HIA reveals how prolonged flooding creates unequal health and socioeconomic burdens and can inform more equitable, health-sensitive flood risk management and community resilience.
Flood retention protects downstream urban and economic areas, but its consequences for people living in retention zones are rarely considered in water-management decisions. We conducted a mixed-methods Health Impact Assessment in seven flood retention areas in Phra Nakhon Si Ayutthaya Province, Thailand. Household survey findings were interpreted together with the experiences of community members and relevant stakeholders. The 2024 flood remained in the study areas for 61 days and reached a maximum depth of 2 m. Prolonged inundation affected daily life as well as health: 62% of respondents had difficulty obtaining health services, 59.44% reported severe stress, and 55.15% reported lost income or employment. The results also revealed a strong sense of unfairness. Most respondents (93.87%) considered the current system unfair, 82.73% understood that their communities were expected to retain more water than other areas, and 79.39% regarded compensation as inadequate or delayed. Flooding alone therefore gives an incomplete account of local impacts. Decisions also need to consider how long water remains, the accumulation of health and livelihood losses, and who carries the cost of protecting other areas. Incorporating HIA into flood planning would provide a practical basis for health monitoring, community participation, timely compensation, and a fairer sharing of responsibility. These measures are necessary if flood management is to contribute to, rather than weaken, community resilience.
Sirima Mongkolsomlit is a public health academic and researcher from Thammasat University in Thailand, specializing in epidemiology, health impact assessment, evaluation and health policy.