Course:EOSC311/2025/Geological Hazards and Public Health in Vancouver

Introduction

Statement of Connection

Many aspects of public health are influenced by geological conditions that shape how communities experience and respond to environmental hazards. In urban regions like Vancouver, the physical landscape directly intersects with modern infrastructure, risk exposure, and health outcomes. As climate change intensifies these geological hazards, the connections between geoscience and public health are becoming critical in the face of accelerating climate risk.

By exploring how earthquakes, sea-level rise, and slope instability affect critical healthcare infrastructure, we can better understand the compound vulnerabilities that put patients and marginalized populations at risk during extreme events . This project draws from both earth science and health science perspectives to demonstrate the real-world consequences of overlooking geohazard risks in public health and healthcare planning.

Why I Chose This Topic

As a student in Integrated Sciences, with themes in public health and environmental science, I’ve become increasingly interested in the intersection of climate resilience, healthcare, and urban geoscience. I chose this topic to better understand how physical risks impact hospital safety and patient care, particularly for vulnerable groups.

The 2021 heat dome and atmospheric river floods exposed the unpreparedness of BC’s health system for climate extremes . These events marked a turning point, revealing that focusing only on emissions reduction is not enough and that system-wide adaptation across healthcare is urgently needed. I wanted to explore how geotechnical knowledge can inform health system resilience as well as how we can design safer, more equitable healthcare systems in an era of climate uncertainty.

Context and Location

Map of Vancouver’s flood-prone zones highlighted in red and the location of Vancouver General Hospital (+).

In recent years, the urgency of addressing climate-related hazards in urban settings has intensified. With the intersection of rising sea levels, aging infrastructure, and existing health inequities, cities like Vancouver face pressing challenges. This project explores how climate-induced geological hazards, such as flooding, heat domes, wildfire smoke, and seismic activity, pose disproportionate risks to vulnerable populations residing near Vancouver General Hospital (VGH). These geohazards also include compounding climate shocks, such as heat domes followed by wildfire smoke or storms that trigger landslides and power outages, each magnifying the strain on public health systems. It also investigates how geology intersects with public health and healthcare resilience to inform forward-thinking, place-based solutions.

Located in the Fairview neighbourhood of Vancouver, VGH is one of the city’s largest healthcare campuses. It lies within an area that faces multiple geohazard threats, notably flooding and liquefaction risk in the event of an earthquake. The site also intersects with urban heat vulnerability zones, as identified by Metro Vancouver and the BC Centre for Disease Control . Proximity to wave effect zones, aging stormwater systems, and sea-level rise make this an increasingly fragile location for critical healthcare delivery. The Flood Construction Level (FCL) of 4.6 metres sets the minimum elevation for new development in these areas to reduce future flood risk from sea-level rise and storm surges for the planning threshold .

Interdisciplinary Connection: Geology and Public Health

The intersection of geology and public health is becoming increasingly significant as climate change intensifies geological hazards. Environmental stressors such as floods, earthquakes, and landslides are strongly influenced by geological conditions, which in turn shape human health outcomes. These hazards can lead to negative impacts on public health, including infrastructure failure, displacement, and exacerbation of chronic illnesses during extreme weather events .

Hospitals and other critical healthcare facilities serve as community lifelines and must remain operational during such disasters. Their geolocation, structural integrity, and integration into emergency preparedness plans represent important geological considerations with substantial public health implications . For instance, inadequate HVAC or filtration systems in healthcare settings during wildfire seasons have been linked to worsened respiratory illness and indoor air degradation, compounding morbidity during concurrent heat or smoke events

Hazard Analysis

Urban Heat Islands and Heat Domes

The 2021 heat dome event resulted in over 600 excess deaths across British Columbia, representing the severe health risks posed by extreme heat for vulnerable groups such as the elderly, immunocompromised individuals, and low-income populations . In the area surrounding VGH, limited tree canopy and dense urban development exacerbate heat exposure. These conditions place additional operational stress on hospitals, including increased patient admissions and the risk of internal overheating. To address these challenges, climate resilience strategies now emphasize expanded HVAC capacity, improved air filtration, and targeted cooling retrofits such as green roofs and reflective surfaces. Site-specific metrics, including Cooling Degree Days, are increasingly used to anticipate and manage thermal stress thresholds critical to patient safety .

Flooding and Sea-Level Rise

According to Vancouver’s Coastal Adaptation Plan , a 1-meter sea-level rise combined with a 500-year storm surge could flood low-lying areas, including major roads leading to VGH. Flooding may also cause power outages and compromise hospital operations. This would significantly hinder access to the hospital, delaying patient transport, disrupting emergency services, and interfering with the delivery of medical supplies, all of which could jeopardize patient care during critical moments .

The HealthADAPT assessment identified a broader gap in climate preparedness across coastal healthcare facilities, particularly the lack of detailed flood risk maps for hospitals and long-term care homes. As previously mentioned, a resilience assessment at the VGH site could help pinpoint vulnerabilities such as outdated flood barriers or insufficient drainage, where these evaluations are key for informing retrofit priorities and ensuring continuity of care during future emergencies.

Wildfires and Air Quality

Climate change creates a cycle of threats to both human health and the healthcare system, as multiple hazards interconnect and amplify each other. Extreme heat increases mortality and hospital admissions, while also causing facilities to overheat.

In the Vancouver Coastal Health and Fraser Health capacity gap report , wildfire smoke exposure is a top growing threat for patients with respiratory illnesses, outdoor hospital staff, and those in aging buildings with poor filtration. Wildfires and poor air quality exacerbate respiratory and cardiovascular illness and can force evacuations of vulnerable patients. Flooding, landslides, and power outages damage infrastructure, disrupt water quality, and delay emergency services . Rising temperatures also expand the range of infectious diseases, including Legionella and Vibrio, while compounding stress on patients and staff. Finally, climate-driven changes to ecosystems, such as ocean acidification, drought, and food insecurity, impact Indigenous and rural communities most acutely. These impacts show the urgent need for hospitals like VGH to integrate climate resilience into both infrastructure and care delivery planning.

Cascading climate impacts disrupt healthcare facilities and communities, affecting staff, patients, and critical infrastructure across VCH and Fraser Health sites.

Equity, Planetary Health, and Resilient Infrastructure

Public health risks are magnified when geohazards intersect with systemic inequities. Patients and visitors of VGH come from across the Lower Mainland, including many who are elderly, disabled, or without secure housing.

Since 2019, Vancouver Coastal Health has recognized planetary health as a strategic priority. Vulnerable groups face greater barriers to accessing cooling centres, evacuation shelters, and emergency information. Energy efficiency upgrades and infrastructure retrofits have already eliminated over 1,650 tonnes of CO₂e annually, aligning climate mitigation efforts with healthcare system resilience . By integrating sustainability with equity-focused planning, hospitals like VGH can better prepare for future climate shocks while ensuring vulnerable populations are not left behind.

Forward Thinking and Solutions

Building resilient hospitals requires smart infrastructure, health equity, and collaborative planning. At VGH, strategies like rain gardens, elevated access roads, cooling system upgrades, and advanced air filtration help mitigate climate risks from floods, heat, and wildfire smoke .

Site-level assessments identify weak points, such as outdated flood defences or inadequate ventilation, that can be targeted for capital upgrades. Meanwhile, coordinated governance between health authorities and civic partners ensures emergency planning is aligned across transportation, utilities, and healthcare networks .

The Climate Adaptation Framework developed by Vancouver Coastal Health and Fraser Health outlines six core pillars that form a roadmap for building climate-resilient healthcare systems:

• Emergency Preparedness ensures continuity of care during crises through wellness checks, vulnerable patient databases, and hospital evacuation protocols.

• Risk Assessment and Surveillance involves monitoring real-time climate-sensitive indicators like air quality and heat-related illness trends.

• Communication focuses on delivering accessible, timely alerts and public health messaging, especially for at-risk groups.

• Health Equity emphasizes Indigenous-led planning, cultural safety, and policies that prioritize marginalized communities.

• Leadership and Advocacy drives systemic change through funding, cross-sector partnerships, and internal climate champions.

• Facilities targets retrofits, greenhouse gas reductions, and site-level resilience audits to keep infrastructure functional during extreme events.

Taken together, these pillars offer a comprehensive strategy for integrating infrastructure, public health, and governance into climate-ready care systems.

Conclusion

As climate change reshapes the physical and social landscape, healthcare systems must evolve to meet a new standard of resilience. Vancouver General Hospital stands at the frontlines of this shift, situated within a zone of heightened exposure to flooding, extreme heat, seismic risk, and air quality hazards.

Overall, protecting access to care amid rising climate risks is not just a technical challenge but also a moral imperative. A resilient healthcare system must centre the needs of the most vulnerable, anticipate future threats, and adapt with purpose. As future healthcare professionals, researchers, and planners, we carry the responsibility to ensure that no one is left behind in an era of accelerating climate uncertainty.

References

This Earth Science resource was created by Course:EOSC311.