REGIONAL INSTITUTE FOR POPULATION STUDIES 

UNIVERSITY OF GHANA 

 

 

 

 
HOUSEHOLD EXPERIENCE OF FLOOD AND ITS EFFECT ON ANXIETY: INVESTIGATING THE 

MEDIATING ROLE OF PLACE ATTACHMENT AND PERCEIVED SAFETY IN TOTOPE AND KETA 

 

 
BY 

 

 
 

MARTIN M. K. AGBODZI 

 
(10938870) 

 

 
 

THIS DISSERATION IS SUBMITTED TO THE UNIVERSITY OF GHANA, 

LEGON IN PARTIAL FULFILLMENT OF THE PREREQUISITES FOR THE 

AWARD OF THE MA POPULATION STUDIES DEGREE. 

 

 

 

 

 
 

APRIL 2023 

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DECLARATION 

 

I, MARTIN MAWUTOR KWABLAH AGBODZI, hereby declare that this is the outcome of my 

research and has not been submitted in whole or in part for another degree, except references to 

other people's work that have been properly acknowledged. 

 

 

  27/04/2023  

AGBODZI MARTIN MAWUTOR KWABLAH DATE 

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ii  

ACCEPTANCE 

 
This dissertation is accepted by the College of Humanities, University of Ghana, Legon, in 

fulfilment of the requirement for the award of an M.A. Population Studies degree. 

 

 

  27/04/2023 
 

DR. MUMUNI ABU DATE 

(SUPERVISOR) 

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iii  

DEDICATION 

 
I dedicate this dissertation firstly to Elohim. Whose mercies and 

boundless grace saw me through this journey. I also dedicate this work 

to my wife who has been my motivation for this study, and my 

parents, siblings, and friends who have been very supportive 

throughout this study. May the good Lord continue to bless you all. 

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iv  

ACKNOWLEDGEMENT 

 
First gratitude goes to my Father in Heaven for His abundant, grace, love, and mercy that kept me 

going and most importantly for the wisdom and knowledge He has blessed me with. 

My sincerest gratitude to my supervisor Dr. Mumuni Abu, for his assistance and belief in me that 

I could do this even when it seemed like I was at a dead end. Thank you for encouraging me to 

enrol in the RIPS MA program. God bless you immensely. 

To the RIPS faculty, a big thank you for your support and guidance throughout the program. 

Special gratitude to Charles Asabere, who encouraged me to take on this challenge and was always 

ready to assist me anytime I called on him. God bless you immensely. 

To my beautiful and loving wife, Ing. Bernadette Dzifa Agbefu, for your prayers, motivation, and 

support. Your support from the very day I applied for the program is very much appreciated. To 

my father, Mr. Andrew Bernhardt Agbodzi, my mother Mrs. Mary Agbodzi, my brother Nathaneal 

Agbodzi and my sister Veronica Agbodzi, thank you for your prayers and support. To my mother-

in-law, Miss Emelia Mensah, thank you for your prayers and support throughout this program. 

Sincerest gratitude also to Pastor Elorm Dartey who assured me it was a great time to pursue my 

master’s and Mr Hiram Anane, a dependable friend. To my colleagues at Dataplas Limited, thank 

you for your support. Also, to Dr. Kwabina Ibrahim of the Department of Earth Science, thank you 

for always being there to offer advice and support. 

Finally, to the entire 2021/2022 MA cohort. Thank you for your friendship. May God in his infinite 

mercy continue to bless us all. 

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ABSTRACT 

 
Natural disasters, especially flooding, could and often do affect different populations, but a portion 

of those affected typically experience clinically significant stress and anxiety symptoms, which 

may necessitate the assistance of mental health professionals. The recent trend of global flooding, 

mostly driven by climate-related issues, will exacerbate the mental health issues associated with 

flooding. This study examined how place attachment and perceived safety mediate the relationship 

between flooding and anxiety. Using the Evaluating Health Impact of Climate Adaptation 

Strategies (EHICAS) Data, collected by the Regional Institute for Population Studies, University 

of Ghana in 2021, the study employed a quantitative approach to understand the relationship 

between experience of flood and anxiety disorders in selected flood-prone coastal communities in 

Ghana. The results showed that a quarter of the respondents did not experience any anxiety as a 

result of the flood experience, while three-quarters of the respondents suffered some anxiety. From 

the results, 47.5% of the respondents did not feel safe in their communities, while 31.5% felt safe. 

The remaining respondents were indifferent about their perception of safety in the community. The 

results further showed that 63% of the respondents were indifferent about their attachment to their 

communities, while 21% showed they were attached to their communities and 16% showed they 

had no attachments. The final model of the study showed that people who experience flood do not 

necessarily experience anxiety but their perception of safety was a more significant predictor of an 

individual’s experience of anxiety. Some other significant predictors of anxiety are income and 

household tenure. The study recommends that measures be in place to meet the psychological 

needs of flood victims. Collaborating with mental health professionals, educating the populace on 

the psychological impacts of floods and involving the community in supporting flood victims are 

some of the measures that can be put in place. 

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TABLE OF CONTENT 

DECLARATION ........................................................................................................................................... i 

ACCEPTANCE ............................................................................................................................................ ii 

DEDICATION ............................................................................................................................................. iii 

ACKNOWLEDGEMENT ........................................................................................................................... iv 

ABSTRACT .................................................................................................................................................. v 

Table of contents .......................................................................................................................................... vi 

List of tables ................................................................................................................................................. ix 

List of figures ................................................................................................................................................ x 

CHAPTER ONE ........................................................................................................................................... 1 

Background ................................................................................................................................................... 1 

1.1 Introduction ......................................................................................................................................... 1 

1.2 Statement of the Problem .................................................................................................................... 4 

1.3 Research Question .............................................................................................................................. 6 

1.4 Research Objectives ............................................................................................................................ 6 

1.5 Rationale ............................................................................................................................................. 6 

CHAPTER TWO .......................................................................................................................................... 8 

LITERATURE REVIEW ............................................................................................................................. 8 

2.1 Introduction ................................................................................................................................... 8 

2.2 Floods ............................................................................................................................................ 8 

2.2.1 Concept of Floods ..................................................................................................................... 8 

2.2.2 Causes of Floods ....................................................................................................................... 9 

2.2.3 Risk and Effects of Floods ........................................................................................................ 9 

2.2.4 Illnesses Associated with Floods and Water Damage ......................................................... 11 

2.2.5 Pathogens in Flood Water ....................................................................................................... 12 

2.2.6 The African Experience of Floods .......................................................................................... 13 

2.3 Anxiety ........................................................................................................................................ 17 

2.3.1 Concept and Definition of Anxiety ......................................................................................... 17 

2.3.2 Types of Anxiety ..................................................................................................................... 18 

2.3.3 Effects of Anxiety ................................................................................................................... 21 

2.4 Place Attachment ........................................................................................................................ 22 

2.4.1 Concept and Definition of Place Attachment...................................................................... 22 

2.4.2 Factors Influencing Place Attachment .................................................................................... 24 

2.4.3 Importance of Place Attachment ............................................................................................. 25 

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2.5 Perceived Safety .......................................................................................................................... 27 

2.5.1 Concept of Perceived Safety ................................................................................................... 27 

2.5.2 The Safety System .............................................................................................................. 28 

2.6 Relationship between flood, anxiety, place attachment and perceived safety ............................. 28 

2.7 Theoretical Framework ..................................................................................................................... 32 

2.8 Conceptual Framework ..................................................................................................................... 34 

CHAPTER THREE .................................................................................................................................... 35 

METHODOLOGY ..................................................................................................................................... 35 

3.1 Introduction ....................................................................................................................................... 35 

3.2 Study Area ........................................................................................................................................ 35 

3.2 Data Source ....................................................................................................................................... 37 

3.3 Sample Design and Selection ............................................................................................................ 37 

3.5 Variables ........................................................................................................................................... 38 

3.5.1 Dependent Variable ....................................................................................................................... 38 

3.5.2 Independent Variables ................................................................................................................... 39 

3.5.3 Mediating Variables ....................................................................................................................... 40 

3.6 Method of Analysis ........................................................................................................................... 41 

CHAPTER FOUR ....................................................................................................................................... 44 

UNIVARIATE AND BIVARIATE ANALYSIS ....................................................................................... 44 

4.1 Introduction ....................................................................................................................................... 44 

4.2.1 Experience of Anxiety among Respondents .............................................................................. 44 

4.2.2 Flood Experience of Respondents .............................................................................................. 45 

4.2.3 Percentage distribution of perceived safety of respondents ....................................................... 45 

4.2.4 Sense of Place Attachment of Respondents ............................................................................... 46 

4.2.5 Perception of trust in Flood Management Authorities by Respondents ..................................... 47 

4.2.6 Age of Respondents ................................................................................................................... 48 

4.2.7 Sex of Respondents .................................................................................................................... 49 

4.2.8 Marital Status of Respondents ................................................................................................... 49 

4.2.9 Educational Level of Respondents ............................................................................................. 50 

4.2.10 Household Tenure Type of Respondents ................................................................................. 51 

4.3 Relationship between individual and household characteristics of respondent and experience of 

anxiety. .................................................................................................................................................... 53 

4.3.1 Age of respondents and experience of anxiety ........................................................................... 53 

4.3.4 Educational level and experience of anxiety .............................................................................. 55 

4.3.5 Household tenure type and experience of anxiety ..................................................................... 58 

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4.3.6 Number of years in community and experience of anxiety ........................................................ 58 

4.3.7 Annual household income and experience of Anxiety ............................................................... 58 

4.3.8 Food experience and experience of anxiety ............................................................................... 59 

4.3.9 Perceived safety and anxiety ...................................................................................................... 59 

4.3.10 Sense of attachment to place and anxiety................................................................................. 60 

4.3.11 Trust in flood management authorities and anxiety ................................................................. 60 

CHAPTER FIVE ........................................................................................................................................ 61 

RESULTS OF MULTIVARIABLE ANALYSIS ....................................................................................... 61 

5.1 Introduction ....................................................................................................................................... 61 

5.2.1 First Model: The relationship between flood experience and anxiety........................................ 61 

5.2.2 Second Model: The relationship between perceived safety and anxiety .................................... 61 

5.2.3 Third Model: Flood experience, socio-demographic characteristics, perceived sense of place 

and perceived safety, and anxiety ....................................................................................................... 62 

CHAPTER SIX ........................................................................................................................................... 68 

6.1 Summary ........................................................................................................................................... 68 

References ................................................................................................................................................... 73 

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LIST OF TABLES 

 
Table 4.1: Percentage distribution of respondents’ age range ...................................................... 48 

Table 4.2: A table showing the percentage distribution of household tenure type of respondents 

.................................................................................................................................................51 

Table 4.6 Respondents’ demographic variables by experience of anxiety. .................................. 55 

Table 4.7 Respondents’ socio-economic characteristics by experience of anxiety ...................... 56 

Table 5.1 Regression Results of flood experience and anxiety, and flood experience, perceived 

safety, sense of place attachment and anxiety .............................................................................. 62 

Table 5.2: Regression Results of flood experience and anxiety, and flood experience, perceived 

safety, sense of place attachment, sex, age, level of education, and anxiety. .............................. 63 

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LIST OF FIGURES 

Figure 2.1: Conceptual framework showing the relationship between the experience of flood and 

anxiety. .......................................................................................................................................... 34 

Fig. 4.1 Percentage distribution of experience of anxiety among respondents ............................. 44 

Figure 4.3 A percentage distribution of how respondents perceive their safety in Totope and Keta 

.................................................................................................................................................46 

Figure 4.4 Percentage distribution of the attachment of respondents to their communities ......... 47 

Fig 4.5 A percentage distribution of how respondents perceive the flood management authorities 

.................................................................................................................................................47 

Figure 4.6 Percentage distribution of sex of respondents ............................................................. 49 

Figure 4.7 Percentage distribution of marital status of respondents ............................................. 50 

Fig. 4.8 Distribution of educational level of respondents ............................................................. 51 

Figure 4.9 Distribution of annual household income of Respondents .......................................... 52 

Figure 4.10 Percentage distribution of length of stay of respondents in the community .............. 53 

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CHAPTER ONE 

BACKGROUND 

1.1 Introduction 

 

Natural disasters such as earthquakes, floods, cyclones, storms, wildfires, volcanic eruptions, and 

landslides have shaped the earth's terrain for countless years. When these natural processes interact 

with man-made characteristics like infrastructure, agriculture, and settlements, they can result in 

natural disasters. (Chaudhary & Piracha, 2021). The problems associated with the impact of natural 

disasters on the affected population include loss of employment, damages to housing, and loss of 

lives, which usually affect the economic well-being of the population as well as their, mental and 

physical health. Natural disasters, especially flooding, affect populations differently, with some 

experiencing clinically significant stress and anxiety symptoms (Schwartz et al. 2015; Schwartz et 

al. 2018), which may necessitate the assistance of mental health professionals (Schwartz et al, 

2018). The recent trend of flooding globally, which is mostly driven by climate-related issues, will 

exacerbate the mental health issues associated with flooding.  

In 2020, The Lancet Global Health estimated that depression and anxiety are two of the most 

prevalent mental disorders that cost the global economy $1 trillion in lost productivity, and more 

than 75% of people with mental disorders in low- and middle-income countries do not receive any 

treatment at all (Suhuyini, 2022). However, research on the impact of floods on the population has 

mostly focused on the damages caused to infrastructure and businesses, with limited attention paid 

to the mental health of the affected population. 

Flooding can challenge the psychosocial resilience of the hardiest of people who are affected 

(Stanke et al. 2012). Anxiety disorders represent a failure to either elect an adaptive response or to 

inhibit a maladaptive response given a situation (Thayer and Lane, 2000). Anxiety is a state of 

diffuse arousal following the perception of a real or imagined threat. This fundamentally 

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experiential, future-oriented, self-focusing emotion at times can be adaptive as anticipatory 

problem-solving thoughts are triggered. Anxiety disorders will directly implicate emotion 

(Amstadter, 2008; Thayer and Lane, 2000). 

This study conducted in Ghana a developing country, focused on anxiety disorders among the 

residents of Totope and Keta, who have been exposed to floods for decades. The Volta Delta has 

the presence of agricultural and transportation opportunities provided by the water bodies, which 

provide water for irrigation, silt for improving soil, and simple transportation for shipping people 

and goods, which have long been exploited by societies in delta areas. On the other hand, flooding 

on these same water bodies puts lives and means of subsistence in danger. Deltas are additionally 

vulnerable to flooding from the sea because of high tides and/or storm surges, cyclones, etc. 

because of their coastal location. Households and communities in the Volta Delta employ both 

autonomous and planned adaptation strategies to respond to the multiple threats of climatic and non-

climatic stressors. The majority of planned adaptation activities have been concentrated on 

implementing change with improved technologies, building capacity (for example, through 

training programs on climate change awareness and adaptation governance), providing alternative 

livelihoods to improve food security, reducing the effects of flooding on communities through 

disaster risk reduction and rural-urban development actions and improving ecological functions 

and services to provide sustainable access to natural resources. 

 

According to data from a household survey conducted in 2016 (DECCMA 2018), approximately 

75% of households in the Volta Delta have implemented one or more autonomous adaptation 

strategies. The main adaptation tactic used by households involves changing how much labour is 

used, which may involve hiring help or having women start working outside the home. Additionally, 

changing the layout of a home or moving is a common practice. Houses are typically constructed 

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of flimsy materials and may call for periodic modification or total abandonment over time. 

Investments in financial capital typically take the form of loans, insurance, or membership in 

cooperatives. 

Due to the communities' attachment to their location and primary source of income which is fishing, 

earlier attempts to resettle the Keta area before independence failed (Akyeampong 2002). Three 

communities in Keta-Adzido, Vodza, and Kedzi were the subject of a comprehensive resettlement 

plan that the government launched in 1996 (Akyeampong 2002; Afram et al. 2015). Resettled 

communities, according to Afram et al. 2015, are generally content with the housing amenities 

offered but are unhappy with the living conditions. People especially prefer to live close to their 

extended families and to have spaces nearby for gatherings like weddings and funerals. Loss of 

family and cultural ties, violations of people's basic human rights, and disregard for community 

cohesion result from failure to take into account these cultural and familial contexts (Danquah et al. 

2014). As a result, retreat management has been employed to help the population in the Volta Delta 

to cope with the situation. Although managed retreat has long been acknowledged as a viable 

adaptation technique and has been employed to mitigate floods and other hazards, it is frequently 

regarded as a last choice, to be utilized only in situations when risk reduction or in situ adaption 

methods are either unfeasible or excessively expensive (IPCC 2007; Siders 2019; Anderson et 

al. 2020). Retreat naturally generates opportunities and losses at the same time.  

 

People can experience less pain and be able to work through their loss and grief in an adaptation 

retreat by deliberately loosening their attachment to a particular place and context, selecting 

aspects to keep, and proactively forming new relationships in a different location (Shear et al, 

2007). This study therefore examined the relationship between flooding and anxiety among a 

population that has long practised managed retreat to mitigate the effects of floods. 

 

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https://link.springer.com/article/10.1007/s13412-021-00700-6#ref-CR29
https://link.springer.com/article/10.1007/s13412-021-00700-6#ref-CR64
https://link.springer.com/article/10.1007/s13412-021-00700-6#ref-CR5


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1.2 Statement of the Problem 

 

The Volta Delta is a dynamic environment that is rich and ever-evolving in both time and space 

(Dada et al. 2016). Natural forces driving change in the biophysical conditions of the delta system 

include rainfall variability, marine and riverine flooding, drought, sea-level rise, storm surges and 

elevated temperatures (Appeaning Addo et al. 2018). Climate variability has altered when the rainy 

season begins. However, the Volta Delta frequently floods during the rainy season due to increased 

rainfall intensity.  

Floods harm the environment, endanger lives, destroy property and force families to relocate. 

Coastal flooding is also made easier by powerful swell waves, rising sea levels and storm surges 

assisted by relatively flat topography (Cudjoe et al. 2019). By 2017, more than 300 people had 

been displaced, and nearly 80 homes and a school had been destroyed in Keta. Farmers and 

plantation owners lost their livelihoods as a result of the erosion of farmland and plantations. In 

2019, the situation worsened, with the shoreline retreating several meters inland in some areas and 

up to 100 meters in others.  

There are increased levels of depression and anxiety among individuals who have been hit by floods 

in the area. Poor psychological outcomes have been linked to secondary stressors like relationship 

issues, and loss of sentimental items (Tempest et al, 2017).  

 

The vulnerability and resilience of households are significantly influenced by risk perception 

(Rana et al, 2020). As a result, it is now more crucial than ever to take climate change adaptation 

and disaster risk reduction into account when assessing risk. 

Place attachment is an affective evaluation that describes the relationship people form over time 

with their environment; this relationship can alter how people view risk or approach it.  

For instance, risk perception may be decreased to avoid the risk of separation and the associated 

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stress (Demuth et al., 2016) and continue to think of the attachment source as a " haven" (Solvic 

1987) when the source of attachment (person or place) is also the source of risk. The degree to 

which a person has a history with a location influences the type of attachment (Hay, 1998). People 

who have little or no attachment to a place, like tourists, have a strong sense of place, which is 

based on the attractive or enjoyable aspects of the location. Others have what is known as a partial 

sense of place, which includes pleasant feelings without a commitment to stay, and is still 

developing, but is still weak, such as young children or seasonal visitors. Long-term residents form 

a stronger connection known as a personal sense of place. These residents frequently have more 

social networks, local knowledge, and involvement in the community. Stronger still is an ancestor 

sense of place, the connection that forms between locals who were raised there and endures even 

if the person is forced to leave. The strongest connection is a cultural sense of place, where the 

location has a long history of association with a particular tribe or cultural group (Hernandez et al, 

2007).  

One of the most frequently mentioned advantages of place attachment was the feeling of belonging. 

It entails sensations of being rooted in a location, fitting in, or relating to others. Indeed, ties to a 

particular place can help us satisfy the need to belong, which appears to be among our most basic 

psychological needs. When they represent one's social circle or as a meeting place, places can give 

one a sense of belonging.  

People who are attached to a place usually have positive emotions such as happiness, joy, and love 

when they find themselves in that place, and these are attributes that are opposite to feeling anxious 

(Baumeiser & Leary, 1995: Pittman & Zeigler, 2007). 

Numerous studies have looked at how hazards affect the mental health of the affected population 

such as the English Cohort Study of Flooding and Health, Mental  Health Disorders due to 

Disaster Exposure among others, but few have looked at how place attachment and perceived 

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safety play a mediating role in the relationship between flooding and anxiety. In the Volta Delta, 

the idea of managed retreat has not been used to study such a relationship. 

 

 

1.3 Research Question 

 

This study seeks to answer the following questions: 

 

i. How does the experience of flooding affect anxiety levels in Totope and Keta? 

 

ii. How do people in Totope and Keta perceive their safety in the area? 

 

iii. How do place attachment and perceived safety mediate the relationship between flood 

experiences and the level of anxiety among residents of Totope and Keta in the Volta 

Delta? 

 
1.4 Research Objectives 

 

The study’s main objective is to advance the field of science by examining how place attachment 

 

and perceived safety affects the relationship between floods and mental well-

being. Specifically, the study seeks to: 

i. Explore how the experience of floods affects anxiety among the people of Totope and Keta. 

 

ii. Assess how place attachment and perceived safety influence anxiety among the people in 

Totope and Keta. 

iii. Examine how place attachment and perceived safety mediate the relationship between 

flood experience and anxiety in Totope and Keta. 

 

 

 

 

 

 

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1.5 Rationale 

 

The Sustainable Development Goal (SDG) 3 talks about ensuring healthy lives and promoting 
 

well-being for all at all ages. This includes vulnerable people such as the people along the Volta 

Delta. The Global Burden of Disease study (2013) showed that the mental health burden had 

increased and accounts for more than 11% of disability-adjusted lost years and it is a burden for 

the health system.  

Natural disasters over the years have resorted to grief, loss, trauma and fear among victims. Owing 

to these harsh truths, this study will not only highlight the negative impact not only on the quality 

of life but also the substantial inconvenience of the mental condition it leaves behind. Losses 

experienced (lives and properties), abandonment, food shortages and a lack of adequate 

counselling services to address mental health challenges affect the mental state of flood victims. 

The impact of mental health has been underestimated and there is a huge gap between individuals 

with mental health disorders and those who are receiving or ever have received treatment (Vigo et 

al. 2016). This is because a significant proportion of people who suffer mental disorders as a result 

of their experience of an environmental hazard may be excluded. 

This study will go a long way to inform policymakers not to just provide victims of floods with 

relief items but also to attend to their psychological needs. This study will also add to the growing 

knowledge of the effect of floods on the psychological resilience of people who have been affected 

by floods, especially in Ghana. This will help achieve SDG goal three, which focuses on ensuring 

healthy lives and well-being for all. 

 

1.6 Organization of the Study  

The first chapter provides a background to the study. It further describes the problem statement, 

rationale, research questions and objectives of the study. The second chapter evaluates relevant 

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literature on floods and their psychological effects. The chapter also includes the theoretical and 

conceptual framework that guides the research. The third chapter discusses the research design and 

methodology as well as the limitations of the study.  

Chapter four details the background descriptions of the study respondents while the fifth chapter 

provides results and discussions of findings. The last chapter (six) gives the summary, conclusion 

and some recommendations for the predicament. 

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CHAPTER TWO 

LITERATURE REVIEW 

2.1 Introduction 

 

To focus on the aims of the study, this section examines current works on flood, anxiety, perceived 

safety, and a sense of attachment to place. This chapter seeks to present a global view on the 

concept of flooding, anxiety, perception of safety, and sense of place attachment as well as some 

demographic and socio-demographic factors which may influence the experience of anxiety. This 

chapter ends with the theoretical framework and conceptual framework of the study. 

 

2.2 Floods 

 

2.2.1 Concept of Floods 

 

Floods represent the single natural disaster with the greatest cost and destructive implication for 

countries and lead to the loss of about 50,000 lives annually while affecting about 75 million people 

at the global level (Mwape, 2009). Carter (1991) indicates that floods possess some key features, 

which are discussed below: 

(i) They are protracted, brief, and come without notice, based on the type of flood (e.g., a flood 

that arises from a major river could take days or even weeks to develop, while flash floods 

occur instantaneously) 

(ii) the start or speed of the flood could be gradual or sudden; and, 

 

(iii) the floods could occur seasonally. 

 

 

Floods arising from hurricanes or similar natural disasters are more contaminated compared to 

floods coming from potable water or rainwater (Brennan & Cole, 2009). Water contamination lies 

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on a spectrum ranging from potable water (Category 1) to those that are utterly contaminated 

(Category 3) (Institute of Inspection Cleaning and Restoration (IICRC), 2006). The IICRC then 

proceeds to list some Category 3 waters including ocean water, rains associated with high winds, 

surface or groundwater, and swelling rivers and streams. Floods as well as hurricane events cause 

injuries, sickness, or deaths (CDC, 2005; 2006; IICRC, 2006; Todd, 2006). Furthermore, people 

also experience sickness and injuries during evacuation, clean-up, and restoration activities (CDC, 

2005; 2006; Sullivent, 2006; Todd, 2006). 

 
 

2.2.2 Causes of Floods 

 

Flood causes can be categorized into physical e.g., climate-related forces, and human factors e.g., 

deforestation and vegetation loss, and construction activities (Nott, 2006). Climate-related factors, 

especially rainfall, are however the most dominant cause of floods. Lengthy rainfall represents the 

primary cause of floods globally (Nott, 2006). Human activity impacts rivers and water bodies and 

influences the occurrence of floods. Deforestation leads to higher run-off, and lesser channel 

capacity arising from increased sedimentation rates. Floods are not deemed as natural hazards till 

they threaten human life or property (Nott, 2006). Landforms that are prone to flash floods are 

more susceptible to experiencing floods. Floods pose a threat due to the high population numbers 

living in flood-prone areas. The seriousness of a flood determines how long it will take for crops, 

pastures and social and economic life to return to normal (Nott, 2006). 

 
 

2.2.3 Risk and Effects of Floods 

 

The past ten years have seen over 55,000 lives being lost to floods globally (CRED, 2020), in 

addition to promoting diseases. WHO (2020) indicates that the avenues for contracting water- 

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borne diseases become pronounced as a result of major population displacement, a compromise to 

the quality of drinking water sources, as well as contact with polluted water. The water-borne 

diseases that affect people the most are diarrhoea and fever (Vollaard et al., 2004; Wade et al., 

2004), as well as skin infections and upper respiratory infections (Bich et al., 2011; Wu et al., 

2015; Saulnier et al., 2018; Watson et al., 2007). Receding floods can also create fertile 

environments for breeding mosquitoes and their associated illnesses like malaria and dengue 

(WHO, 2020). 

 

Furthermore, the seriousness of exposure as well as pre-existing mental illness is an important 

predictor of psychological problems attributable to natural events (Sullivan et al., 2013). As a case 

in point, the effects of typhoons like forced evacuation, injury, and prior psychological health 

conditions have been found to cause mental health problems in Vietnam (Acierno et al., 2009). In 

Mexico as well, communities that suffered mass fatalities and displacement from floods and 

mudslides reported increased Post-Traumatic Stress Disorder and depressive illnesses (Norris et 

al., 2004). Adverse outcomes like loss of life, property, and employment in addition to starvation 

and homelessness cause mental health problems after floods (Galea et al., 2007). 

 

Poor areas are at increasing risk of experiencing disastrous floods (IPCC 2007; UN-Habitat 2014), 

requiring robust evidence on the effect of floods on vulnerable populations. Studies show the 

negative effects of floods and hurricanes in the developed world on life satisfaction (Luechinger 

& Raschky, 2009), birth outcomes (Currie & Rossin-Slater, 2013), health metrics associated with 

disability in adults (Sastry & Gregory, 2013), psychological problems (Baryshnikova & Pham, 

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2019), as well as the tendency to travel after the event, and death (Deryugina & Molitor, 2020). 

Low-to-middle-income countries (LMICs) may however not be impacted in this manner. Most 

people in LMICs are more vulnerable owing to poor housing, sanitation and drainage, and erratic 

water supply (Baker, 2012). 

 

Poor people suffer adverse economic and health outcomes when they experience floods. This 

includes destruction of their homes, loss of livelihood, and heightened risks of injury and germs 

(WHO 2018; Ezeh et al. 2017). Where effective social welfare programmes do not exist, the poor 

cope by disposing of productive assets, lessening food eaten, or putting school-going children into 

the workforce. Household income and consumption are negatively impacted (Bui et al., 2014; 

Carter et al., 2007; Dercon, 2004), as well as unemployment levels (Handa & King, 2003; Carter 

& Maluccio, 2003; Hoddinott & Kinsey, 2001) in the long run. 

 

In India, natural disasters led to an increase in diseases like diarrhoea, fever and respiratory illness 

among young children (Datar et al., 2013). Similarly, children in Ecuador who were in their 

mother’s wombs when severe floods occurred were found to be relatively shorter in height than 

those who didn’t experience floods five and seven years down the line (Rosales-Rueda, 2018). 

Conversely, Deuchert & Felfe (2015) found that a typhoon did not negatively affect children’s z-

scores for weight and height in the Philippines, which are proxies for child health (Glewwe & 

Miguel, 2007). 

 

2.2.4 Illnesses Associated with Floods and Water Damage 

 

According to a global systematic review of 163 studies in 2020, an association was established 

between climate change and mental health. Results pointed out that 20% of flood victims were 

diagnosed with depression, 28.3% with anxiety, and 36% with PTSD (Cianconi et al., 2020). 

Additionally, in 2010 a study among flood victims in Sindh Pakistan reported a 59% prevalence in 

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severe Post Traumatic Stress Disorder (PTSD) and 54.4% in depression (Cianconi et al., 2020). 

Several health problems and illnesses are associated with floods and water damage. Brennan and 

Cole (2009) list these illnesses and health problems as including: 

 

➢ Injury: 

 

o Drowning, physical trauma, wounds, scrapes (Sullivent, 2006; IICRC, 2006) 
 

o Bites from animals i.e., mammals, insects, and reptiles (CDC 2006) 
 

➢ Infection (wounds, gastro-intestinal or respiratory) (Todd 2006) 

 

o Pathogens in flood waters from sewage, soil and animal waste (CDC 2006) 
 

o At cleanup operations (elements found in flood residues) (CDC 2006) 
 

o Flood area environment or at evacuation sites (food and water contamination, poor 

sanitation services and overcrowding) (CDC 2005; 2006) 

➢ Non-biological contaminants 

 

o Carbon monoxide from machines used indoors (CDC, 2006a; 2006b) 
 

o Heavy metals 
 

o Pesticides 
 

o Organic compounds like petroleum or PAH (CDC 2006) 
 

➢ Asthmatic or allergic attacks from living in or cleaning damp, mouldy buildings (CDC, 

2006a; 2006b) 

➢ Psychological shock and PTSD (CDC, 2002; 2006) 

 

 

2.2.5 Pathogens in Flood Water 

 

Some of the pathogens found in flood water come from sewage, farm animal wastes, and wild 

animals, or are those pathogens naturally living in water bodies (IICRC, 2006; Godfree, 2005). 

These include: 

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➢ Parasites: Entameba, Giardia 

 

➢ Bacteria: Enterococci, Leptospira, Norovirus, Shigella, E. coli, Salmonella, Legionella, 

and Campylobacter 

➢ Viruses: Enterovirus, Parvovirus, Adenovirus, Rotavirus and Hepatitis A 

 
Contamination levels in flood water differ significantly across place and time. The nature, size, 

and location of contaminant sources have a direct impact on the direction and volume of flood 

waters. Three affected the Cape Fear watershed of North Carolina from 1996 to 2000 while a study 

on water quality was ongoing (Mallin 2002). It was discovered that different storms had different 

impacts on bacterial levels. Specifically, Hurricanes Fran and Floyd did not affect coliform 

bacteria presence in the watershed environment, with Hurricane Bonnie however increasing 

bacterial in the area. Samples tested after Hurricane Katrina showed similar increases in bacterial 

levels (Pardue 2005). 

Several studies show that floods cause illnesses (CDC 2005; Katteruttanakul 2005; Karande 2003; 

Waring 2002). People whose homes were flooded were found to experience four times more illness 

rates, unlike those not affected by floods (Waring, 2002). Another study highlighted flood-related 

illnesses which, though present, were not linked to drinking contaminated water (Wade 2004). The 

research found an association between increased gastrointestinal conditions and contact with flood 

water.  

 

A norovirus infection was also experienced in an evacuation centre, while a National Guard 

battalion reported increased acute respiratory illness (CDC 2005) due to its closeness to the 

evacuation site. 

 
 

 

 

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2.2.6 The African Experience of Floods 

 

The UNEP (2006) indicates that Africa is more vulnerable to the effects of climate change than 
 

any other continent. The last decade of the 20th century saw about two (2) billion people 

experiencing disasters. Parker (2000) argues that all over the world, floodplains serve as important 

locations for human settlement, and Africa is no exception. A case in point is Egypt, where the Nile 

River floodplain is the location with the highest population concentration in the country. About 

twenty urban locations constitute prime areas for flooding in Mozambique, including settlements 

along the Zambezi River. Over the centuries, African communities have utilized the continent’s 

floodplains for their benefit due to the proximity of water, and fertility of these plains (Parker, 

2000). In Africa, flood events affect both the formal and informal sectors of economies, leading to 

challenges in assessing the direct and indirect impacts of floods. The primary damage caused by 

floods occurs by way of destruction to public and private buildings, as well as crops and livestock. 

Buildings could be partially or destroyed based on the structural integrity of the houses and the 

seriousness of the flood. Homeless statistics increase after floods due to the effect of floods on 

houses. Floods destroy infrastructural networks, which leads to disruption in transportation 

systems. 

Floods and droughts represented about 86% of these disasters. Serious floods in Southern Africa 

in early 2008 led to the deaths of many people and displaced thousands more. The successive floods 

of 1983, 1984 and 1985 in South Africa negatively impacted the farming sector (Du Plessis, 1988). 

This necessitated the importation of various farming products to feed the domestic market. 

Furthermore, it negatively impacted grazing capacity to the point where animal production had to 

be reduced. Consequently, some farmers acquired no income in some areas while others suffered 

losses. Farmers therefore reduced their investment in farm machinery, and limited their planting 

activities, with their investment in fertilizer dwindling as well. Floods occurred again in 1986/87, 

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negatively affecting farmers and consumers alike and seriously destroying infrastructure in towns 

close to rivers. Stocks and irrigation land were lost; farm implements, plantations and sheds along 

rivers were damaged; and infrastructure was destroyed. The drinking water supply was also 

disrupted, requiring the institution of special measures to prevent health crises (Du Plessis 1988). 

These outcomes led to economic stagnation as the South African government redirected resources 

to respond to the floods (Nxumalo, 1984). 

 

Climate change and rising sea levels will impact the natural environment and human society 

(Snoussi, et al., 2008). In Morocco, coastal zones are a key socio-economic hub, with over 60% of 

the country’s inhabitants living in coastal cities and 90% of industries located there, making them 

prone to the negative effects of flooding. Parker (2000) notes that floods pose threats to life, health 

and population in many African countries. The intensity of the effects of floods on human 

settlements and activities derives from the importance of flood plains in African societies, and the 

resilience of African societies to disasters. The impact of flood disasters on African societies 

depends on how these societies degrade their environment, in addition to their vulnerability to 

floods and tropical storms. 

 

The economic impacts of floods far outweigh the physical effects of the floods themselves (Parker, 

2000). Food shortages occur after floods since floods destroy crops and animals (Parker, 2000). 

As a case in point, Sudan’s floods of 1988 led to food shortages. Floods cause food shortages in 

several ways.  

 

First, floods may damage food stocks if flooding extends into storage facilities or centres. Serious 

flooding makes transporting food difficult, which leads to insufficient food supplies and 

subsequent food deficit, especially in places cut off by the water. Sudan’s 1988 flood is a classic 

example of this situation. Flooding in the Nile River from rains led to immense destruction of 

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property. Food production in Khartoum province alone dropped by 60%, and infrastructure 

destroyed ranged from irrigation canals, sewage systems, electricity, and roads to water systems. 

The agricultural industry also reported severe losses. 

 
 

OCHA (2008) reports that over 194,103 people were affected by floods in 2007 in Southern Africa. 

The numbers included 60,995 people in Malawi; 94,760 in Mozambique; and over 31,848 in 

Zambia and Zimbabwe. Also, Lesotho saw about 4,000 persons being impacted, with Swaziland 

recording 2,500 people. About 1,200 families experienced disruption to their livelihoods and food 

security in the northeastern region in 2008 because their farmlands were destroyed by floods (IRIN 

2008). Floods affected countries like Ghana, Nigeria, Cote d’Ivoire, Kenya, Sudan, Mauritania, 

Mali, Senegal, Uganda, Sierra Leon, Togo, Burkina Faso, Gambia, Guinea, Liberia, Berlin, 

Rwanda, Ethiopia, and Algeria (Theron, 2007). Further, approximately 300 people in 20 countries 

lost their lives due to floods across a two-month period, with the inaccessibility of affected areas 

creating challenges in accurately accessing the death toll (Theron, 2007). 

Floods that occurred during harvest time in Ivory Coast led to crop losses (Theron, 2007). The soil 

fertility was also compromised by the floods, lessening future harvests. This ultimately led to 

disease outbreaks in the long term. Development efforts in African societies are also stemmed by 

floods, as people are displaced and infrastructure is destroyed, making it difficult to achieve the 

global developmental agenda (Theron, 2007). 

 
 

Khandlhela and May (2006) show that vulnerability to floods depends on socioeconomic and 
 

political factors. Floods in southern Africa caused deaths, and destruction to assets (Adamson, 

1983). A large chunk of the town was washed away by the flood, with 100 lives lost. Further, 

bridges and irrigation schemes were damaged as well. The heavy rains of January, 1974 also 

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negatively impacted agriculture in the central regions of South Africa (Adamson, 1983). All these 

go to show that floods have significantly impacted the African continent. 

 
 

2.3 Anxiety 

 

2.3.1 Concept and Definition of Anxiety 

 

‘Anxiety’ derives from the Latin root word “angere,” meaning distress (Sharma & Sharma, 2015). 

It is a feeling caused by stressors and worsened by lengthy stress (Lazarus & Folkman, 1984). 

Anxiety is the “anticipation of future threats” often linked to “vigilance in preparation for future 

danger and cautious or avoidant behaviours” (American Psychiatric Association, 2013). It is a kind 

of psycho-physiological difficulty encountered by people (Callahan, 2001). Harris and Coy (2003) 

define anxiety as a feeling made up of uneasiness and ambiguity which occurs when a person 

considers an event to threaten their self-esteem or ego. Anxiety engenders feelings which heighten 

the nervous system (Spielberger, 1983). This makes it difficult for people affected by anxiety to 

lead normal lives and interferes with their everyday activities. Rachel and Chidsey (2005) list it as 

part of the spectrum of emotional and behavioural conditions. Anxiety comes in different forms, 

including unnecessary worrying, fear, agitation, heightened emotional reactions, and undesirable 

thoughts (Vitasari et al., 2011).  

It has been said that everyone has or will experience anxiety at different stages in life, which could 

even be normal in certain instances (National Anxiety Foundation, 2005). 

Anxiety occurs when people report heightened fear and then respond to signals indicating a real 
 

or imaginary present or past threat (Craske et al., 2009). Anxiety disorders possess the features 

associated with heightened distress and mental arousal (Breuer, 1999). Anxiety consists of 

uneasiness and doubt which typically occurs when people consider something as threatening their 

ego or self-esteem (Sarason in Harris et al., 2003). For Spielberger (1995), anxiety involves tension 

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and apprehension which affects the nervous system. Feeling anxious can interfere with how well 

people perform by blocking their minds, affecting attention resources, inhibiting cognitive ability, 

causing worry and fear (Vitasari et al., 2011). 

 
 

2.3.2 Types of Anxiety 

 

Anxiety can be categorized into state anxiety and trait anxiety. In relation to state anxiety, it refers 

to a momentary emotional state which conveys a person’s understanding of an event that causes 

stress at every point in time. Trait anxiety on the other hand concerns the stable individual 

differences which determine whether people will get anxious or not (Spielberger, 1983). State 

anxiety is “the emotional state of an individual in response to a particular situation or moment that 

includes symptoms of apprehension, tension, and activation of the autonomic nervous system, and 

can include tremors, sweating, or increased heart rate and blood pressure (Spielberger, Gorsuch, 

Lushene, Vagg, & Jacobs, 1983). Trait anxiety is the tendency of an individual to respond to stress 

with state anxiety (Bisson, 2017). Another type of anxiety, normative anxiety, may include being 

concerned about issues such as money, health, and/or family problems, but those with an anxiety 

disorder are extremely worried about these or other things, even when there is little or no reason 

to worry about them. They are very anxious about getting through the day, have a negative outlook, 

and think that things will go wrong (Robinson et al, 2013). 

Anxiety disorders feature excessive fear or anxiety that persists beyond developmentally 
 

appropriate lengths of time. These disorders cause clinically significant impairment or distress in 

important areas of functioning (American Psychiatric Association, 2013). The different types of 

anxiety disorders are categorized by the type of objects or situations that cause the anxiety and can 

have different ages of onset (American Psychiatric Association, 2013). One type of anxiety is 

social anxiety, which is marked by fear or anxiety about social situations in which individuals feel 

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that he/she will be scrutinized by others. Social anxiety has been found as a barrier to developing 

social ties in several studies (Brook & Willoughby, 2015; Goguen, Hiester, & Nordstrom, 2010; 

Pascarella & Terenzini, 2005). This type of anxiety is found to be more prevalent in college 

students, ranging from ten to thirty-three percent, when compared to the general population, 

ranging from seven to thirteen percent (Russell & Shaw, 2009). 

In the conceptualization, individuals with high levels of anxiety generally hold heightened levels 

of trait anxiety, but in evaluative situations, the state anxiety also elevates (Vistari et al., 2011). To 

meet the criteria for an anxiety disorder diagnosis, the individual must experience excessive 

anxiety and worry that he/she finds difficult to control for at least six months to the extent that it 

causes significant distress or impairment in functioning. The individual must also experience three 

or more of these symptoms: sleep disturbances, difficulty concentrating, restlessness, fatigue, 

irritability, and muscle tension (Bisson, 2017). 

 

Erica (2010) ranked anxiety into four levels: mild, moderate, severe and panic anxiety. 

 

1. Mild level anxiety is healthy. At this level, the perceptual field is heightened, pupils dilate 

to accommodate much light, hearing and smelling intensify, and sense of touch is highly 

sensitive. The individual is highly alert and attentive and learning and cognition is in its 

best state. 

2. Moderate level anxiety on the other hand is unhealthy, the perceptional field of a person at 

this level is narrowed. Individuals experiencing this level of anxiety have selective 

inattention. They have decreased focus, and automatism can be observed as repetitive 

purposeless movements such as shaking of the hands and feet, twirling of hair and, tapping 

of fingers. 

3. Severe level of anxiety is characterized by reduced perceptual field and a difficulty in 

communication. Gross motor movements, such as pacing are characteristic of people at this 

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stage. Communication with such persons should be kept short and simple since 

communication is altered. Performance at this stage is reduced. 

4. Panic level of anxiety is the worst and most severe form of anxiety. Total disruption of 

perceptual field is present. It is also characterized by loss of ability to communicate, loss 

of rational thought, and total loss of conscious thinking. Performance at this level is very 

poor since the person is unable to remember exactly what he/she is supposed to do. 

 
The American Psychiatric Association (2000) has also categorized anxiety into several psychiatric 

disorders as follows: 

(1) Generalized Anxiety Disorder: Individuals who suffer this condition live each day in a state 

of high tension, feeling uneasy, and tend to overreact even in mild stresses. The individual 

finds it difficult to concentrate instead of worrying about potential problems. 

(2) Panic Disorder: This is characterized by episodes of acute and overhauling apprehension 

to terror. It begins abruptly and reaches a peak within 10 minutes with such symptoms as 

perspiration, muscle tremors, faintness and shortness of breath. Eventually this fear 

intensifies and interferes with everyday activities thus disrupting concentration, and 

decision-making, resulting in poor performance. 

(3) Agoraphobia: Involves intense fear and anxiety of any place or situation where escape 

might be difficult, leading to avoidance of the situation such as being alone outside the 

home, travelling in a car, bus, aeroplane, writing an examination or being in a crowded place 

(Kessler et al., 2005). 

(4) Phobias: It is a persistent fear of a specific object or situation. The fear occurs when the 

phobic individual is brought in contact with the object or situation. 

(5) Obsessive-Compulsive Disorders: Individuals with this condition feel compelled to think 

about things they would rather not think about or perform acts they do not wish to carry 

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out. Obsessions are persistent, irresistible urges to carry out certain acts or rituals. Obsessive 

thoughts may be linked with compulsive acts. People with this disorder are preoccupied 

with these irrelevant thoughts they cannot control, thereby negatively impacting their lives. 

(6) Post-Traumatic Stress Disorder: It is a type of anxiety that occurs after a frightening event 

or situation. This affects performance because some people continue to dwell on their past 

failures and are unable to face new challenges before them. These people often perform 

poorly because they fail to concentrate on new challenges. 

 
 

2.3.3 Effects of Anxiety 

 

Some longitudinal studies have demonstrated that untreated anxiety in adolescents and young 

adults may lead to several behavioural, physical, and mental difficulties (Mahmoud, Staten, Lennie, 

& Hall, 2015). Hypertension, coronary heart disease, alcohol dependence, nicotine addiction, 

depression, and suicidality are some of the complications that may be experienced by those with 

untreated anxiety (Boden et al., 2006; Goodwin et al., 2004; Sonntag et al., 2000; Stein et al., 2001; 

Volgelzangs et al., 2010; Yan et al., 2010). These difficulties and complications harm those 

experiencing them and can worsen anxiety, making it challenging for students to be successful. 

 

Furthermore, untreated anxiety may lead to pathological anxiety disorders (Emilien, Durlach, & 

Lepola, 2002). Many individuals who have symptoms of anxiety also have symptoms of 

depression. According to the American Psychiatric Association (2013), “Individuals whose 

presentation meets criteria for generalized anxiety disorder are likely to have met, or currently 

meet, criteria for other anxiety and depressive disorders”. 

 

 

 

 
 

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2.4 Place Attachment 

 

2.4.1 Concept and Definition of Place Attachment 

 

According to Low and Altman (1992) “Place” refers to space, that has been given meaning through 

personal, group or cultural processes”. “Place comes into existence when people give meaning to 

a part of the larger, undifferentiated space in which they live” (Jack, 2010). Place attachment is “a 

positive affective bond between an individual and a specific place, the main characteristic of which 

is the tendency of the individual to maintain closeness to such a place” (Hidalgo and Hernandez, 

2001). Place attachment encompasses long-standing connections between people and physical 

places like homes (Brown & Perkins, 1992). A sense of pride is usually associated with residential 

place attachment concerning how a residential area feels and looks (Twigger-Ross & Uzzell, 

1996), in addition to eliciting feelings of wholesomeness (Harris et al., 1995). 

From the day-to-day interactions people have with the environment and their neighbours, periodic 

events, daily upkeep of the environment, and affection for home and the area, place attachment 

gradually grows (Werner et al., 1993). Residential attachment ensures security, stability and 

familiarity. Place attachments, however, change with time as people grow, the environment 

changes, and activities in the environment change. Numerous neighbourhoods decline because 

houses grow, homes are rented, and poor people move into neighbourhoods (Myers, 1983). 

 

The evolving housing and neighbourhood conditions influence place attachment. Research has 

shown that place attachment is important in promoting revitalization in severely distressed 

neighbourhoods where houses have been abandoned by landlords. Residents who pursued 

revitalization in neighbourhoods were attached to their neighbourhoods irrespective of the poor 

conditions in these neighbourhoods (Saegert, 1989), and engaged in activities like collecting rent, 

ensuring repairs were conducted, and lobbying government authorities to improve their 

communities. When neighbourhoods decline, people leave, and new tenants move in (Myers, 1983). 

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Though some residents stay because of the inability to leave (Stokols & Shumaker, 1981), others 

on the other hand become attached over long periods of stay (Taylor, 1996). Residents portraying 

a high incidence of place attachment are usually older (Lawton, 1990), spending considerable 

amounts of time in the neighbourhood (Fuhrer et al., 1993). Investing in buying a home also 

improves conditions in neighbourhoods as well as people’s attachment to it (Taylor, 1996). People 

who own homes stay longer in an area than renters (Rohe & Stewart, 1996), have close 

relationships with their neighbours (Fischer, 1982), are involved in community activities (Rossi & 

Weber, 1996), and stay longer in poor neighbourhoods (South & Crowder, 1997). People who rent 

for short periods have few connections that encourage them to stay and improve a neighbourhood. 

Home ownership and long stay therefore promote greater place attachment. 

 

 

2.4.2 Factors Influencing Place Attachment 

 

The places we live in and visit hold deep meaning for us and evoke strong emotional attachments 

in us. Relph (1976) indicates that: “there is for virtually everyone a deep association with and 

consciousness of the places where we were born and grew up, where we live now, or where we 

have had particularly moving experiences. This association seems to constitute a vital source of 

both individual and cultural identity and security”. Furthermore, a significant overlap exists 

“between factors such as emotional bonds, affiliation, behavioural commitment, satisfaction and 

belonging, which are loosely associated with theoretical descriptions” of place attachment (Pretty 

et al., 2003). 

 

Place attachment involves different aspects of the bond between people and a place, like behaviour, 

affect and cognition. This includes the interaction between factors like emotions, knowledge, 

beliefs, and behaviours regarding a location (Altman & Low, 1992). The satisfaction experienced 

regarding a place leads to the development of affective bonds since places allow for control, 

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engender creativity and allow for a sense of peace (Altman & Low, 1992). Bonds are also affected 

by factors like duration of living in a place, role played in the area, and availability of connections 

in the area (Moore, 2000). Social relations are therefore important in building attachment. Altman 

& Low (1992) support this position by saying: “… attachments may not only be to landscapes 

solely as physical entities but may be primarily associated with the meanings of and experiences in 

place which often involve relationships with other people” (Altman & Low, 1992). 

 

2.4.3 Importance of Place Attachment 

 

Orr (2005) states that “knowledge of a place where you are and where you come from is 

intertwined with knowledge of who you are”. At least two interpretations can be ascribed to this 

quote. The first is that people with an emotional attachment to a place have a greater likelihood of 

deepening their knowledge of the place and their roots. The second interpretation is that place 

attachment leads to the creation and sustenance of a person’s identity. Place attachment therefore 

leads to the expansion of personal knowledge and identity (Lewicka, 2008; Orr, 2005). 

Place attachment is important for individuals’ psychological balance (Lewicka, 2008). Connection 

to a place enables people to be stable and adapt easily to changing conditions. Particularly for 

elderly people, place attachment gives them a sense of identity and self-esteem (Rubinstein and 

Parmelee, 1992). This is important in these times, especially when social bonds and traditional 

values are loosening. Similarly, many people are relocating, further weakening their roots (Jack, 

2010). To illustrate, a study reported by Jack (2010) shows how children without place attachment 

lacked a sense of grounding and self-identity. Similarly, emotional bonds with a place engender 

feelings of safety in people attached to the place. This security arises from familiarity with the 

place; either with its facilities or through the psychological buffer provided in difficult times (Jack, 

2010). 

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Orr (2005) argues that differences exist between residents and inhabitants. Residents have weak 

connections with places they stay at and are not knowledgeable about or hold the place dear. 

Conversely, inhabitants share a deep connection with a place, which shows in the very core of their 

being. Inhabitants generally have greater connection to a place and make it a good place to live in. 

Environmental behaviour encompasses ways of living that are sustainable (Vaske and Kobrin, 

2001). 

 

Increased place attachment has been shown to increase helpful attitudes towards the environment 

(Kudryavtsev et. al., 2012). A significant correlation was found between neighbourhood attachment 

and pro-environmental behaviour (Rioux, 2011). Vaske and Kobrin (2001) discovered higher place 

identity to be associated with positive affection towards the environment. The development of 

place attachment has also been found to contribute to environmentally responsible behaviour 

(Halpenny, 2006). 

 

Vorkinn and Riese (2001) also found place attachment to positively influence residents’ attitudes 

towards environmental changes in their community. This means that lesser place attachment led 

to a reduction in the overall value or quality of a place. Communities can therefore be negatively 

impacted environmentally and socially owing to an absence of a sense of place (Semken and 

Freeman, 2008). Developing place attachment allows societies to develop responsible citizens 

(Vaske and Kobrin, 2001). This can be achieved by introducing children first to the environment, 

and growing empathy in them towards the environment, which should begin from places closer to 

home and school (Sobel, 1996). With time, they can then start working towards exploring other 

places in the environment. Without developing this initial love for the environment, knowledge of 

what it suffers from and ways of addressing the problem will be difficult to grow in. 

 

Orr (2004) defines biophilia, and says that pure love must be present for biophilia to grow. 

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Biophilia is a close relationship with the environment or with nature (Orr, 2004). It also includes 

people’s interactions with each other and memories about a place. It can therefore create a strong 

bond among people (Low and Altman, 1992). 

 

 

2.5 Perceived Safety 

 

2.5.1 Concept of Perceived Safety 

 

Safety perception (or perceived risk) refers to the prospect of unwanted outcomes occurring 

(Hamed & Al Rousan, 1998). Perceived safety concerns people’s perception of “the risk of 

becoming a victim of crime and disturbance of public order” (Uittenbogaard et al., 2018). The 

possibility of becoming a victim, and becoming one, are real encounters for people (Halbur, 2010; 

Uittenbogaard et al., 2018). An evaluation of risk perception varies from person to person based 

on their background and their approach to handling risks (Adams, 1988). 

 

The need to be safe is surpassed only by the physiological need (food, shelter). Therefore, the 

safety sentiment leads to the attainment of higher emotional needs in promoting well-being 

(Mouratidis, 2019). Research also shows that an optimistic perception of safety contributes to 

positive health outcomes, especially in neighbourhoods (Baum et al., 2009). Contrariwise, 

perceiving neighbourhoods to be unsafe heightens anxiety and decreases life satisfaction (Møller, 

2005), which further leads to bad experiences of health by people (Chandola, 2001) and 

undesirable diseases (He et al., 2022). Loss of safety has been progressively considered a critical 

social problem (Innes & Jones, 2006; Wang et al., 2019; Makinde, 2020). This makes it imperative 

for urban planners to unearth the factors and mechanisms which contribute to growing unsafe 

feelings in the urban space (Makinde, 2020). 

Perceived safety is important both at the large and small level. Perceived safety comes up 
 

frequently during deliberations on public space that is fair and just for all (Haas & Mehaffy, 2018) 

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as well as city life (Harvey, 2008). Safe mobility is “an individual right, to be attained by all, 

regardless of the individual’s gender, age, abilities or resources” (Vania Ceccato, 2014). At a lesser 

scale, perceived safety affects people at the individual level. Individuals strive to address, and 

reduce, the risk of suffering adverse outcomes. Women, especially, adopt evasive measures when 

out and about and conceal valuable items. Other vulnerable groups like the elderly would prefer 

not to visit parks, or alternatively reduce time spent outside. These behavioural adjustments and 

restrictions on movement, and the unease and fear that accompany it, negatively impact quality of 

life (Jackson and Gray, 2010; Bremberg et al., 2015). This can disrupt mental health, and reduce 

social cohesion (Jackson and Gray, 2010). 

 

 

2.6 Relationship between flood, anxiety, place attachment and perceived safety 

 

Some research  has  been  undertaken  into  the  relationship  between  floods  and  anxiety  or 
 

psychological distress, place attachment and perceived safety. Direct and indirect exposure to 

floods have been found to have several negative mental health impacts (BDI, 2021). Fernandez et 

al., (2015) after undertaking a global systematic review of 83 studies found that the risk of 

experiencing post-traumatic stress disorder (PTSD), psychological distress, depression, and 

anxiety increased in areas affected by floods compared to areas not affected. After studying floods 

in the Australian locations of Brisbane in 2011 (Alderman et al., 2013) and New South Wales in 

2017 (Matthews et al., 2019), the researchers found that business owners and households which 

were affected by floods or evacuated experienced a higher risk of psychological distress and PTSD. 

Matthews et al., (2019) in particular found that Aboriginal and Torres Strait Islander people were 

more likely to report depression and anxiety since they stood greater chances of being evacuated 

or displaced. Bei et al., (2013) also found that among older adults, 1 in 6 persons affected by floods 

reported symptoms of post-traumatic stress disorder (PTSD) which would require clinical 

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treatment, as well as increased trauma symptoms. 

 

Flood exposure also has an effect on suicidal ideation (BDI, 2021). Matthews et al., (2019) found 

that the 2017 New South Wales floods increased suicidal ideation among people whose homes or 

businesses were affected by floods. It needs to be emphasized however that some studies did not 

find differences in suicide rates related to floods (De Leo et al., 2013). Another study also found 

some evidence of flood exposure increasing alcohol, tobacco and drug use (Turner et al., 2013). 

Flooding has been found to also exacerbate anxiety and mental distress among people who 

experienced greater damages or threat of harm (Liu et al., 2006, Fredman et al., 2013), financial 

losses (Bei et al., 2013), and disruption to routine or employment (Bei et al., 2013, Tunstall et al., 

2006). Furthermore, sudden onset of floods which give no warning prior to occurrence have been 

found to also increase psychological distress in communities (Munro et al., 2017; Liu et al., 2006). 

In the same vein, floods have been found to increase psychological difficulties for people with 

poorer psychological and physical health prior to the onset of the flood (Alderman et al., 2013; 

Ginexi et al., 2000). Also, Norris et al., (2004) found low social support to increase the onset of 

mental illness after floods. 

 

Place attachment has been shown to prevent or minimize losses during disasters because it 

motivates people to engage in disaster awareness, planning, information sharing, mitigation, 

preparedness, stewardship, or activism behaviours (Anton & Lawrence, 2016; Cutter et al., 2008; 

Zhang, Zhang, Zhang & Cheng, 2014). Place attachment has also been shown to aid in managing 

rapid onset disasters like floods, wildfires and volcanic eruptions (Bihari & Ryan, 2012; Bird, 

Gısladottir & Dominey-Howes, 2011; Mishra et al., 2010). Residents with strong place attachment 

have been found to refuse to evacuate during disasters, sometimes putting their lives in danger to 

stay close to home (e.g., Boon, 2014; Chamlee-Wright & Storr, 2009; Fried, 2000; Paton, Burgelt 

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& Prior, 2008). 

 

Li et al. (2020) found that flood experiences were significantly associated with perceived safety 

and anxiety. The study reported that individuals who experienced floods had a higher level of 

anxiety and lower perceived safety compared to those who did not experience floods. Similarly, 

Bubeck et al. (2013) reported that individuals who had experienced floods had a higher level of 

perceived safety concerns and anxiety, even after controlling for the flood's magnitude. In the same 

vein, Botzen and Aerts (2013) found that individuals living in areas with a higher flood risk had a 

higher level of perceived safety concerns and anxiety. This is supported by van der Velden et al. 

 (2013) who report that flood experience and flood severity were significant predictors of anxiety 

and perceived safety. Furthermore, Mano et al. (2018) also found that individuals who had adaptive 

coping strategies had a lower level of anxiety and higher perceived safety compared to those who 

had maladaptive coping strategies. Hernandez et al. (2016) similarly find that individuals with a 

stronger attachment to their homes had higher levels of anxiety during and after a flood event. 

Kim et al. (2018) also found in their study that place attachment was positively associated with 

anxiety related to flood risk. The study also reported that individuals with higher levels of place 

attachment were more likely to experience anxiety related to the potential loss of their homes or 

communities. Steinführer and Witt (2015) show that the relationship between place attachment and 

anxiety related to floods was stronger for individuals with higher levels of education and those living 

in areas with a lower flood risk. Knez and Eliasson (2017) similarly show that individuals with 

higher levels of place attachment had lower levels of anxiety related to floods when they employed 

adaptive coping strategies. 

 

In Ghana, studies have shown that exposure to floods can lead to increased levels of anxiety and 

stress. Agyei-Mensah et al., (2012) found that women who had experienced a flood event were 

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more likely to experience symptoms of anxiety, such as worry, nervousness, and fear, compared 

to women who had not experienced a flood. Another study found that flood survivors in Ghana 

experienced elevated levels of stress and anxiety in the aftermath of the disaster, with symptoms 

persisting for several months after the event (Adinkrah et al., 2014). In addition to direct exposure 

to floods, the impact of floods on social and economic well-being may also contribute to anxiety. 

For example, a study of flood-affected communities in Ghana found that loss of property and 

income was a significant source of stress and anxiety, particularly among women (Oppong & 

Agyei-Mensah, 2018). Furthermore, disruptions to social networks and community support 

structures may increase feelings of isolation and vulnerability, further exacerbating anxiety among 

flood survivors (Agyei-Mensah et al., 2012). Given the high levels of anxiety experienced by flood 

survivors in Ghana, it is important to address the psychological needs of these communities in the 

aftermath of a disaster. Several interventions have been proposed, including psychological first 

aid, counselling, and community-based interventions (Adinkrah et al., 2014). Furthermore, it is 

important to consider the role of gender in disaster recovery, as women may experience greater 

levels of stress and anxiety, and may benefit from targeted interventions that address their specific 

needs and concerns (Oppong & Agyei-Mensah, 2018). 

 

2.7  Flood Management Authorities 

 

Flood management authorities are pivotal in addressing the multifaceted challenges posed by flooding 

events. A comprehensive study by Penning-Rowsell et al. (2013) delves into the roles of flood 

management authorities in Europe. The research highlights the diverse functions these authorities 

undertake, encompassing flood risk assessment, infrastructure maintenance, and community 

engagement. Additionally, it underscores the necessity of collaboration between national and local 

authorities in effective flood management.  

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Authorities in charge of flood management should prioritize community interaction, according to 

research by Kreibich et al. (2017). It talks about how communicating flood risks and running public 

awareness programs can improve community resilience. The study emphasizes how authorities can 

considerably lessen community susceptibility to flooding by actively educating communities. 

 

Merz et al. (2010) examine flood control infrastructure and the role that flood management agencies 

play in preserving and modernizing flood defenses. The study emphasizes how important it is to have 

well-maintained infrastructure if you want to lower your risk of flooding and increase community 

resilience. Communities' resistance to flood disasters is examined by Botzen et al. (2019), who also 

evaluate the efficacy of flood management authorities. The study highlights the necessity of adaptive 

flood risk management techniques that increase community resilience to shifting climatic trends while 

simultaneously reducing susceptibility. 

 

To sum up, flood control authorities have a variety of responsibilities when it comes to reducing the 

likelihood of flooding and building community resilience. Empirical studies suggest that their efficacy 

is contingent upon cooperative endeavors, community involvement, upkeep of infrastructure, and 

adjustment to dynamic environmental obstacles. The importance of flood management agencies in 

developing long-term flood risk management strategies is highlighted by these research. 

 

 

2.8 Theoretical Framework 

 

The theoretical framework for this study is a blend of two theories. Namely the Social 

Vulnerability theory and the Conservation of Resources (COR) theory (Hobfoll, 1998). Social 

vulnerability theory is a framework that examines how social factors such as race, class, gender, 

and other forms of social inequality influence people's ability to prepare for, cope with, and recover 

from disasters. According to the theory, social factors create unequal access to resources, power, 

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and social support, which increases vulnerability to the impacts of disasters (Cutter et al., 2003). 

The COR theory focuses on the resources of both individuals and groups, and provides a thorough 

framework for evaluating the impact of evaluation on emotions and performance. This study adopts 

these two theories. The theory has been widely applied in the field of disaster research and has 

been used to understand the disproportionate impact of disasters on marginalized groups. 

Researchers have found that social vulnerability can vary depending on the context of the disaster, 

the characteristics of the population, and the level of social inequality present in the community 

 (Wisner et al., 2004). Therefore, social vulnerability theory emphasizes the need to address 

underlying social inequalities to reduce the impact of disasters and build resilience in communities. 

According to COR theory, human people are primarily motivated to create, maintain, and grow 

their resource bases in order to safeguard their own well-being and the social ties that support it. 

The idea offers a framework for avoiding resource depletion, preserving existing resources, and 

accumulating resources required for adopting optimal actions. According to the COR hypothesis, 

resources are crucial in influencing whether people perceive events as stressful and how they are 

able to handle stressful circumstances. Events in a person's life that are traumatic or disruptive 

have the potential to deplete their personal and environmental resources as well as their 

psychological well-being. 

 

 

 

 

 

 

 

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2.9 Conceptual Framework 

 
 

 

Figure 2.8: Conceptual framework showing the relationship between the experience of flood and 

anxiety.  
 

 

Figure 2.8 above shows the relationship existing between experience of flood and anxiety. 

Based on the diagram, the main independent variable Household Experience of Flood may have 

a direct impact on anxiety (outcome variable).  On the other hand, the independent variable 

along with the mediating variables (placed attachment and perceived safety) may also result in 

anxiety.  The control variables (age, sex, marital status, level of education, household income, 

household tenure and length of stay in the community) can also have a direct impact on anxiety. 

In all, a combination of the independent variables, control variables and mediating variables 

also have an impact on anxiety. 

 

 

 

 

 

 

 
 

 
 

 

 
 

 
 

 

 

 

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2.10 Hypotheses 

      H1: Households with a higher experience of floods will report higher levels of anxiety. 

      H2: The relationship between the experience of floods and anxiety is mediated by the   level 

of perceived safety. 

      H3: The relationship between the experience of floods and anxiety is mediated by the   level 

of place attachment. 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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CHAPTER THREE 

METHODOLOGY 

3.1 Introduction 

 

This chapter presents the study design and methodology used in the study. The chapter also 

presents information about the study area as well as some important demographic and geographic 

information, source of data for the study, sample design, description of variables, analytical 

methods, and limitations associated with the data. 

 
 

3.2 Study Area 

 

The Volta Delta falls within the southeastern coastal plains climatic zone. The study was conducted 

in Keta and Totope, located along the coast of Ghana and are found in the Volta and Greater Accra 

Regions respectively. 

 

Keta is located in the Keta Municipality. The Municipality is located between Latitudes 5.45oN 

and 6.005oN and Longitudes 0.30oE and 1.05oE. It is about 160 kilometres from Accra, and is 

situated to the east of the Volta Estuary. Its shared borders with the South Tongu District to the 

west, the Gulf of Guinea to the south, Ketu North and South District to the east, and Akatsi South 

District to the north. The Municipality has a total surface area of 753.1 km2. The Keta Lagoon, 

which is the largest lagoon in Ghana, is the largest of the bodies of water. Keta is one of the 

communities in the municipality which has experienced an increased rate of erosion and flooding, 

with more than half of Keta and its surrounding towns under water (Ile et al. 2014). This makes 

Keta one of the eligible communities for this study. According to the 2021 Population and Housing 

Census, Keta Municipality has 78,862 residents or 5.0% of the total population of the Volta Region. 

Males make up 46.8% of the total population of the Municipality while females make up 53.2%. 

Urban areas are home to more than half (60.8%) of the residents of Keta Municipality. The 

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Municipality's sex ratio is 88.3, which indicates that there are 88 males for every 100 females. 

 

The Keta municipality is also blessed with some tourist attraction sites such as the Ramsar site, 

because it offers refuge to a variety of birds, both migratory and resident, particularly waterfowl. 

Several thousand migratory birds that travel the South Atlantic and Mediterranean flyways are said 

to meet at the Anlo- Keta Ramsar site. There are many different species of terns, gulls, and pelicans 

that nest, rest, feed, and breed there. There are many miles of pristine, distinctive golden beaches 

in the nation that can serve as tourist-friendly retreats. The beaches, which are bathed in brilliant 

sunshine, have sands with different sizes of grains, from fine to coarse. 

 

Totope on the other hand is located in the Ada East District. The district, which is part of the 
 

Greater Accra Region has a total land area of 289.783 acres (square km). It is located at an elevation 
 

of 42 meters above sea level. Totope is a community that is sandwiched between the ocean and the 

Songhor Lagoon. It has a population of a little over 3000. The main occupation in this community 

is fishing. Totope is one of the communities located along the Volta Delta, which is constantly 

experiencing flooding (Gampson et al. 2017). 

 

One of the issues Totope is confronted with is access to good drinking water. Pipe-borne water is 

not available in the community. The main source of drinking water is from shallow wells and 

sachet water. Amounts of land that were once dry enough for the Totope villagers to cultivate 

crops, construct homes, and raise families have been overtaken by the ocean. Totope which was a 

nesting site for endangered turtles and a habitat for migratory birds is being destroyed. It is one of 

the flood-prone coastal areas in Ghana making it a suitable place for the study. 

 
 

3.2 Data Source 

 

The data used for this study is the data collected by the Evaluating Health Impact of Climate 

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Adaptation Strategies (EHICAS) project at the Regional Institute for Population Studies, 

University of Ghana. The data was collected in December 2021. The study employed a cross-

sectional design, a scientific approach crucial for capturing the experiences of diverse communities 

within the same time frame, thereby avoiding the variations that could arise at different times and 

seasons. The objective of the study was to gather information from communities affected by floods, 

their adaptation strategies, and health- related issues emanating from flood adaptation strategies 

employed in the study communities and how these factors interrelated. 

 
 

3.3 Sample Design and Selection 

 

The sample size for this study was 500 households but ended up collecting data from 505 

household in Keta and Totope. The unit of analysis for this study is the household member 

responding to the questions. There were two main stages of sampling: the sampling of the study 

communities and the sampling of the individual respondents. For the study communities, the study 

targeted communities that have been affected by floods over the years and have also received some 

intervention from the government about the flood hazard. Both Keta and Totope were selected 

because of their history with flood hazards and managed retreat over the years to cope with the 

situation. Also, scientists on the project have had previous projects in Keta and Totope, so that made 

it prudent for them to select these two communities over other communities that have similar 

characteristics in the Volta Delta. 

 
 

In terms of the selection of participants for the study, a household listing was conducted in the two 

project locations to first identify individual household members who were aged 18 years and 

above. In Keta, the household listing was done in Kedzikope and Havedzi. However, because 

Totope is a small village, the listing was done in the entire village. After the listing, individual 

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household members aged 18 years and above were randomly selected for the study. The sampling 

was done by taking into consideration the sex of the respondents, and also ensuring that not more 

than two members of the same household were selected to participate in the study. 

 
 

All those who were selected for the study were interviewed in person using computer aided 

personal interview (CAPI). 

 
 

3.5 Variables 

 

To carry out this study, some variables were listed as independent variables, others as intermediate 

variables, and some listed as dependent variables. 

 
 

3.5.1 Dependent Variable 

 

The dependent variable in this study is the anxiety levels of the respondents. To measure anxiety, 

respondents were asked if they felt anxious or on edge with regard to their flood experience. The 

responses are scored and scaled using the General Anxiety Disorder (GAD-2) scale. The GAD-2 

is a very quick measuring tool, and it only contains two questions that are directly related to the 

symptoms of anxiety disorders. The questions asked are: 

When thinking about flood management activities do you feel the following: 

 

• Feeling nervous, anxious, or on edge 
 

• Not being able to stop or control worrying 

 
With 4 response categories, “not bothered at all”, “Occasionally bothered (once or twice a 

week)”, “Occasionally bothered (once or twice a month),” and “Extremely bothered (nearly 

every day)”. The GAD-2 scale reads from 0 to 6. A GAD-2 score of between 0 to 3 is regarded as 

a diagnosis of mild anxiety. Without additional methods or therapies, the level of anxiety that the 

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majority of us experience in our daily activities is manageable. A GAD-2 score of 3 or higher is a 

reliable indicator of an anxiety disorder in the clinical setting. The scores were categorized into 

two, no sign of anxiety and signs of anxiety. 

 
 

3.5.2 Independent Variables 

 

The main independent variable for this study is the household experience of flood. This is 

measured by asking the respondent to circle which of the responses below reflects their current 

situation: 

• In my current residence, I have not been affected by flooding 

• In my current residence, I have been indirectly affected by flooding i.e., flooding has never 

entered my house but I have suffered temporary disruption such as disruption to services 

like gas, electricity, water, transportation and / or disruption to daily life such as school, 

health centre, shop closures etc. 

• In my current residence I have been directly affected by flooding with water entering my 

home. 

 

     Those who circled the third and second responses were put together as having experienced flood.   

This study also uses some demographic and socioeconomic indicators as predictor variables. The 

listed demographic variables used in this study are sex, age, and marital status. The sex of the 

respondents was split into male and female. The age of respondents was used as a continuous 

variable. Marital status was recategorized as never married, married, and formerly married. Single 

respondents were those who had never been in a relationship at the time of the study. The married 

category includes people who were either married or living with their partners, while the formerly 

married category includes those who were either widowed, divorced, no longer living together, or 

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separated. 

 

Level of education, household tenure, and annual household income are the socio-economic factors 

that were employed in this study. In the data, the level of education was divided into no education, 

primary, secondary, and higher. Household tenure was recategorized into renting, owner-occupier 

and living with family/friends. The household annual income was also recategorized into below 

GHc 10,000, GHc 10,000 to GHc 20,000, and above GHc 20,000. 

 

Other variables used as predictors are the length of stay in the community and the perception of 
 

trust in flood management authorities in Totope and Keta. The length of stay was split into five 

exclusive categories, less than 1 year, 1 to 5 years, 6 to 10 years, and more than 10 years of stay in 

the community. The perception of trust in flood management authorities was measured as a 

composite score ranging from 4-20. The scores were then categorized into 3. Those who trust   

flood management authorities, those who neither trust or do not trust management authorities, and 

those who do not trust management authorities at all.  

 

Questions used in the composite scoring for the perception of trust in flood management authorities 

are; ‘if flood management authorities behave in an honest manner, if they acted in a socially 

responsible way, if they felt the information provided by the flood management authorities was 

honest and if the flood management authorities are good and kind’ 

 
 

3.5.3 Mediating Variables 

 

This study identifies two variables that act as either enabling or deterring factors to the experience 

of anxiety by the respondents. These variables are respondents’ sense of attachment to the place 

and how they perceive their safety in the community in relation to flood management activities. 

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To measure perception of safety, the questions below were asked. 

• When thinking about flood management activities, I feel safe in my community. 

 

• When thinking about flood management activities, I feel safe in my home. 

 

• I feel much safer about future flooding events because of the flood management activities 

that are happening in this community. 

These questions were measured as strongly disagree, disagree, neither agree nor disagree, agree, 

and strongly agree. The questions were added to get a cumulative score with a range from 3-15 

and the mean for the scores was calculated to measure the perception of safety. The scores were 

categorized into do not feel safe, feel neither safe nor unsafe, and feel safe. Respondents who 

scored 1 and 2 were placed in category 1 “Do not feel safe”, those who scored 3 were placed in 

the 2nd category “Neither feel safe or