Indicator Assessment

Floods and health

Indicator Assessment
Prod-ID: IND-347-en
  Also known as: CLIM 046
Created 15 Dec 2016 Published 20 Dec 2016 Last modified 20 Dec 2016
12 min read
  • River and coastal flooding have affected many millions of people in Europe since 2000. Flooding affects human health through drowning, heart attacks, injuries, infections, exposure to chemical hazards and mental health consequences. Disruption of services, including health services, safe water, sanitation and transportation ways, plays a major role in vulnerability.
  • Observed increases in heavy precipitation and extreme coastal water levels have increased the risk of river and coastal flooding in many European regions.
  • In the absence of additional adaptation, the projected increases in extreme precipitation events and in sea level would substantially increase the health risks associated with river and coastal flooding in Europe.

Deaths related to flooding in Europe

Note: This map shows the number of deaths related to flooding per million inhabitants (cumulative over the period 1991–2015, with respect to 2015 population).

Data source:

Past trends

Most regions in Europe have exhibited an increasing trend in heavy precipitation over recent decades, in particular in winter. The number of large inland floods in Europe has been increasing since the 1980s; however, there is not yet conclusive evidence that climate change has already contributed to this trend [i].

Estimates for the World Health Organization (WHO) European Region based on a combination of data from the Emergency Events Database (EM-DAT) and the Dartmouth Flood Observatory (DFO) indicate that coastal and inland floods killed more than 2 000 people and affected 8.7 million in the period 2000–2014. Figure 1 shows the number of deaths related to flooding in each European Environment Agency (EEA) member and cooperating country for the same period, normalised by their population. The largest numbers are found in south-eastern Europe, eastern Europe and central Europe. Note that, because of the relatively short time period of 15 years, the value of the indicator can be significantly affected by a single catastrophic event. For example, at least 50 people were killed in massive floods in the Balkan countries in May 2014 [ii].

The EM-DAT database also includes data on people injured or (otherwise) affected by floods. This information is not presented here owing to concerns regarding the consistency with which these data are assessed and reported across countries and even for different flood events in the same country.


Heavy precipitation events are likely to become more frequent in many regions in Europe, and sea level rise is projected to accelerate compared with the 20th century under all emissions scenarios. The PESETA II project and the ClimateCost project have estimated the economic and health effects of river and coastal flooding under various climate change scenarios, including sea level rise.

For a medium emissions scenario (IPCC Special Report on Emissions Scenarios (SRES) A1B) and in the absence of adaptation, river flooding is estimated to affect about 300 000 people per year in the EU by the 2050s and 390 000 people by the 2080s; the latter figure corresponds to more than a doubling with respect to the baseline period (1961–1990). The British Isles, western Europe and northern Italy show a robust increase in future flood hazards; these regions also show the greatest increase in the population affected by river floods [iii].

If no additional adaptation measures were taken, the number of people affected by coastal flooding in the EU at the end of the 21st century would range from 775 000 to 5.5 million people annually, depending on the emissions scenario. The number of deaths in the EU due to coastal flooding in the 2080s would increase by 3 000, 620 and 150 per year under a high emissions scenario (assuming 88 cm sea level rise), the SRES A1B ‘business as usual’ scenario and the E1 mitigation scenario, respectively. Two-thirds of these deaths would occur in western Europe. Coastal adaptation measures (dikes and beach nourishment) could significantly reduce risks to less than 10 deaths per year in 2080 [iv]. Somewhat different estimates were provided in another study [v].

Flooding is also associated with mental health impacts. Coastal flooding in the EU could potentially cause five million additional cases of mild depression annually by the end of the 21st century under a high sea level rise scenario in the absence of adaptation [vi].

[i] O Zolina et al., ‘Changing Structure of European Precipitation: Longer Wet Periods Leading to More Abundant Rainfalls’,Geophysical Research Letters 37 (2010): 1–5; Øystein Hov et al., ‘Extreme Weather Events in Europe: Preparing for Climate Change Adaptation’ (Oslo: Norwegian Meteorological Institute, 2013),; Zbigniew W. Kundzewicz, Iwona Pińskwar, and G. Robert Brakenridge, ‘Large Floods in Europe, 1985–2009’,Hydrological Sciences Journal 58, no. 1 (January 2013): 1–7, doi:10.1080/02626667.2012.745082.

[ii] Ed Holt, ‘Disease Outbreaks Predicted in Flood-Ravaged Balkans’,The Lancet 383, no. 9933 (June 2014): 1959, doi:10.1016/S0140-6736(14)60940-5.

[iii] R. Rojas et al., ‘Assessment of Future Flood Hazard in Europe Using a Large Ensemble of Bias Corrected Regional Climate Simulations’,Journal of Geophysical Research 117 (2012): D17109, doi:10.1029/2012JD017461; Rodrigo Rojas, Luc Feyen, and Paul Watkiss, ‘Climate Change and River Floods in the European Union: Socio-Economic Consequences and the Costs and Benefits of Adaptation’,Global Environmental Change 23, no. 6 (December 2013): 1737–51, doi:10.1016/j.gloenvcha.2013.08.006; J. C. Ciscar et al., ‘Climate Impacts in Europe: The JRC PESETA II Project’, JRC Scientific and Policy Reports (European Commission — Joint Research Centre, Institute for Prospective Technological Studies, Institute for Environment and Sustainability, 2014),

[iv] J. C. Ciscar et al., ‘Physical and Economic Consequences of Climate Change in Europe’,Proceedings of the National Academy of Sciences 108, no. 7 (31 January 2011): 2678–83, doi:10.1073/pnas.1011612108; R.S. Kovats et al., ‘The Impacts and Economic Costs on Health in Europe and the Costs and Benefits of Adaptation. Results of the EC RTD ClimateCost Project. Final Report’, The ClimateCost Project. Volume 1: Europe (Sweden: Stockholm Environment Institute, 2011),

[v] Tanja Wolf et al., ‘The Health Effects of Climate Change in the WHO European Region’,Climate 3, no. 4 (16 November 2015): 901–36, doi:10.3390/cli3040901.

[vi] Francesco Bosello et al., ‘Economic Impacts of Climate Change in Europe: Sea-Level Rise’,Climatic Change 112, no. 1 (23 November 2011): 63–81, doi:10.1007/s10584-011-0340-1; Paul Watkiss and Alistair Hunt, ‘Projection of Economic Impacts of Climate Change in Sectors of Europe Based on Bottom up Analysis: Human Health’,Climatic Change 112, no. 1 (2012): 101–26, doi:10.1007/s10584-011-0342-z.

Supporting information

Indicator definition

  • Deaths related to flooding


  • Deaths per million population (dimensionless)


Policy context and targets

Context description

In April 2013, the European Commission (EC) presented the EU Adaptation Strategy Package. This package consists of the EU Strategy on adaptation to climate change (COM/2013/216 final) and a number of supporting documents. The overall aim of the EU Adaptation Strategy is to contribute to a more climate-resilient Europe.

One of the objectives of the EU Adaptation Strategy is Better informed decision-making, which will be achieved by bridging the knowledge gap and further developing the European climate adaptation platform (Climate-ADAPT) as the ‘one-stop shop’ for adaptation information in Europe. Climate-ADAPT has been developed jointly by the EC and the EEA to share knowledge on (1) observed and projected climate change and its impacts on environmental and social systems and on human health, (2) relevant research, (3) EU, transnational, national and subnational adaptation strategies and plans, and (4) adaptation case studies.

Further objectives include Promoting adaptation in key vulnerables ectors through climate-proofing EU sector policies and Promoting action by Member States. Most EU Member States have already adopted national adaptation strategies and many have also prepared action plans on climate change adaptation. The EC also supports adaptation in cities through the Covenant of Mayors for Climate and Energy initiative.

In September 2016, the EC presented an indicative roadmap for the evaluation of the EU Adaptation Strategy by 2018.

In November 2013, the European Parliament and the European Council adopted the 7th EU Environment Action Programme (7th EAP) to 2020, ‘Living well, within the limits of our planet’. The 7th EAP is intended to help guide EU action on environment and climate change up to and beyond 2020. It highlights that ‘Action to mitigate and adapt to climate change will increase the resilience of the Union’s economy and society, while stimulating innovation and protecting the Union’s natural resources.’ Consequently, several priority objectives of the 7th EAP refer to climate change adaptation.


No targets have been specified.

Related policy documents

  • 7th Environment Action Programme
    DECISION No 1386/2013/EU OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 20 November 2013 on a General Union Environment Action Programme to 2020 ‘Living well, within the limits of our planet’. In November 2013, the European Parliament and the European Council adopted the 7 th EU Environment Action Programme to 2020 ‘Living well, within the limits of our planet’. This programme is intended to help guide EU action on the environment and climate change up to and beyond 2020 based on the following vision: ‘In 2050, we live well, within the planet’s ecological limits. Our prosperity and healthy environment stem from an innovative, circular economy where nothing is wasted and where natural resources are managed sustainably, and biodiversity is protected, valued and restored in ways that enhance our society’s resilience. Our low-carbon growth has long been decoupled from resource use, setting the pace for a safe and sustainable global society.’
  • Climate-ADAPT: Adaptation in EU policy sectors
    Overview of EU sector policies in which mainstreaming of adaptation to climate change is ongoing or explored
  • Climate-ADAPT: Country profiles
    Overview of activities of EEA member countries in preparing, developing and implementing adaptation strategies
  • DG CLIMA: Adaptation to climate change
    Adaptation means anticipating the adverse effects of climate change and taking appropriate action to prevent or minimise the damage they can cause, or taking advantage of opportunities that may arise. It has been shown that well planned, early adaptation action saves money and lives in the future. This web portal provides information on all adaptation activities of the European Commission.
  • EU Adaptation Strategy Package
    In April 2013, the European Commission adopted an EU strategy on adaptation to climate change, which has been welcomed by the EU Member States. The strategy aims to make Europe more climate-resilient. By taking a coherent approach and providing for improved coordination, it enhances the preparedness and capacity of all governance levels to respond to the impacts of climate change.
  • Implementing the European Regional Framework for Action to protect health from climate change
    How far have Member States in the WHO European Region progressed in implementing the European Commitment to Act on climate change and health? This was the question addressed to members of the Working Group on Health in Climate Change (HIC) of the European Environment and Health Task Force in summer 2012. The HIC members were asked to respond to a comprehensive questionnaire to assess the current status of health-relevant climate change mitigation and adaptation actions. A total of 22 Member States answered the questions focusing on eight thematic areas or topics: governance, vulnerability, impact and adaptation assessments, national and subnational adaptation strategies, climate-change mitigation, strengthening of health systems, awareness raising and capacity building, green health services and sharing best practices. This publication describes and analyses their responses.


Methodology for indicator calculation

Data on deaths related to flooding is taken from the EM-DAT database.

Methodology for gap filling

Not applicable

Methodology references



Methodology uncertainty

Not applicable

Data sets uncertainty

The attribution of health effects to climate change is difficult owing to the complexity of interactions and the potential modifying effects of a range of other factors (such as land-use changes, public health preparedness and socio-economic conditions). Criteria for defining a climate-sensitive health impact are not always well identified, and their detection sometimes relies on complex observational or prospective studies, applying a mix of epidemiological, statistical and/or modelling methodologies. Furthermore, these criteria, as well as the completeness and reliability of observations, may differ between regions and/or institutions, and they may change over time. Data availability and quality are crucial in climate change and human health assessments, both for longer term changes in climate-sensitive health outcomes and for health impacts of extreme events. The monitoring of climate-sensitive health effects is currently fragmentary and heterogeneous. All these factors make it difficult to identify significant trends in climate-sensitive health outcomes over time, and to compare them across regions. In the absence of reliable time series, more complex approaches are often used to assess the past, current and future impacts of climate change on human health.

The links between climate change and health have been the subject of intense research in Europe in the early 2000s (e.g. the projects cCASHh, EDEN, EDENext and Climate-TRAP); more recently health has been incorporated, to a minor extent, into some cross-sectorial projects (e.g. CIRCE, PESETA II, IMPACT2C and RAMSES). Furthermore, the World Health Organization (WHO) has a policy, country support and research mandate given by its 193 Member States through the World Health Assembly on all aspects of climate change and health.

Rationale uncertainty

No uncertainty has been specified

Data sources

Other info

DPSIR: Impact
Typology: Descriptive indicator (Type A - What is happening to the environment and to humans?)
Indicator codes
  • CLIM 046
Frequency of updates
Updates are scheduled every 4 years
EEA Contact Info


Geographic coverage


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