How a major Bay Area earthquake could endanger healthcare access – Berkeley Engineering

Report on Earthquake Impact on Healthcare Access and Alignment with Sustainable Development Goals

Introduction: Assessing Urban Resilience in the Context of SDG 3 and SDG 11

A collaborative study by researchers from UC Berkeley, New York University, the World Bank Group, and Stanford University has analyzed the potential impact of a major earthquake on healthcare access in the San Francisco Bay Area. This research directly addresses the objectives of several Sustainable Development Goals (SDGs), particularly SDG 3 (Good Health and Well-being), SDG 9 (Industry, Innovation and Infrastructure), and SDG 11 (Sustainable Cities and Communities), by examining the resilience of critical urban systems.

Methodology: Simulating a Regional Disaster Scenario

The study employed a regional-scale simulation to understand the cascading effects of infrastructure failure, a critical step towards achieving SDG 11.5, which aims to reduce the impact of disasters.

• Event Simulated: A magnitude 7.25 earthquake on the Hayward Fault.
• Infrastructure Analyzed:
  • 76 hospitals (comprising 426 buildings and 16,639 beds).
  • 5,163 bridges within the transportation network.
• Objective: To quantify simultaneous failures and cascading disruptions across healthcare and transportation systems, highlighting vulnerabilities that impede progress on SDG 9 (Resilient Infrastructure).

Key Findings: Systemic Vulnerabilities Threatening SDG Targets

The simulation revealed life-threatening disruptions that would severely compromise regional capacity to provide emergency healthcare, directly undermining SDG 3. The interdependent nature of these failures highlights systemic risks to building sustainable and resilient communities as outlined in SDG 11.

1. Reduction in Healthcare Capacity:
   • Regional hospital bed capacity was projected to decrease to 51%.
   • Alameda County, with a population of 1.6 million, was identified as the most vulnerable, potentially retaining only 20% of its functional hospital beds (651 out of 3,221). This severe reduction poses a direct threat to ensuring healthy lives and promoting well-being for all (SDG 3).
2. Disruption of Transportation Networks:
   • Widespread transportation failures were found to significantly restrict access to the remaining functional hospitals, a critical failure in resilient infrastructure (SDG 9).
   • Regional travel times were projected to increase by 177% (from 6.1 minutes to 16.9 minutes).
   • Certain areas in the East Bay could experience travel time increases exceeding 1,000%.
   • In Alameda County, only 44% of bridges (282 out of 642) were projected to remain functional.
3. Compounding Failures and Interdependencies:
   • The study demonstrated how failures in one system (e.g., transportation) exacerbate failures in another (e.g., healthcare), creating a cascading effect that isolates communities and overwhelms remaining facilities. This underscores the need for integrated planning to achieve SDG 11.
   • The case of Novato in Marin County illustrated this, with travel times increasing from 7.3 minutes to 185.5 minutes due to combined hospital and transport failures, compared to only 14.1 minutes when considering hospital failures alone.

Implications for Sustainable Development Goals

The findings underscore the interconnected nature of the SDGs and the critical need for integrated planning to build resilient communities.

• SDG 3 (Good Health and Well-being): A significant reduction in hospital capacity and access directly threatens the ability to provide life-saving care, jeopardizing health outcomes for a large urban population.
• SDG 9 (Industry, Innovation and Infrastructure): The vulnerability of existing hospital and transportation infrastructure highlights the urgent need to invest in resilient infrastructure capable of withstanding natural disasters, as mandated by Target 9.1.
• SDG 11 (Sustainable Cities and Communities): The report provides critical data for making cities safer and more resilient (Target 11.5). It shows that without a systemic approach to infrastructure, urban areas remain highly susceptible to catastrophic failures that disproportionately affect dense population centers.

Conclusion and Recommendations for Policy Alignment with the SDGs

The research concludes that effective resilience planning requires a system-level approach that acknowledges the operational interdependencies between critical infrastructure sectors. To advance the 2030 Agenda for Sustainable Development, particularly goals related to health, infrastructure, and urban resilience, the following is recommended:

1. Adopt region-wide models grounded in real-world data to guide infrastructure investment and policy, in line with SDG 9 and SDG 11.
2. Prioritize mitigation efforts based on an understanding of how failures propagate across interconnected urban systems to protect and sustain progress on SDG 3.
3. Move beyond treating assets in isolation and focus on the regional importance and interdependencies of infrastructure to ensure a sustainable and resilient future for all.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article highlights issues that are directly connected to the following Sustainable Development Goals (SDGs):

• SDG 3: Good Health and Well-being

  The core focus of the article is on how a major earthquake could “disrupt access to healthcare” and “acute care hospitals.” The study’s findings reveal “life-threatening disruptions” due to reduced hospital capacity and increased travel times, which directly relates to ensuring healthy lives and promoting well-being for all at all ages, especially during emergencies.

• SDG 9: Industry, Innovation and Infrastructure

  The article is fundamentally about the resilience of infrastructure. It analyzes the impact of an earthquake on “hospitals and transportation networks,” specifically mentioning “426 [hospital] buildings” and “5,163 bridges.” The study calls for “more resilient healthcare and transportation infrastructure” and a “system-level approach to infrastructure resilience planning,” which aligns with the goal of building resilient infrastructure.

• SDG 11: Sustainable Cities and Communities

  The research is set in a “densely populated region”—the San Francisco Bay Area—and examines how to make this urban area safer and more resilient to a natural disaster. The article discusses how failures can “propagate across urban systems” and the need for “effective resilience planning across large metropolitan areas.” This directly addresses the goal of making cities and human settlements inclusive, safe, resilient, and sustainable, particularly in the face of disasters.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s content, the following specific SDG targets can be identified:

1. Target 3.d: Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks.

   The study simulates a major earthquake to “understand how these events could disrupt access to healthcare” and “how best to prepare for them.” By modeling the potential drop in hospital bed capacity and analyzing cascading failures, the research directly contributes to strengthening the capacity for risk reduction and management of health risks associated with a major natural disaster.

2. Target 9.1: Develop quality, reliable, sustainable and resilient infrastructure… to support economic development and human well-being, with a focus on affordable and equitable access for all.

   The article explicitly focuses on the need for “more resilient healthcare and transportation infrastructure.” The analysis of potential failures in “hospital and bridge infrastructure” and the call for prioritizing “interdependencies and regional importance” in planning are directly aimed at developing resilient infrastructure to ensure human well-being (access to healthcare) after a disaster.

3. Target 11.5: By 2030, significantly reduce the number of deaths and the number of people affected… caused by disasters… with a focus on protecting the poor and people in vulnerable situations.

   The research aims to mitigate “life-threatening disruptions” that would occur after a major earthquake. By identifying vulnerabilities in healthcare and transportation systems, the study provides a basis for policy changes and mitigation efforts that would reduce the number of people affected and prevent deaths by ensuring continued access to emergency care.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions and implies several quantitative indicators that can be used to measure progress towards resilience and the identified targets:

• Hospital Bed Capacity

  The article explicitly uses this as a key indicator of healthcare system resilience. It states that after a simulated M7.25 earthquake, “hospital bed capacity across the region could drop to 51%, with Alameda County retaining only 20% — or just 651 of 3,221 functional beds.” This metric can be used to measure the resilience of health infrastructure (Target 9.1) and the capacity to manage health risks (Target 3.d).

• Travel Time to Healthcare Facilities

  This is a critical indicator of access to healthcare. The article quantifies the impact of infrastructure failure on this metric, noting that widespread transportation failures could increase “regional travel times by 177% — going from 6.1 minutes pre-earthquake to 16.9 minutes post-earthquake — and exceeding 1,000% in parts of the East Bay.” Measuring and working to reduce this post-disaster travel time is a direct indicator of progress.

• Functionality of Transportation Infrastructure

  The article implies this indicator by providing specific data on bridge failures. It notes that Alameda County faces “retaining only 282 functional bridges out of 642, or 44%.” The percentage of functional critical transportation assets (like bridges) post-disaster is a direct measure of infrastructure resilience (Target 9.1) and a key factor in making a city resilient (Target 11.5).

4. Table of SDGs, Targets, and Indicators

Source: engineering.berkeley.edu