gms | German Medical Science

Introduction: Unaware and insufficient understanding of possible climate-related hazards in the future may lead to investment in health care services in hazard-prone areas, which manifests in high exposure of the health care facilities and health population to climate risk. Vice versa, lacking integration of future-oriented climate risk-informed spatial planning, urbanization often presses cities to compromise hazard-prone areas for development, which demands public infrastructure service. This dilemma could exacerbate a local public health service to deal with high service demands due to urbanization and at the same time confront intensified climate-related hazards.

Material and methods: This research presents Health Integrative Climate Resilience and Adaptation Future (HICRAF), a collaborative scenario planning framework to help the local public health service address the potential impact of climatic and non-climatic change interactions. The framework encompasses the local public health care to tailor and operationalize their climate resilience and adaptation target(s) in the long-term, considering the deep uncertainty of the bandwidth of possible future conditions. This mixed method of quantitative and qualitative techniques enables the local stakeholders to manifest their future urban development envisions and future climate trajectories and then debate them through a spectrum of possible futures and their intertwined potential impact on the local public health services. With collaborative scenario planning highlighted backcasting approach, the local stakeholders determine their own desirable future versions and shape the way how to realize them. Then, composite indicators come to play as an innovative element in assessing the potential impact of future climate-related hazards that helps to track climate resilience interventions in both spatial-based settings and network-based operations. The assembly of scenario planning and composite indicator tool helps fasten the day-to-day public health operation and long-term strategic planning aspect, which public health care operators and policymakers often ignore.

Results & conclusion: Nevertheless, local stakeholders in Khon Kaen City, Thailand, well embraced this future-oriented and humble planning approach for integrated urban health climate resilience. However, there are still vast gaps in addressing the reality of spatial-system risks entangling in our urban health infrastructure, such as hybridizing spatial-system risk in urban health care services in a forward-looking manner and identifying barriers and transformative solutions for mainstreaming spatial-system risk concerns to climate-resilient urban health care investment and operation.