Physical and mental health after the Valencia cold drop: health challenges for population recovery

Abstract

Floods are associated with severe physical and mental health consequences for affected populations, and these psychological effects may persist for months or even years, driven by personal loss, reconstruction delays, financial insecurity, and social disruption. On 29 October 2024, a DANA triggered catastrophic flooding in Valencia region, affecting over 500,000 people and causing 220 deaths. A mixed methods study was conducted, comprising a cross-sectional survey with 1,007 affected individuals and 6 focus groups discussion, and 5 in-depth interviews (45 participants in total). Only 47% of survey participants reported good well-being (WHO-5 Index >50). 48% reported worse mental health and 28% poorer physical health than before DANA. 42% of respondents reported at least one DANA-related health diagnoses, such as anxiety (57%), depression (34%) and gastrointestinal infections (29%). Concern about future disasters was high; 72% were worried whenever it rains and 79% reported low resilience. Qualitative data suggest new drivers of persistent mental and physical health impacts, particularly a profound sense of institutional abandonment. Participants reported overwhelmed health services, limited access to psychological care, and a high perception of environmental health risks linked to damp housing, residual mud and sediment, and airborne dust, which they associated with respiratory, dermatological, and allergic conditions. However, Public Health authorities reported that no major health risks or outbreaks have been identified in the affected area six months after the DANA, despite these latent risks. This mismatch in risk perception represents a significant challenge for public health management. Addressing this gap would help communities reduce their sense of uncertainty and abandonment. Behavioral sciences would help to design preparedness plans including ongoing, accessible, tailored health and mental health support based on the identified context-specific drivers.