A Geospatial Analysis of Contributors to Flood Health Behaviors Among Midwest Residents

Inland flooding poses significant acute and longer-term health risks, but many individuals living in or near floodplains may be unaware of their danger. Major flooding occurred in the Midwest USA during 2019. Our objective was to assess inland flood-related risk reduction behaviors and preparedness in flood-prone communities to inform risk communication and flood education interventions. We mailed a survey to residential addresses in the floodplains of Iowa and Nebraska in 2022 to assess flood knowledge, awareness, and risk reduction behaviors (such as having a flood plan). The 258 survey responses were linked to area-level Social Vulnerability Index (2020) and flood hazard maps to assess whether flood awareness and reduction behaviors were associated with risk. None of the examined factors explained flood-related behaviors well, although area-level race variables and distance from a major city were statistically significant (p<.05) for overall flood-related behavior. More targeted approaches may be warranted.