Beyond Flood Control: A Scoping Review Deciphering the Co-benefits of Nature-Based Flood Risk Reduction for Healthy Ageing in China

Abstract

Climate change and population ageing are some of the most pressing challenges of the twenty-first century, whose convergence exacerbates the vulnerability of older adults to floods. Nature-based solutions for flood risk reduction (NbS-FRR) is central to China’s “ecological civilization” vision, offering sustainable adaptation. However, empirical evidence of their ancillary health benefits for older adults remains nascent. This scoping review systematically maps the qualitative evidence on the co-benefits of NbS-FRR for healthy ageing (HA) in China, aligning with the Healthy China 2030 strategy. Following the Arksey and O’Malley framework, we systematically searched three databases (PubMed, Scopus, and Google Scholar) for qualitative studies (2000–2025). Of the 622 retrieved records, 13 studies were included. A narrative synthesis and Sankey diagram analysis revealed that NbS-FRR interventions, particularly Sponge City and green infrastructure, generate a cascade of co-benefits for HA. These benefits span six HA domains, including enhanced psychosocial well-being, social support, and improved mental health. Furthermore, they contribute to increased physical activity, better environmental quality for independent living, supported cognitive functioning, and greater economic and community participation. The study findings demonstrate a critical synergy between NbS-FRR and HA, positioning NbS as foundational infrastructure for resilient and age-friendly communities. However, the evidence base is predominantly urban, reliant on perceived benefits, and lacks a gerontological focus. Future research must employ longitudinal designs and validated health metrics to quantify impact, particularly in underserved rural areas, to fully leverage NbS as a strategy for enhancing longevity and successfully ageing in a changing climate within and outside China.