During the 15th World Congress on Disaster and Emergency Medicine in Amsterdam, May 2007 (15WCDEM), a targeted agenda program (TAP) about the public health aspects of large-scale floods was organized. The main goal of the TAP was the establishment of an overview of issues that would help governmental decision-makers to develop policies to increase the resilience of the citizens during floods. During the meetings, it became clear that citizens have a natural resistance to evacuations. This results in death due to drowning and injuries. Recently, communication and education programs have been developed that may increase awareness that timely evacuation is important and can be life-saving. After a flood, health problems persist over prolonged periods, including increased death rates during the first year after a flood and a higher incidence of chronic illnesses that last for decades after the flood recedes. Population-based resilience (bottom-up) and governmental responsibility (top-down) must be combined to prepare regions for the health impact of evacuations and floods. More research data are needed to become better informed about the health impact and consequences of translocation of health infrastructures after evacuations. A better understanding of the consequences of floods will support governmental decision-making to mitigate the health impact. A top-10 priority action list was formulated.

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Storm surge barriers are large movable hydraulic structures which close during a storm surge to prevent coastal floods. In the regions they protect, a failure to close the barrier is often the most likely cause for a catastrophic flood. Nevertheless, flood risk assessments usually only focus on raising flood defences behind the barrier. Despite its importance, there is no general method to assess the costs and benefits of improving the closure reliability. This paper presents a model that optimises investments considering both closure reliability improvements and raising flood defences behind the barrier, using the region protected by the Maeslant barrier as a case. We substantiate that constructing the Maeslant barrier was an optimal economic decision. Moreover, we demonstrate large investments such as a redundant barrier already being economically sound with a few decimetres of sea level rise. Based on our experience with this case study, we expect the model is useful in finding strategies to adapt to rising sea levels and other developments that cause coastal flood risk to rise worldwide.