Introduction: The 2021 European floods in Germany, Belgium, and the Netherlands significantly impacted healthcare. With climate change increasing flood risks, healthcare preparedness is essential. Floods affect healthcare directly and indirectly by disrupting patient access, damaging infrastructure and impeding care continuity. Our interdisciplinary research in the Netherlands systematically assesses flood impacts on healthcare, optimises disaster preparedness, patient logistics, and continuity and explores crisis governance, incorporating lessons from coronavirus disease-2019 (COVID-19). Methods: Our multi-sited, interdisciplinary project titled “Pandemic lessons for flood disaster preparedness” includes literature reviews on: (i) the (in) direct impacts of floods on healthcare, (ii) disaster decision-making strategies and (iii) patient logistics during crises. Empirically, ethnographic methods (interviews, focus groups, document analyses, and observations) will: (a) assess hospital flood preparedness, (b) explore decision-making and crisis management strategies and (c) analyse the dynamics of health system governance during floods. Data from these sources and flood scenarios will inform models on healthcare impacts and decision-making, culminating in a simulation game for research and training. Discussion: This study offers a comprehensive, interdisciplinary approach to understanding and improving healthcare system preparedness for floods. By integrating diverse fields such as healthcare governance, disaster risk management, logistics and hydraulic engineering, we provide a unique lens on resilience. A key strength is the incorporation of lessons from the COVID-19 pandemic, allowing us to draw parallels between pandemic response and flood preparedness. In addition, our simulation game serves as a robust tool for translating knowledge into practice. However, the study’s reliance on collaboration with busy healthcare and disaster response professionals may limit engagement. Moreover, the absence of direct public and patient involvement in the research design, though partially mitigated by engaging representative organizations, presents a potential limitation. Lastly, the challenge of obtaining real-time data from flood events could introduce recall bias, but triangulation of various data sources aims to address this issue. Despite these challenges, the study’s integration of long-term data from recent floods and focus on healthcare-specific crisis governance provides valuable insights for improving disaster preparedness.

In emergencies, high stake decisions often have to be made under time pressure and strain. In order to support such decisions, information from various sources needs to be collected and processed rapidly. The information available tends to be temporally and spatially variable, uncertain, and sometimes conflicting, leading to potential biases in decisions. Currently, there is a lack of systematic approaches for information processing and situation assessment which meet the particular demands of emergency situations. To address this gap, we present a Bayesian network-based method called ERIMap that is tailored to the complex information-scape during emergencies. The method enables the systematic and rapid processing of heterogeneous and potentially uncertain observations and draws inferences about key variables of an emergency. It thereby reduces complexity and cognitive load for decision makers. The output of the ERIMap method is a dynamically evolving and spatially resolved map of beliefs about key variables of an emergency that is updated each time a new observation becomes available. The method is illustrated in a case study in which an emergency response is triggered by an accident causing a gas leakage on a chemical plant site.

Urban vulnerability is affected by changing patterns of hazards due to climate change, increasing inequalities, rapid urban growth and inadequate infrastructure. While we have a relatively good understanding of how urban vulnerability changes in space, we know relatively little about the temporal dynamics of urban vulnerability. This paper presents a framework to assess urban vulnerability over time and space to address this gap. We apply the framework to Amsterdam, Rotterdam, and The Hague, the Netherlands. Using high-resolution, anonymised ambulance calls and socio-economic, built environment, and proximity data, we identify three temporal patterns: ’Midday Peaks’, ’Early Birds’, and ’All-Day All-Night’. Each pattern represents a unique rhythm of risk arising from the interaction of people with diverse demographic and socio-economic backgrounds and the temporal flow of their daily activities within various urban environments. Our findings also highlight the polycentric nature of modern Dutch cities, where similar rhythms emerge in areas with varying population densities. Through these case studies, we demonstrate that our framework uncovers the spatio-temporal dynamics of urban vulnerability. These insights suggest that a more nuanced approach is necessary for assessing urban vulnerability and enhancing preparedness efforts.

Increasing frequency of climate-related disruptions requires transformational responses over the lifecycles of interconnected urban systems with short- and long-term change dynamics. However, the aftermath of disruptions is often characterised by short-sighted decision-making, neglecting long-term urban shifts. In this study, we present a first attempt to develop the theoretical foundation for temporal dynamics for increasingly disrupted yet ”connecting and moving” cities that can be used in planning for urban resilience. Using the lens of climate urbanism, we conceptualise the interplay of temporal dynamics to empirically examine how planning practice perceives and addresses temporality in two regions - Amsterdam, the Netherlands, and Mumbai, India. Our findings reinforce that disruptions do not inform long-term planning. Endogenous and exogenous dynamics of change are not viewed together nor used to embed short-term planning goals within long-term resilience visions. To address the lack of systematic planning approaches that can leverage temporal dynamics, we propose two options for temporally flexible urban planning processes.

Increasingly, our cities are confronted with crises. Fuelled by climate change and a loss of biodiversity, increasing inequalities and fragmentation, challenges range from social unrest and outbursts of violence to heatwaves, torrential rainfall, or epidemics. As crises require rapid interventions that overwhelm human decision-making capacity, AI has been portrayed as a potential avenue to support or even automate decision-making. In this paper, I analyse the specific challenges of AI in urban crisis management as an example and test case for many super wicked decision problems. These super wicked problems are characterised by a coincidence of great complexity and urgency. I will argue that from this combination, specific challenges arise that are only partially covered in the current guidelines and standards around trustworthy or human-centered AI. By following a decision-centric perspective, I argue that to solve urgent crisis problems, the context, capacities, and networks need to be addressed. AI for crisis response needs to follow dedicated design principles that ensure (i) human control in complex social networks, where many humans interact with AI; (ii) principled design that considers core principles of crisis response such as solidarity and humanity; (iii) designing for the most vulnerable. As such this paper is meant to inspire researchers, AI developers and practitioners in the space of AI for (urban) crisis response – and other urgent and complex problems that urban planners are confronted with.

Urban areas are dynamic systems, in which different infrastructural, social and economic subsystems continuously co-evolve. As such, disruptions in one system can propagate to another. However, open challenges remain in (i) assessing the long-term implications of change for resilience and (ii) understanding how resilience propagates throughout urban systems over time. Despite the increasing reliance on data in smart cities, few studies empirically investigate long-term urban co-evolution using data-driven methods, leading to a gap in urban resilience assessments. This paper presents an approach that combines Getis-ord Gi* statistical and correlation analyses to investigate how cities recover from crises and adapt by analysing how the spatial patterns of urban characteristics and their relationships changed over time. We illustrate our approach through a study on Helsinki’s road infrastructure, socioeconomic system and built-up area from 1991 to 2016, a period marked by a major socioeconomic crisis. By analysing this case study, we provide insights into the co-evolution over more than two decades, thereby addressing the lack of longitudinal studies on urban resilience.

Covid-19 has dramatically changed life in cities across the globe. What remains uncertain is how national policies and appeals to comply with suggested rules translate to changes in the behaviour of citizens in urban areas. This lack of local knowledge leaves urban policy makers and planners with few clues as to the determinants of social resilience in cities during protracted crises like a pandemic. Methods are required to measure the capacity of people to conduct routine activities without risking exposure to a prevalent disease, particularly for those most vulnerable during a health crisis. By spanning the fields of urban resilience, human geography, mobility studies and the behavioural sciences, this study explores how to measure social resilience in cities during a protracted crisis. Using a public participation GIS online platform, we observe changes in citizen behaviour within urban spaces during the Covid-19 pandemic. Inhabitants from three districts of a Dutch city mapped their activity routines during the lockdown period and during the year before the pandemic. Spatio-temporal analysis reveals changes in the clustering of activities into what we describe as ‘activity bubbles'. We reflect on the influence of the urban space on these changes and assess the contribution of this exploratory research methodology for gaining insights into behavioural change. Implications for urban planning and resilience theory are discussed.

Climate change is one of the main drivers of uncertainty in urban planning, but only a few studies systematically address these uncertainties, especially in the long term. Urban resilience theory presents principles to manage uncertainty but largely focuses on individual urban systems rather than complex interdependent dynamics. Further, most planning and resilience theory originates from the Global North and is unsuitable for capturing the dynamics of the Global South. This study uses an exploratory multi-case analysis towards developing an enhanced understanding of urban planning for climate uncertainty. We argue that long-term urban planning for climate uncertainty can benefit from systematically integrating resilience principles. We use a two-step qualitative research approach: (1) To propose a conceptual framework connecting urban resilience principles, approaches to urban planning under uncertainty and planning responses in urban systems. (2) To use the conceptual framework to analyse climate-related planning responses in two contrasting case studies in the Global North (GN) and Global South (GS) (Amsterdam and Mumbai). We conclude with four propositions towards an enhanced understanding of urban planning for climate uncertainty by drawing upon the empirical insights from the two case studies.

Evaluation and testing are significant steps in developing any information system. More attention must be devoted to these steps if the system is to be used in high-risk contexts, such as the response to conflict disasters. Several testing methodologies are designed to guarantee that software fulfills technology requirements; others will assure usability and usefulness. However, there is currently no integrated evaluation framework with agreed standards that bring together the three elements: technology requirements, usability, and usefulness. This gap constitutes a barrier to innovation and imposes risks to responders or affected populations if the technology is introduced without proper testing. This chapter aims to close this gap. Based on a review of evaluation methods and measurement metrics for information systems, we designed an integrated evaluation framework including standard metrics for code quality testing, usability methods, subjective usefulness questionnaires, and key performance indicators. We developed and implemented a reporting and evaluation system that demonstrates our evaluation framework within the context of the EU H2020 project iTRACK. iTRACK developed an integrated system for the safety and security of humanitarian missions. We demonstrate how our approach allows measuring the quality and usefulness of the iTRACK integrated system.

Qualitative research is a powerful means to capture human interactions and behavior. Although there are different methodologies to develop models based on qualitative research, a methodology is missing that enables to strike a balance between the comparability across cases provided by methodologies that rely on a common and context-independent framework and the flexibility to study any policy problem provided by methodologies that focus on capturing a case study without relying on a common framework. Additionally, a rigorous methodology is missing that enables the development of both theoretical and empirical models for supporting policy formulation and evaluation with respect to a specific policy problem. In this article, the authors propose a methodology targeting these gaps for ABMs in two stages. First, a novel conceptual framework centered on a particular policy problem is developed based on existing theories and qualitative insights from one or more case studies. Second, empirical or theoretical ABMs are developed based on the conceptual framework and generic models. This methodology is illustrated by an example application for disaster information management in Jakarta, resulting in an empirical descriptive agent-based model.

BACKGROUND: Prompted by recent shocks and stresses to health systems globally, various studies have emerged on health system resilience. Our aim is to describe how health system resilience is operationalised within empirical studies and previous reviews. We compare these to the core conceptualisations and characteristics of resilience in a broader set of domains (specifically, engineering, socio-ecological, organisational and community resilience concepts), and trace the different schools, concepts and applications of resilience across the health literature. METHODS: We searched the Pubmed database for concepts related to 'resilience' and 'health systems'. Two separate analyses were conducted for included studies: a total of n = 87 empirical studies on health system resilience were characterised according to part of health systems covered, type of threat, resilience phase, resilience paradigm, and approaches to building resilience; and a total of n = 30 reviews received full-text review and characterised according to type of review, resilience concepts identified in the review, and theoretical framework or underlying resilience conceptualisation. RESULTS: The intersection of health and resilience clearly has gained importance in the academic discourse with most papers published since 2018 in a variety of journals and in response to external threats, or in reference to more frequent hospital crisis management. Most studies focus on either resilience of health systems generally (and thereby responding to an external shock or stress), or on resilience within hospitals (and thereby to regular shocks and operations). Less attention has been given to community-based and primary care, whether formal or informal. While most publications do not make the research paradigm explicit, 'resilience engineering' is the most prominent one, followed by 'community resilience' and 'organisational resilience'. The social-ecological systems roots of resilience find the least application, confirming our findings of the limited application of the concept of transformation in the health resilience literature. CONCLUSIONS: Our review shows that the field is fragmented, especially in the use of resilience paradigms and approaches from non-health resilience domains, and the health system settings in which these are used. This fragmentation and siloed approach can be problematic given the connections within and between the complex and adaptive health systems, ranging from community actors to local, regional, or national public health organisations to secondary care. Without a comprehensive definition and framework that captures these interdependencies, operationalising, measuring and improving resilience remains challenging.

Involuntary displacement from conflict and other causes leads to clustering of refugees and internally displaced people, often in long-term settlements. Within refugee-hosting countries, refugee settlements are frequently located in isolated and remote areas, characterized by poor-quality land and harsh climatic conditions. Yet, the exposure of refugee settlements to climatic events is underresearched. In this article, we study the exposure of the 20 largest refugee settlements worldwide to extreme variations in climatic conditions. The analysis integrates exposure of camp locations compared to the national trends for both slow- and rapid-onset events and includes descriptive statistics, signal-to-noise analyses, and trend analyses. Our findings show that most refugee settlements included face relatively high exposure to slow-onset events, including high temperatures (for settlements in Kenya, Ethiopia, Rwanda, Sudan, and Uganda), low temperatures (in the case of Jordan and Pakistan), and low levels of rainfall (in Ethiopia, Rwanda, Kenya, and Uganda) compared to national averages. Our findings for rapid-onset events-heatwaves, coldwaves, and extreme rainfall-are less conclusive compared to country trends, although we find relatively high exposure to extreme rainfall in Cox's Bazar, Bangladesh. Our analyses confirm that refugee populations are exposed to extreme weather conditions postdisplacement, which, in combination with their sociopolitical exclusion, poses a threat to well-being and increased marginalization. Our findings call for an inclusive and integrated approach, including refugees and their host communities, in designing climate adaptation and sustainable development policies, in order to promote equitable sustainable development pathways in refugee-hosting countries.

The evidence review report from SAPEA presents the latest scientific evidence on the subject of crisis management, and evidence-based policy options for action. The European Union is confronted with an increasing number of crises with growing complexity. Their effects can cascade and ripple to all parts of society, the economy, and the environment. The effects of such crises are not limited to specific geographical regions or sectors of society, and many crises continue indefinitely. Because they last, they overlap and amplify each other. Decisions made during crises are not only urgent, but have long-lasting consequences. Therefore, strategic crisis management needs to be aligned with broader policy objectives. Using digital tools, guidance and standards can be set for strategic foresight and risk monitoring, to ensure that a longer-term perspective is integrated. Better data preparedness can ensure that information can be shared effectively while respecting privacy and security when a crisis hits. To address the growing complexity of crises, we need a vision that integrates both risk management and crisis management. Different activities and organisations also need to coordinate: responses on multiple geographical and temporal scales need to be aligned, rather than aiming at the one ‘right’ level. Here, the EU could play an important coordinating role. The EU can also play a role in training decision- and policy-makers to coordinate and manage crises. Crises amplify existing inequalities, hitting the most vulnerable the hardest — and this can erode trust across society at exactly the time when trust is most needed. New technologies and forms of communication offer ways for citizens to be engaged and empowered. Involving civil society can bring many advantages, producing a better informed, tailored, and localised response.

During infectious disease outbreaks, early warning is crucial to prevent and control the further spread of the disease. While the different waves of the Covid-19 pandemic have demonstrated the need for continued compliance, little is known about the impact of warning messages and risk perception on individual behavior in public health emergencies. To address this gap, this paper uses data from the second wave of Covid-19 in China to analyse how warning information influences preventive behavior through four categories risk perception and information interaction. Drawing on the protective action decision model (PADM) and the social amplification of risk framework (SARF), risk warning information (content, channel, and type), risk perception (threat perception, hazard- and resource-related preparedness behavior perception and stakeholder perception), information interaction, and preparedness behavior intention are integrated into a comprehensive model. To test our model, we run a survey with 724 residents in Northern China. The results show that hazard-related preparedness behavior perception and stakeholder perception act as mediators between warning and preventive action. Stakeholder perception had much stronger mediating effects than the hazard-related attributes. In addition, information interaction is effective in increasing all categories risk perception, stimulating public response, while functioning as a mediator for warning. The risk warning information content, channel, and type are identified as key drivers of risk perception. The research found that information channel was more related to different risk perception than other characteristics. Overall, these associations in our model explain core mechanisms behind compliance and allow policy-makers to gain new insights into preventive risk communication in public health emergencies.

The growing need for humanitarian assistance has inspired an increasing amount of academic publications in the field of humanitarian logistics. Over the past two decades, the humanitarian logistics literature has developed a powerful toolbox of standardized problem formulations to address problems ranging from distribution to scheduling or locations planning. At the same time, the humanitarian field is quickly evolving, and problem formulations heavily rely on the context, leading to calls for more evidence-based research. While mixed methods research designs provide a promising avenue to embed research in the reality of the field, there is a lack of rigorous mixed methods research designs tailored to translating field findings into relevant HL optimization models. In this paper, we set out to address this gap by providing a systematic mixed methods research design for HL problem in disasters response. The methodology includes eight steps taking into account specifics of humanitarian disasters. We illustrate our methodology by applying it to the 2015 Nepal earthquake response, resulting in two evidence-based HL optimization models.

Cities are complex socio-technical systems (STSs) under tremendous stress due to climate change. To incorporate resilience into urban plans and move towards evidence-based long-term decision-making, we must unravel complex land-use dynamics and the effect of climate uncertainties on cities. Currently, land-use dynamics are explored through Cellular Automata models to investigate the impacts of urban planning scenarios. What is, however, missing to support resilience decisions, is a systematic analysis of long-term climate uncertainties on land-use change. This study addresses this gap by analysing the effects of flood uncertainties on land-use patterns. While conventionally, urban planning decisions for climate uncertainty are based on a few scenarios, we use exploratory modeling to sample and combine uncertain climate variables to scenarios and understand the implications of the climate scenarios on land use via computational experiments. Specifically, we integrate flood probability maps into land-use maps to assess land suitability. Agglomerative clustering allows us to analyze the resulting land-use maps based on their similarity. Finally, we select representative maps from each cluster and compare them with the baseline map. We apply our integrated modeling approach in the Metropolitan Region of Amsterdam (MRA). Our results show spatially explicit alternatives for high-density residential development that is climate-resilient. The proposed framework can be applied to other cities to investigate the long-term impacts of climate uncertainties and adopt resilience-informed decision-making.

Droughts and changing rainfall patterns due to natural climate variability and climate change, threaten the livelihoods of Malawi's smallholder farmers, who constitute 80% of the population. Provision of seasonal climate forecasts (SCFs) is one means to potentially increase the resilience of rainfed farming to drought by informing farmers in their agricultural decisions. Local knowledge can play an important role in improving the value of SCFs, by making the forecast better-suited to the local environment and decision-making. This study explores whether the contextual relevance of the information provided in SCFs can be improved through the integration of farmers’ local knowledge in three districts in central and southern Malawi. A forecast threshold model is established that uses meteorological indicators before the rainy season as predictors of dry conditions during that season. Local knowledge informs our selection of the meteorological indicators as potential predictors. Verification of forecasts made with this model shows that meteorological indicators based on local knowledge have a predictive value for forecasting dry conditions in the rainy season. The forecast skill differs per location, with increased skill in the Southern Highlands climate zone. In addition, the local knowledge indicators show increased predictive value in forecasting locally relevant dry conditions, in comparison to the currently-used El Niño-Southern Oscillation (ENSO) indicators. We argue that the inclusion of local knowledge in the current drought information system of Malawi may improve the SCFs for farmers. We show that it is possible to capture local knowledge using observed station and climate reanalysis data. Our approach could benefit National Meteorological and Hydrological Services in the development of relevant climate services and support drought-risk reduction by humanitarian actors.

Humanitarian crises, such as the 2014 West Africa Ebola epidemic, challenge information management and thereby threaten the digital resilience of the responding organizations. Crisis information management (CIM) is characterised by the urgency to respond despite the uncertainty of the situation. Coupled with high stakes, limited resources and a high cognitive load, crises are prone to induce biases in the data and the cognitive processes of analysts and decision-makers. When biases remain undetected and untreated in CIM, they may lead to decisions based on biased information, increasing the risk of an inefficient response. Literature suggests that crisis response needs to address the initial uncertainty and possible biases by adapting to new and better information as it becomes available. However, we know little about whether adaptive approaches mitigate the interplay of data and cognitive biases. We investigated this question in an exploratory, three-stage experiment on epidemic response. Our participants were experienced practitioners in the fields of crisis decision-making and information analysis. We found that analysts fail to successfully debias data, even when biases are detected, and that this failure can be attributed to undervaluing debiasing efforts in favor of rapid results. This failure leads to the development of biased information products that are conveyed to decision-makers, who consequently make decisions based on biased information. Confirmation bias reinforces the reliance on conclusions reached with biased data, leading to a vicious cycle, in which biased assumptions remain uncorrected. We suggest mindful debiasing as a possible counter-strategy against these bias effects in CIM.

The challenges for sustainable cities to protect the environment, ensure economic growth, and maintain social justice have been widely recognized. Along with the digitization, availability of large datasets, Machine Learning (ML) and Artificial Intelligence (AI) are promising to revolutionize the way we analyze and plan urban areas, opening new opportunities for the sustainable city agenda. Especially urban spatial planning problems can benefit from ML approaches, leading to an increasing number of ML publications across different domains. What is missing is an overview of the most prominent domains in spatial urban ML along with a mapping of specific applied approaches. This paper aims to address this gap and guide researchers in the field of urban science and spatial data analysis to the most used methods and unexplored research gaps. We present a scoping review of ML studies that used geospatial data to analyze urban areas. Our review focuses on revealing the most prominent topics, data sources, ML methods and approaches to parameter selection. Furthermore, we determine the most prominent patterns and challenges in the use of ML. Through our analysis, we identify knowledge gaps in ML methods for spatial data science and data specifications to guide future research.