Incorporating health and wellbeing into adaptation planning for flood risk: Stakeholder perceptions of dominant structures and norms

The constraints to framing of adaptation actions as health and well-being enhancing are hypothesised to be related to dominant institutional structures in flood risk management, and norms in what constitutes legitimate evaluative criteria. Here we generate insights into these constraints through interrogating the perceptions of flood risk professionals on the usefulness of framing adaptation through health and well-being outcomes. The data come from interviews with stakeholders (n=33) spanning varied roles (i.e. flood and adaptation risk management, n=19; public health, n=9; and community representatives, n=5) to explore and interpret the challenges of incorporating health and wellbeing for those working on the front-line implementing different adaptation processes in diverse global contexts (UK, n=12; Ireland, n=8; and Ghana, n=13). Across these contexts, we find evidence for key challenges to integrating and operationalising health and wellbeing in flood adaptation planning and practice related to the institutional structures and everyday routines that shape it. We conclude that, in order to integrate health and wellbeing into adaptation planning and assessment, changes are required to the conventions of cost effectiveness assessment and the institutional scope for novel forms of collaboration.