# Understanding vulnerability to flood-induced disasters: a comprehensive scoping review on at-risk individuals and evacuation challenges

## TL;DR

This study reviews how vulnerable populations are managed during floods in high-income countries, highlighting gaps in evacuation strategies and the need for inclusive approaches.

## Contribution

The study provides a comprehensive scoping review of vulnerability definitions and evacuation challenges in flood-induced disasters, identifying underrepresented groups and inconsistent practices.

## Key findings

- Several vulnerable groups, such as single-parent households and undocumented workers, are underrepresented in evacuation research.
- National approaches to vulnerability mapping and management show substantial variation and fragmentation.
- Research on Flexible Surge Capacity and Alternative Care Facilities for vulnerable populations remains limited.

## Abstract

Flood-induced disasters are increasing in frequency and severity, with high-income countries (HICs) facing growing health, social, and operational challenges, particularly in managing and protecting vulnerable populations that are disproportionately affected. This scoping review, conducted in accordance with PRISMA-ScR guidelines, examined how vulnerability is defined, addressed, and operationalized in evacuation management during flood-induced disasters in HICs. A systematic search identified 98 peer-reviewed studies published between 2014 and 2025. The analysis revealed critical gaps and inconsistencies in how vulnerability is conceptualized and applied in evacuation contexts. Several groups–including single-parent households, caregivers, individuals with mental health conditions, undocumented workers, and those facing linguistic or educational barriers–remain underrepresented, while others, such as informal caregivers, religious minorities, and victims of domestic abuse, are not addressed at all. The review also identified substantial variation in national approaches to vulnerability mapping and management, with most countries relying on fragmented and inconsistently integrated practices. Evidence linking vulnerability assessment to evacuation planning and sheltering decisions remains limited. Research on Flexible Surge Capacity and the use of Alternative Care Facilities for vulnerability-informed evacuation remains scarce, particularly regarding non-medical facilities as community-based hubs for rapid assessment and triage. Furthermore, few studies addressed continuity across the disaster timeline, linking pre-disaster vulnerability assessment, rapid needs assessment, and long-term recovery support. This review advances understanding of how vulnerability can be more effectively embedded in evacuation management, providing empirically grounded and comparative insights to inform inclusive, intersectional, and operational flood-induced disaster management strategies in HICs.

The online version contains supplementary material available at 10.1186/s12913-025-13898-w.