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2023 XDI Global Hospital Infrastructure Physical Climate Risk Report December 2023 XDI BENCHMARK SERIESPublished by XDI (Cross Dependency Initiative) ISBN: 978-0-646-88965-8 © Copyright 2023 XDI.About XDI Our data has been helping global leaders price physical climate risk since 2007, making the group the world’s longest standing independent specialist in physical climate risk and adaptation analytics. Today, XDI works with governments, corporates and the international finance sector, providing cutting edge analysis to help make informed decisions. XDI is part of The Climate Risk Group, a group of companies committed to quantifying and communicating the costs of climate change. XDI believes that physical climate risk data needs to be accessed and understood by everyone, including citizens and civil society organisations. To support this, XDI regularly releases public datasets to generate debate and understanding about the costs of climate change. XDI’s goal is to accelerate action on climate change by embedding physical climate risk data in all decisions Experts in physical climate risk since 2007 Backed by a team of specialists across science, engineering and software development, XDI (Cross Dependency Initiative) combines asset, climate change and contextual data to determine asset vulnerability, hazard exposure and the likely physical and financial impacts on assets from climate change and extreme weather.2023 Lancet Countdown on Health and Climate Change report “ At the current 10-year mean heating of 1.14°C above pre-industrial levels, climate change is increasingly impacting the health and survival of people worldwideContents About XDI.........................................................................................................3 Foreword...........................................................................................................6 About the datasets.......................................................................................7 How is risk measured?...............................................................................8 The impact of extreme weather on hospital infrastructure and health care delivery............................................10 World Overview............................................................................................11 Regional Overview.....................................................................................15 South East Asia............................................................................................25 South Asia......................................................................................................29 East Asia..........................................................................................................32 Sub-Saharan Africa....................................................................................35 North Africa..................................................................................................46 Latin America and Caribbean..............................................................49 North America..............................................................................................57 Europe..............................................................................................................59 West Asia and Middle East.....................................................................69 Russia and Central Asia...........................................................................75 Oceania............................................................................................................78 Further Information...................................................................................81 Methods Background........................................................................81 Access to the 2023 XDI Global Hospital Infrastructure Datasets ...................................................................81 Third Party use of this data ...........................................................81 Disclaimer and Terms .......................................................................81Foreword The 2023 XDI Global Hospital Infrastructure Datasets analyse the vulnerability of over 200, 000 hospitals around the world to six climate change hazards including flooding, forest fire, extreme wind and coastal inundation. The analysis focuses on physical damage to building structures, examining how this risk increases as we head to the end of the century. It also quantifies how different emission scenarios can reduce risk and increase resilience. The 2023 XDI Global Hospital Infrastructure Physical Climate Risk Report provides a summary of these findings. For access to the full 2023 XDI Global Hospital Infrastructure Datasets please contact: media@xdi.systems. Climate exacerbated extreme weather: hospital infrastructure under threat Extreme winds, torrential rain, flooding, and coastal inundation driven by climate change are already damaging hospital infrastructure and disrupting health care delivery around the world. In 2023, as this report is being written, multiple hospitals are being evacuated due to unprecedented flooding in Tuscany, Italy. When disasters strike, access to emergency medical care is critical. Yet events like these are preventing communities accessing emergency care, right when they need it most. This damage to hospitals from extreme weather is set to escalate as global temperatures rise. The future risks to communities from hospital outages will depend on two things: whether the global emission trajectory is changed from its current path; and the extent to which hospitals can be adapted for the much higher severities of extreme events expected with climate change. 6 XDI Global Hospital Infrastructure Physical Climate Risk Report 2023 About the datasets Dataset 1: Overview of risk to hospital infrastructure by country and region. This dataset uses two lenses through which to measure risk: Risk bands Hospitals are analysed and categorised into 1 of 3 risk bands: 1.High Risk Hospitals 2.Medium Risk Hospitals 3.Low Risk Hospitals The number of High Risk Hospitals is used to identify countries and regions with the highest number of hospitals (generally those with high populations). Percentage of High Risk Hospitals identifies countries and regions with a proportionally high number of High Risk Hospitals. Note: this metric will not capture the increase in damage risk to hospital infrastructure within each risk band. Some hospitals are already at high risk, but this risk becomes even more extreme over time. The measurement is also used to provide: 1.A comparison of risk under two different emission scenarios: RCP 8.5 (high) and RCP 2.6 (low). 2.A comparison or risk over three time intervals: 2020, 2050 and 2100. Average increase in damage to hospital infrastructure This metric looks at the increase in risk of damage to all hospital infrastructure around the world from a 1990 baseline until the end of the century. The measurement is also used to provide: 1.A comparison of risk under two different emission scenarios: RCP 8.5 and RCP 2.6 2.A comparison or risk increase over four time intervals from a 1990 baseline to 2100. Comparison of risk to hospitals at country and regional levels For each country and region the following analysis is provided: → Amount of damage to hospital infrastructure over time → Number of high, medium and low risk hospitals over time (from 2020) → Percentage increase in damage to hospital infrastructure over time (from 1990) → Impact of different emission scenarios. 7 XDI Global Hospital Infrastructure Physical Climate Risk Report 2023 How is risk measured? Amount of damage to hospital infrastructure: Maximum-to-Date Value-at-Risk (MVAR). To quantify damage to the built environment from climate change hazards, XDI looks at the annual average loss from extreme weather damage to a property, expressed as a percentage of the replacement cost of that property. In this report, XDI uses this annual average loss metric to measure the percentage increase in damage risk to a property over time. Note: for the purposes of this analysis, percentage increase is capped at 1000%. High Risk Hospital High probability of total or partial shutdown of the hospital within the design life of the building. If this was a residential or commercial building it would be considered uninsurable. In depth analysis of risk to building advised to identify whether adaptation measures could reduce risk or if location unviable. Medium Risk Hospital Building is exposed to extreme weather and climate change hazards capable of causing significant damage from extreme weather events - though probabilities or severities are moderate. Adaptation is recommended. Low Risk Hospital The building is either not exposed to known extreme weather and climate change related hazards, or the probabilities and severities are very low. The net probability of significant disruption or damage is low and within normal risk tolerances for these hospitals. Dataset 2: Analysis of 200,216 individual hospitals around the world → A physical climate risk analysis of over 200,000 individual hospital structures. Each hospital is listed by name, state, country and region. Where names are not available, location co ordinates are provided. → Each individual hospital is categorised into 1 of 3 risk bands: 1.High Risk Hospitals 2.Medium Risk Hospitals 3.Low Risk Hospitals → The analysis looks at two different emission scenarios: RCP 8.5 (high) and RCP 2.6 (low) over three time intervals until the end of the century: 2020, 2050, 2100. → Governments are urged to use this dataset to check for high risk hospitals in their region and conduct further analysis to identify and understand their physical climate risk. → The names and/or coordinates provided for each individual hospital can be entered into the open data source website healthsites.io in order to view each hospital on a map. Risk Bands 8 XDI Global Hospital Infrastructure Physical Climate Risk Report 2023 RCP 8.5 vs RCP 2.6 A Representative Concentration Pathway (RCP) is a greenhouse gas concentration trajectory adopted by the IPCC. Four pathways are used for climate modelling and research and XDI uses these in its analyses. The RCP 8.5 pathway delivers a temperature increase of around 4.3˚C by 2100, relative to pre- industrial temperatures. RCP 8.5 is contrasted with RCP 2.6, which would deliver a total warming of around 1.8˚C by 2100. Hazards Riverine Flooding Changes in precipitation in a catchment that causes a river to exceed its capacity, inundating nearby areas. Riverine (Fluvial) flooding can damage low-lying building or infrastructure assets. Surface Water Flooding Increased frequency of extreme rainfall leading to overland flooding. Surface Water (Pluvial) flooding can damage low-lying building or infrastructure assets. Coastal Inundation Sea water flooding due to high tides, wind, low air pressure and waves can damage coastal land, infrastructure and buildings. Extreme Wind Changes in wind regimes, sea surface temperature and wind speeds. High-wind conditions that may exceed a building’s design specifications. Forest Fire A destructive fire that spreads via trees and forest. Flames and heat from burning vegetation can damage buildings and infrastructure. Increased incidence of fire weather due to confluence of days with higher temperatures, high wind speeds and drier conditions. Cyclone (Incl. Hurricane, Typhoon) Extreme wind speeds caused by tropical cyclones formed in areas with high sea surface temperatures which may be exacerbated by ocean warming. Why use RCP 8.5? Evidence indicates that greenhouse gas emissions are flattening and annual emissions are not tracking RCP 8.5. This is a good sign, but RCP 8.5 is still an appropriate scenario to use in a prudent risk assessment, given that it remains a feasible bound of future levels of warming and impact. RCPs are based on cumulative greenhouse gases in the atmosphere, rather than annual emissions levels and this concentration tracked closest to RCP 8.5 at least up to 2020. Feedbacks remain highly uncertain and aren’t included in all models, so using a higher carbon emission scenario can be used as a proxy to capture low likelihood high-end impacts. Modelling potential worst-case outcomes is important. Data and analysis in this report The names and locations of hospitals used in this analysis are taken from healthsites.io, an open data source of health facility data. Data for China was supplemented by using additional data sources. Countries with a very low number of hospitals or whose hospital data was limited (less than 10 hospitals per country) have not been singled out for focus in the 2023 XDI Global Hospital Infrastructure Climate Risk Report, although their analysis can be found in the full 2023 XDI Global Hospital Infrastructure Datasets. The purpose of this analysis is to provide a systematic analysis across all hospitals around the world in order to identify trends. The analysis does not take into account individual hospital structures or adaptation measures that may have been introduced. Further analysis is advised to understand the risk of individual structures. For more information, view our Methodology. 9 XDI Global Hospital Infrastructure Physical Climate Risk Report 2023 Next >