Deficiency of healthcare accessibility of elderly people exposed to future extreme coastal floods: A case study of Shanghai, China

Using Shanghai as a case, this study introduced a new analytical framework to integrate models of coastal flooding, local population growth, and medical resource supply-demand estimation. Socioeconomic development, subsidence, and climate change have led to high flood risks in coastal cities, making the vulnerable, especially elderly people, more prone to floods. However, we mostly do not know how the accessibility of life-saving public resources for the elderly population will change under future scenarios. The results show that under an extreme scenario of coastal flooding in the year 2050, in the absence of adaptation, half of the elderly population may be exposed to floods, the supply of medical resources will be seriously insufficient compared to the demand, and the accessibility of emergency medical services will be impaired by flooding. The methodology can be applied to gain insights for other vulnerable coastal cities, to assist robust decision making about emergency responses to flood risks for elderly populations in an uncertain future.

The publications provide the following takeaways: 

• Under the RCP2.6 and RCP8.5 emission scenarios, the spatial patterns of predicted population exposure are similar. Exposure will be the highest along the Huangpu River, in the low-lying areas of the city center, and on Chongming Island in Shanghai.
• As the years and return periods increase, the difference between the supply and demand ratios of medical resources in the future and that in 2010 becomes larger, indicating that extreme foods will have major impacts on the supply-demand ratio of medical resources for Shanghai’s elderly population, assuming no adaptation to the new reality of demography and food hazard.
• With the future growth of the elderly population, the accessibility of emergency services will decrease, and most neighborhood committees will have poor accessibility to emergency response centers in the city of Shanghai.