A socio-hydro-epidemiological model for simulating trade-off between dengue infections, water shortages, and adaptive behavior

Dengue and drought severity are rising worldwide, with drought responses shaping mosquito breeding conditions in cities. Current modeling approaches do not couple household water-use behavior, climate extremes, and vector-borne disease transmission. Here, we developed a system dynamics model that links dengue transmission, human-water interactions, multiple adaptation strategies, and social behavior in a synthetic city. We compared three adaptation pathways: dengue-focused, drought-focused, and co-adaptation guided by social awareness. Results show that adaptation choices strongly affect awareness, water shortages, mosquito abundance, and human infections. Drought-focused adaptation reduces average water shortages, but prolonged standing water in rainwater tanks increases mosquito growth and dengue transmission. Co-adaptation retains drought buffering while limiting favorable habitat for vector growth. Changes in drought-awareness decay can influence dengue outbreaks more strongly than changes in dengue-awareness decay. These results highlight the value of coordinated drought and dengue management for reducing health risks while maintaining water security under climate change.