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Susceptibility of Public Health Impacts from Flooded Water, Wastewater and Public Health Infrastructure

About the Project

Coastal infrastructure is becoming increasingly vulnerable to hazards including extreme precipitation events, stronger storm surge, riverine flooding and rising seas. Knowing that there is an intimate connection between infrastructure and public health, it is important to engage local communities in assessing the susceptibility of their populations to health risks from infrastructure failure.

This project, funded by NOAA’s Coastal and Ocean Climate Applications Program , brought together diverse groups of decision-makers to better understand the cascading public health impacts from water infrastructure vulnerability due to flooding and to develop an assessment that fosters preventive activities to increase resilience. A group of research partners from the South Carolina Sea Grant Consortium, Carolinas Integrated Sciences and Assessments, East Carolina University, North Carolina Sea Grant, Old Dominion University, and Virginia Tech piloted this process in Charleston, S.C. and Morehead City, N.C.

Purpose of the Project

The purpose of this project was to develop a method of assessing the resilience of public water and wastewater systems to flooding as well as the access to health care facilities, and therefore, to improve the health outcomes of communities when faced with tropical storms, increased tidal flooding, and extreme rain events.

Using a simple model of Susceptibility = Vulnerability – Resilience, resources and tools were developed to help communities lower their susceptibility to the public health impacts from these events.

Guidebook and Tools for Community Level Assessment

Two cities – Morehead City, N.C. and Charleston, S.C. – were selected to develop the tool based on their desire to lessen impacts from flooding, their differences in size and geomorphology, and their engagement with state Sea Grant programs and Carolinas Integrated Sciences and Assessments.

Community members such as hospital, municipal, county and local emergency managers, environmental non-governmental organizations, municipal elected and staff officials, public service, water and wastewater managers, local planners, state emergency management and public health planners, and health care leaders and associations were enlisted in developing the background information for the project and in identifying the resources needed to assess the vulnerability of water and wastewater infrastructure and the access to health facilities. Then the communities pilot-tested and evaluated the tools.

With further refining, the result is a guidebook with associated spreadsheet tools and instructional video. The intention is to guide communities that wish to assess their susceptibility to flooding impacts. An outcome of the tool is a list of flood resilience best management practices not currently used by the community. The guide will assist communities in conducting their own assessments, finding partners to conduct the assessments, or contracting out an assessment as best meets their resources and capacity to conduct the technical and engagement work needed.

Assess Your Community

Susceptibility Index Resilience Exercise Walk-through

This video shows how to use the spreadsheet tool to create a Susceptibility Index for your community.


For additional information, please contact Susan Lovelace, S.C. Sea Grant Consortium (