Influence of Urban Flooding on the Spatial Equity of Access to Emergency Medical Services Among Nursing Homes in Shanghai

Xueqing Zhou, Shanshan Wang, Shenjun Yao () and Lei Fang
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Xueqing Zhou: Key Laboratory of Geographic Information Science, Ministry of Education, East China Normal University, Shanghai 200241, China
Shanshan Wang: Department of Think Tank Construction, Zhejiang Development and Planning Institute, Hangzhou 310030, China
Shenjun Yao: Key Laboratory of Geographic Information Science, Ministry of Education, East China Normal University, Shanghai 200241, China
Lei Fang: Undergraduate Academic Affairs Office, Fudan University, Shanghai 200438, China

Land, 2025, vol. 14, issue 2, 1-22

Abstract: With the rapid aging of the population and increasing demand for elderly care services, ensuring equitable access to emergency medical service (EMS) for nursing homes has become a critical public health challenge. As the first Chinese city to experience an aging society, Shanghai faces compounding pressures from rapid urbanization and recurrent urban flooding, both of which exacerbate disparities in healthcare accessibility. This study investigates the spatial equity of EMS access among nursing homes in Shanghai, with a particular focus on the impacts of urban flooding. Using ordinary least squares and geographically weighted regression models, the study reveals that EMS accessibility is relatively equitable under normal conditions but deteriorates significantly during flood events, particularly in suburban and low-lying areas. The findings show that flood-induced disruptions to road networks disproportionately impact nursing homes in peripheral districts, widening accessibility gaps. Additionally, the study identifies that factors such as road density, emergency center distribution, and flood inundation depth play critical roles in shaping spatial equity. The results underscore the need for strategic interventions to enhance healthcare resilience, including optimized facility allocation and flood-resistant infrastructure. Policymakers should adopt integrated planning approaches to ensure equitable EMS access for vulnerable elderly populations during emergencies.

Keywords: nursing home; flood; spatial equity; accessibility; emergency medical service (search for similar items in EconPapers)
JEL-codes: Q15 Q2 Q24 Q28 Q5 R14 R52 (search for similar items in EconPapers)
Date: 2025
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