Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Disruption of emergency response to vulnerable populations during floods

Abstract

Emergency responders must reach urgent cases within mandatory timeframes, regardless of weather conditions. However, flooding of transport networks can add critical minutes to travel times between dispatch and arrival. Here, we explicitly model the spatial coverage of all Ambulance Service and Fire and Rescue Service stations in England during flooding of varying severity under compliant response times. We show that even low-magnitude floods can lead to a reduction in national-level compliance with mandatory response times and this reduction can be even more dramatic in some urban agglomerations, making the effectiveness of the emergency response particularly sensitive to the expected impacts of future increases in extreme rainfall and flood risk. Underpinning this sensitivity are policies leading to the centralization of the Ambulance Service and the decentralization of the Fire and Rescue Service. The results provide opportunities to identify hotspots of vulnerability (such as care homes, sheltered accommodation, nurseries and schools) for optimizing the distribution of response stations and developing contingency plans for stranded sites.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Accessibility by Fire and Rescue Service stations in England within 5 min, 8 min and 10 min during a local 1-in-100-years surface-water flood event.
Fig. 2: Ambulance Service spatial accessibility coverage for at-risk populations in England during flooding.
Fig. 3: Scatter plots of Ambulance Service baseline coverage versus coverage for coastal/fluvial floods of various magnitudes.
Fig. 4: Care homes in England and the Ambulance 7-min and 15-min service area.
Fig. 5: Timing, response time and delay mode for each incident attended by the London Fire and Rescue Service during the period 22 to 24 June 2016.
Fig. 6: Modelled 6-min service area for the London Fire and Rescue Service on 23 June 2016.

Similar content being viewed by others

Data availability

Source Data are provided with this paper. The transport network of roads in England were obtained from the UK Ordnance Survey MasterMap Integrated Transport Network (https://digimap.edina.ac.uk/). Locations of emergency service stations were collated from various sources including the UK Ordnance Survey, Ambulance trusts, Fire and Rescue Services. Although station locations were quality-checked to ensure their accuracy, there might be inconsistencies because the data came from different sources. Data were used under licence for the current study. Certain datasets are available from the lead and corresponding authors upon reasonable request and with permission of the parties that provided the data. Locations of vulnerable facilities were extracted from the UK Ordnance Survey datasets (https://digimap.edina.ac.uk/) under license. Fluvial, coastal and surface water flood risk maps were provided by the UK Environment Agency (https://data.gov.uk/publisher/environment-agency). Vulnerable population groups were derived from the 2011 England and Wales Census, available from the Office for National Statistics. Major city and town boundaries are defined by the Office for National Statistics in 201522.

References

  1. Ngo, E. B. When disasters and age collide: reviewing vulnerability of the elderly. Nat. Disaster Rev. 2, 80–89 (2001).

    Google Scholar 

  2. Nick, G. A. et al. Emergency preparedness for vulnerable populations: people with special health-care needs. Public Health Rep. 124, 338–343 (2009).

    Article  Google Scholar 

  3. Walker, M. et al. Children and Young People ‘After the Rain Has Gone’—Learning Lessons for Flood Recovery and Resilience Final project report for ‘Children, Flood and Urban Resilience: Understanding Children and Young People’s Experience and Agency in the Flood Recovery Process’ (Lancaster Univ., 2010); http://www.lec.lancs.ac.uk/cswm/hcfp

  4. Lesnikowski, A., Ford, J., Biesbroek, R., Berrang-Ford, L. & Heymann, S. J. National-level progress on adaptation. Nat. Clim. Change 6, 261–265 (2015).

    Article  Google Scholar 

  5. Adger, W. N. Vulnerability. Glob. Environ. Change 16, 268–281 (2006).

    Article  Google Scholar 

  6. Arent, D. J. et al. in Climate Change 2014: Impacts, Adaptation, and Vulnerability (eds Field, C. B. et al.) 659–708 (Cambridge Univ. Press, 2014).

  7. Banks, L. L., Shah, M. B. & Richards, M. E. Effective healthcare system response to consecutive Florida hurricanes. Am. J. Disaster Med. 2, 285–295 (2007).

    Article  Google Scholar 

  8. Hess, J. J., Heilpern, K. L., Davis, T. E. & Frumkin, H. Climate change and emergency medicine: impacts and opportunities. Academic Emerg. Med. 16, 782–794 (2009).

    Article  Google Scholar 

  9. Emergency Planning For People With Disability (Iowa Department of Public Health, 2009); https://go.nature.com/35ec6g1

  10. Weiss, D. J. et al. A global map of travel time to cities to assess inequalities in accessibility in 2015. Nature 553, 333–336 (2018).

    Article  CAS  Google Scholar 

  11. Coles, D., Yu, D., Wilby, R. L., Green, D. & Herring, Z. Beyond ‘flood hotspots’: modelling emergency service accessibility during flooding in York, UK. J. Hydrol. 546, 419–436 (2017).

    Article  Google Scholar 

  12. Green, D. et al. City-scale accessibility of emergency responders operating during flood events. Nat. Hazards Earth Syst. Sci. 17, 1–16 (2017).

    Article  CAS  Google Scholar 

  13. Dawson, R. J. et al. A systems framework for national assessment of climate risks to infrastructure. Phil. Trans. R. Soc. A 376, 20170298 (2018).

    Article  Google Scholar 

  14. Williams, B. T., Nicholl, J. & Brazier, J. E. Health care needs assessment: accident and emergency departments. in Health Care Needs Assessment 2nd Ser. (eds Stevens, A. & Raftery, J.) (Radcliffe Medical Press, 1996).

  15. Turner, J. et al. Ambulance Response Programme: Evaluation Of Phase 1 And Phase 2 Final report (Univ. Sheffield, 2017); https://go.nature.com/2W8G1lK

  16. Bentham, G. Proximity to hospital and mortality from motor vehicle traffic accidents. Soc. Sci. Med. 23, 1021–1026 (1986).

    Article  CAS  Google Scholar 

  17. Jones, A. P. & Bentham, G. Emergency medical service accessibility and outcome from road traffic accidents. Public Health 109, 169–177 (1995).

    Article  CAS  Google Scholar 

  18. Williams, F. L. R., Lloyd, O. L. I. & Dunbar, J. A. Deaths from road traffic accidents in Scotland: 1979–1988. Does it matter where you live? Public Health 105, 319–326 (1991).

    Article  CAS  Google Scholar 

  19. Brown, D. B. Proxy measures in accident countermeasure evaluation: a study of emergency medical services. J. Saf. Res. 11, 37–41 (1979).

    Google Scholar 

  20. Byrne, J. P. et al. Association between emergency medical service response time and motor vehicle crash mortality in the United States. JAMA Surg. 154, 286–293 (2019).

    Article  Google Scholar 

  21. Nicholl, J., West, J., Goodacre, S. & Turner, J. The relationship between distance to hospital and patient mortality in emergencies: an observational study. Emerg. Med. J. 24, 609–609 (2007).

    Article  Google Scholar 

  22. Major Towns and Cities (December 2015) Boundaries (UK Office for National Statistics, 2015); https://go.nature.com/2W4lbnx

  23. Cutter, S. L. Hazards, Vulnerability And Environmental Justice 418 (Earthscan, 2006).

  24. Maantay, J. & Maroko, A. Mapping urban risk: flood hazards, race & environmental justice in New York City. Appl. Geogr. 29, 111–124 (2009).

    Article  Google Scholar 

  25. Walker, G. & Burningham, K. Flood risk, vulnerability and environmental justice: evidence and evaluation of inequality in a UK context. Crit. Soc. Policy 32, 216–240 (2011).

    Article  Google Scholar 

  26. Brunkard, J., Namulanda, G. & Ratard, R. Hurricane Katrina deaths, Louisiana, 2005. Disaster Med. Public Health Prep. 2, 215–223 (2008).

    Article  Google Scholar 

  27. Sharkey, P. Survival and death in New Orleans—an empirical look at the human impact of Katrina. J. Black Stud. 37, 482–501 (2007).

    Article  Google Scholar 

  28. London Fire Brigade Incident Mobilisation Records (London Fire Brigade, 2016); https://go.nature.com/2SejqDs

  29. Pregnolato, M., Ford, A., Glenis, V., Wilkinson, S. & Dawson, R. J. Potential impact of climate change on flooding disruptions to urban transport networks. J. Infrastruct. Syst. 23, 04017015 (2017a).

    Article  Google Scholar 

  30. Pregnolato, M., Ford, A., Wilkinson, S. M. & Dawson, R. J. The impact of flooding on road transport: a depth-disruption function. Transport. Res. D 55, 67–81 (2017b).

    Article  Google Scholar 

  31. Mahmood, M. A., Thornes, J. E., Pope, F. D., Fisher, P. A. & Vardoulakis, S. Impact of air temperature on London ambulance call-out incidents and response times. Climate 5, 61 (2017).

    Article  Google Scholar 

  32. Fire and Rescue Incident Statistics: England, April 2016 to March 2017 Statistical Bulletin 13/17 (Home Office, 2017); https://go.nature.com/3bLtWd1

  33. De Luca, P., Hillier, J., Wilby, R. L., Quinn, N. W. & Harrigan, S. Extreme multi-basin flooding linked with extra-tropical cyclones. Environ. Res. Lett. 12, 114009 (2017).

    Article  Google Scholar 

  34. NHS Ambulance Services HC 972 Session 2016-17 (National Audit Office, 2017); https://go.nature.com/3bMlGcD

  35. Report of the Joint Committee on Standards of Fire Cover by Central Fire Brigades Advisory Councils for England and Wales and Scotland (Home Office, 1985); https://go.nature.com/2xW1NkU

  36. Risks of Flooding from Rivers and Sea (RoFRS) (Environment Agency, 2016); https://go.nature.com/2W3ERrQ

  37. Risks of Flooding from Surface Water (RoFSW) (Environment Agency, 2013); https://go.nature.com/2zDdGwr

  38. Office for National Statistics 2001 Census aggregate data, May 2011 (UK Data Service, 2011); https://go.nature.com/3eZhwQA

  39. Digimap Ordnance Survey Collection, May 2018 (Ordnance Survey, 2018); https://digimap.edina.ac.uk/

  40. Silverman, B. W. Density Estimation for Statistics and Data Analysis (Chapman and Hall, 1986).

  41. Brown, C. & Wilby, R. L. An alternate approach to assessing climate risks. Eos 93, 401–402 (2012).

    Article  Google Scholar 

  42. Haer, T., Wouter Botzen, W. J. & Aerts, C. J. H. Advancing disaster policies by integrating dynamic adaptive behaviour in risk assessments using an agent-based modelling approach. Environ. Res. Lett. 14, 044022 (2019).

    Article  Google Scholar 

Download references

Acknowledgements

The work was supported by the Natural Environment Research Council of the UK (grant numbers NE/R009600/1, NE/N013050/1 and NE/S017186/1); by the National Key Research and Development Program of China (grant number 2017YFE0100700); by the National Natural Science Foundation of China (grant number 41871164); and by the National Science Foundation of the United States (grant number EAR-1520683). We thank M. Oppenheimer from Princeton University for his early contribution to the methodological development of this work.

Author information

Authors and Affiliations

Authors

Contributions

D.Y. coordinated this work and wrote the first draft of the manuscript. D.Y., J.Y. and R.L.W. designed the initial method. J.C., J.C.J.H.A., S.N.L. and N.L. contributed to the further development of the methods. D.Y., J.Y. and J.C. performed the data processing and analysis. D.Y., J.Y., R.L.W., S.N.L., J.C., J.C.J.H.A. and N.L. interpreted the results and wrote the final manuscript. All authors contributed to the analysis and interpretation of results and drafting of the manuscript.

Corresponding authors

Correspondence to Dapeng Yu or Jie Yin.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Source data

Source Data Fig. 2

Raw data used to generate Fig. 2.

Source Data Fig. 3

Raw data used to generate Fig. 3.

Source Data Fig. 6

Raw data used to generate Fig. 6.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yu, D., Yin, J., Wilby, R.L. et al. Disruption of emergency response to vulnerable populations during floods. Nat Sustain 3, 728–736 (2020). https://doi.org/10.1038/s41893-020-0516-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41893-020-0516-7

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing