The 2007 European Union Floods Directive encouraged member nations to pursue a more integrated view of flood risks and management strategies, taking into account social vulnerabilities of residents. To date, most flood-risk analyses conducted by the Dutch government have focused on physical risk. This study utilizes fine-scale data to construct a social vulnerability index for 147 districts of the Dutch province of Zeeland, located in the Southwestern Delta and the scene of widespread devastation following the 1953 North Sea Flood. Factor analysis of 25 indicators of social vulnerability selected from related research in Europe and the United States results in seven factors explaining roughly 66% of the total variance. These factors of social vulnerability in Zeeland are urban density, low-income households, recent population change, female gender, train access, and self-employed and service-sector employment. The index was constructed using the toploading variable in each of these factors, with weights determined by the variance explained by each factor. Scores range from a low of 0.20 in Schore, municipality of Kapelle, to the highest score of 0.64 in Oudelandse Hoeve of Terneuzen. The most vulnerable districts are located in South Zeeland, with eight of the 10 found in Terneuzen. The majority of less vulnerable districts are located in Zeeland's central region.

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.