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Unequal roles of cities in the intercity healthcare system

Cities are increasingly interdependent regarding healthcare provision and demand. However, the intercity healthcare system (IHS) behind the nationwide patient mobility remains insufficiently understood. Here, leveraging human mobility big data, we reveal cities’ roles in providing and demanding quality healthcare within the IHS of China. We find that 8% of Chinese cities are national and regional hubs that address the healthcare shortage of cities deprived of quality healthcare, while 63% of the cities that are unnoticed compensate for migrant workers being denied healthcare rights in megacities. The IHS generates new structural inequalities in healthcare access exhibiting a Matthew effect. The few cities (12%) that are already rich in healthcare resources benefit more and can strengthen their advantages in providing healthcare to local populations (32% of China’s total population). The many cities (35%), while facing healthcare shortages, are further disadvantaged in ensuring adequate healthcare for their local populations (26% of China’s total population).

Urban Nature Indexes tool offers comprehensive and flexible approach to monitoring urban ecological performance

We present the Urban Nature Indexes (UNI), a comprehensive tool that measures urban ecological performance under one standard framework linked to global commitments. The UNI was developed by interdisciplinary experts and evaluated by practitioners from diverse cities to capture each city’s ecological footprint from local to global scale. The UNI comprises six themes (consumption drivers, human pressures, habitat status, species status, nature’s contributions to people, and governance responses) that encompass measurable impacts on climate change, biodiversity loss, ecosystem services, pollution, consumption, water management, and equity within one comprehensive system. Cities then adapt the UNI to their context and capacity by selecting among indicator topics within each theme. This adaptability and holistic approach position the UNI as an essential instrument for nature-positive transformations. With the institutional support of IUCN, the UNI offers an opportunity for cities to assess and enhance their contributions towards a more sustainable and biodiverse future.

The effects of COVID-19 on the resilience of urban life in China

Understanding the impacts of COVID-19 on citizens from different cities is crucial for urban resilience-building and reducing inequal resilience distribution. However, little research focuses on urban life at the individual level, particularly in second- and third-tier cities. An online survey was therefore conducted to collect data on how COVID-19 affected the cities and urban residents in mainland China. The results indicate that COVID-19 limited citizens’ access to healthcare facilities and socioeconomic activities apart from the immediate health crisis. Most citizens suffered reduced income, unemployment, and social anxiety. However, COVID-19 also raised social awareness and actions for disaster adaptation. The Chinese pandemic management has strengthened governmental leadership and credibility among most citizens in the early stage. Importantly, the results suggested that citizens in first-tier cities appeared more resilient to pandemics than those in second-tier cities. A networked resilience framework was therefore discussed for resilience-building policy implications.

Biodiversity offsets, their effectiveness and their role in a nature positive future

Biodiversity offsetting is a mechanism for addressing the impacts of development projects on biodiversity, but the practice remains controversial and its effectiveness generally poor. In the context of the Global Biodiversity Framework and the emergence of new approaches for mitigating damage, we need to learn from the past. In this Review, we explore biodiversity offsetting, its effectiveness and its future prospects, especially in relation to ‘nature positive’ goals. Offsets often fall short of their stated goal: to achieve at least no net loss of affected biodiversity. However, such failures are prominent because offsets have more explicit quantitative objectives than most other conservation approaches, whose effectiveness is also variable. These clear objectives provide the potential for the transparency that alternative approaches to addressing negative human impacts on biodiversity lack. Unfortunately, promising alternatives are scarce, so offsetting and offset-like mechanisms remain a necessary component of strategies to halt and reverse nature loss. However, improving their performance is essential. No quick and easy solution exists; instead, upholding best practice principles and rigorous implementation — including in the face of challenges from opposing narratives and interest groups — remains key.

Engineering blue-green infrastructure for and with biodiversity in cities

Blue-green infrastructure (BGI), combining semi-natural and engineered elements, offers multifaceted benefits like stormwater management, water purification, heat mitigation, and habitat provision. However, current BGI designs prioritize engineering goals, overlooking its ecological potential. Here we advocate for integrating engineering and ecological objectives into BGI design to enhance performance and biodiversity. Through an interdisciplinary literature review, we emphasize the importance of species diversity, abundance, and ecological processes, to improve engineering performance and resilience, and lower management costs. We emphasize the importance of interdisciplinary collaboration to navigate trade-offs between engineering and ecological objectives, ultimately enabling us to engineer both for and with biodiversity.

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