] and drowning is thought to be a leading cause of death during times of flood [2]. The World Health Organization (WHO) estimates between 1980 and 2009, floods have claimed the lives of over 500,000 people around the world [3]. Reports into causes of death due to interacting with floodwaters have identified several factors impacting drowning risk during times of flood including accidental falls into water, being swept away by floodwater due to a lack of early warning or evacuation procedures, or deliberately entering floodwaters to recreate [4,5]. Driving into floodwaters is a leading activity immediately prior to flood-related drowning, a fact that has been highlighted in a number of countries [[5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20]].

There are also other behaviours that may increase risk of mortality or morbidity during times of flood including living on floodplains or near waterbodies prone to flooding [21,22] as well as the behaviour in the lead up and immediately after a flood that can impact health and safety such as refusal to evacuate [23,24] and flood-related infection and disease [25,26]. These cascading crises [27,28,29] after a flood event can have wide-ranging implications on flood preparedness, mitigation, and response, and point to the need for a better understanding of human behaviour during times of flood. This knowledge can help to inform strategies to improve behaviour and reduce flood-related mortality and morbidity as well as flood-related losses to property and livelihoods.

Human behaviour is vulnerable to crises and disasters and, as a consequence, such events bring about challenges for prevention efforts. Flood events can be considered a natural disaster [30] which can develop into a crisis – “a situation in which important decisions involving threat and opportunity have to be made in a particular short time” ([31]; p. 24). For a reconceptualizing of the story of disaster and the term ‘natural disaster’ in terms of present-day trends and tendencies, see works of Alexander [32] and Blaikie et al. [33]. Effective management of human behaviour in crises and disasters is important to reduce negative impacts and save lives. Ritchie [34,35] considered three steps in the process of effective crisis and disaster management: (1) planning and preparedness activities before a crisis or disaster; (2) response to, or management of, a crisis or disaster as it occurs; and, (3) final resolution to a new or improved state after the crisis or disaster is over. This paper focuses on the second step, specifically focussing on understanding human behavioural responses as they occur in a flood event.

Although not all flood-related deaths and injuries are preventable (e.g., when individuals are unexpectedly inundated with water leaving no time to make decisions), where decision making is possible, individuals' behavioural responses in and around floodwater during a flood event may help to prevent flood-related incidents [13,14,36]. Therefore, understanding human behaviour in and around floodwater is needed to help inform effective prevention strategies. This is because decisions informing people's behavioural responses in floods are likely to be psychological in nature, involving a range of social and motivational factors [[12], [13], [14],36]. Once safety compromising behaviours in and around floodwaters can be identified, investigations into the mechanisms that guide these risky acts can be elucidated and interventions developed.

With extreme weather events predicted to result in increased frequency and severity of flooding over the coming decades as a consequence of global climate change [1,37,38], there is a need for more effective prevention strategies to prevent flood-related loss of life. Given that many fatalities in floodwaters are associated with behaviours that put one at risk (e.g., driving into floodwater, recreating in floodwater), and that deaths can be minimized through adoption of safety behaviours, identification of the social, environmental, and psychological factors that determine these behaviours is essential to inform the development of behavioural interventions and policy aimed at minimizing risk and reducing flood-related incidents.

In scoping the literature, it seems apparent that various factors may influence flood-related behaviours including intrapersonal variables such as demographics (e.g., gender, age) [19,39] and psychological factors such as attitudes and beliefs [40,41]; interpersonal variables (e.g., social support, social norms) [42]; and physical environmental variables such as flooded roads [6] or the more general characteristics of a flood such as velocity or ‘suddenness’ [43]. Integrating these various factors into a theoretical framework is the basis for an ecological model of behaviour. Ecological models of behaviour target multiple levels of influence; thus, individual, as well as social and physical environmental influences, are deemed to influence individual behaviour and are likely to interact to promote or hinder behavioural performance [[44], [45], [46]]. Working within an ecological model requires the inclusion of all these levels of influence and is proposed to be what distinguishes potential contributions of ecological models from that of other intrapersonal and interpersonal theories [45]. The current study, therefore, adopts an ecological model of behaviour to better understand human behaviour during times of flood.

The overarching aim of this systematic review is to summarise the current literature regarding human behaviour in and around floodwater to identify behaviour patterns as well as protective and risk factors, to guide prevention. This study used the definitions adopted by Jonkman and Kelman [47]; namely that a flood is defined as the presence of water in areas that are usually dry. This includes both the flood characteristics of flash flooding and slow-onset flooding [5]. In the following sections of the review, the methodological approach is outlined, including the selection criteria, search strategy, and inclusion/exclusion process. The results section outlines key findings from the included studies, organised under the following sections: activities and risk-taking behaviours; loss reduction, knowledge, and warnings; and, diet and hygiene. The discussion outlines gaps in the published literature across the same sections and highlights opportunities for further research to advance understanding of flood-related human behaviour and minimise loss of life and injury due to flooding. This review builds upon the findings of Becker et al.'s [48] review of people's behaviour in and around floodwaters by taking a theoretical approach based on an ecological model of behaviour to improve understanding of human behaviour during times of flood, and updating the literature to April 2019 using a systematic review approach.

Section snippets

Method

The current review adopted published guidelines for narrative reviews [49,50]. A PRISMA checklist is provided as supplementary material (see Supplement 1).

Description of included studies

A total of 54 studies were included. Table 1 provides an overview of study characteristics. Most studies (n = 19) were from Asia, followed by Australia (n = 15), Europe (n = 9), the United States (n = 7), and Africa (n = 3) with one study examining the United States and Europe. Most studies used surveys (n = 21) or databases (n = 14) for data collection, followed by qualitative interviews (n = 8); the remaining 10 studies used multiple data collection methods. The majority of studies (n = 37)

Discussion

Globally, flooding is a common natural disaster, with drowning thought to be a leading cause of death. As much flood-related mortality and morbidity is preventable and often the result of individuals' behavioural responses in the flood event, gaining a better understanding of people's flood-related behaviour is important so that prevention strategies can target these behaviours and the underpinning mechanisms that guide these risky acts [93]. This is also true of the after-effects of flooding,

Conclusion

This systematic review identified a range of human behaviours in and around floodwater during a flood event, with common themes being activities and risk-taking behaviours; loss reduction, knowledge, and warnings; and diet and hygiene. This review also had limitations which prevented definitive conclusions being made. What does seem apparent is the limited knowledge of the social psychological mechanisms that guide behavioural responses in a flood event. This knowledge is important to gain

Declaration of competing interest

Authors KH, DD, and MH declare that they have no conflict of interest. Author AP is a honorary senior research fellow of the Royal Life Saving Society – Australia and employed by the University New South Wales, Sydney, Australia. Data analysis and interpretation of findings is conducted independent of author AP and Royal Life Saving Society – Australia. The contribution of author MH is supported by a Finland Distinguished Professor (FiDiPro) award (Dnro 1801/31/2105) from Business Finland. The

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