Abstract
<title>Abstract</title> <p>Urban resilience has risen rapidly on policy agendas after COVID-19, and health systems are described as core pillars of resilient cities. Yet little is known about how urban resilience agendas are actually perceived and taken up within health sector. Drawing on 43 interviews with 79 participants from related health agencies in seven Chinese cities, this study explores how resilient city construction are understood, translated and enacted in everyday practice. We find that resilience largely arrives as a top-down political and planning term: many respondents first heard it only after COVID-19, often treat it as a new label for existing work, or view it as an external political task rather than an internal organising principle. To interpret these patterns, we develop the Elliptical Focus Resonance Model, which distinguishes three configurations of interdepartmental relations: separated circles of routine mandates in normal times; crisis-induced convergence and temporary deformation during major incidents; and longer-term “elliptical” dual-focus configurations under a central gravitational agenda such as resilient city construction. The model suggests that weak health sector engagement with urban resilience is largely a structural effect of how cross-sector agendas are layered onto existing mandates and incentive systems, rather than simply a problem of awareness or motivation.</p>