Human health in systemic adaptation to climate change: insights from flood risk management in a river basin

Human health risks in dealing with floods in a river basin in South-Western Finland are analysed as an example of scientific and practical challenges in systemic adaptation to climate change and in integrated governance of water resources. The analysis is based on case reports and plans, on literature studies and on conceptual models of risks and risk management. Flood risks in the Northern European study area are aggravated by melt- and storm-water runoff, ice jams and coastal flooding. Flood risk assessment is linked with management plans based on EU directives as applied in the case area. National risk management policies and procedures of increasing scope and depth have been devised for climate change, water resources and overall safety, but an integrated approach to health risks is still largely missing. The same is true of surveys of perceived flood risks, and participatory deliberation and collaborative planning procedures for flood risk management in the case area, specifically for adaptive lake regulation. Health impacts, risks and benefits, socio-economic and systemic risks, and over-arching prevention, adaptation and compensation measures are not fully included. We propose a systematic framework for these extensions. Particular attention needs to be given to health risks due to flooding, e.g. from water contamination, moist buildings, mental stress and infrastructure damage and also from management actions. Uncertainties and ambiguities about risks present continuing challenges. It is concluded that health aspects of flooding are complex and need to be better included in assessment and control, to develop more integrated and adaptive systemic risk governance.