Zhao Jingyi, Hao Xiaowei, Sun Xiaofeng, Du Yajie, Zhang Meng, Wang Qing
Department of Biostatistics, School of Public Health, Shandong University, Jinan, Shandong, People's Republic of China.
National Institute of Health Data Science of China, Shandong University, Jinan, People's Republic of China.
Risk Manag Healthc Policy. 2024 Dec 11;17:3085-3098. doi: 10.2147/RMHP.S494486. eCollection 2024.
This study includes health system capacities into the assessment framework of a temperature-resilience health system while accounting for system interactions.
In accordance with the guidelines provided by the World Health Organization, the conceptual framework of a climate-resilient health system has been adopted. The International Health Regulations are utilized to assess the health system capacities in 171 countries from year 2011 to 2019. Exploratory factor analysis and reliability tests have been conducted to confirm the validity and reliability of the framework. Moreover, a data-driven decision-making trial and evaluation laboratory method is employed to quantify the interactions among the structured aspects.
The assessment framework consists of five aspects, namely high temperature-sensitive risks, low temperature-sensitive risks, low-temperature exposure, vulnerability factors and health system capacities. Globally, the mean (standard deviation) for addressing the first four aspects are 0.77 (0.14), 0.87 (0.13), 0.88 (0.21), 0.72 (0.17), respectively, and health system capacities reach 0.67 (0.17). This study identifies health system capacities as the main driving forces. Interactions between it and other aspects call for multisectoral and coordinated actions. On a global scope, low-temperature exposure and its health risks, with the strongest dependence, should be prioritized to enhance temperature resilience, especially in high-income countries. In order to mitigate these risks, it might be necessary to disrupt the cascade effects resulting from low-temperature exposure by leveraging the capacities of coordination and multisectoral communication. Notably, low-income countries are more affected by high-temperature exposure, thus requiring flexible ways to strengthen temperature resilience.
Our study underscores the significance of health system capacities in strengthening a temperature-resilient health system. Undoubtedly, the development of the temperature-resilient health system ought to follow a coordinated and flexible approach, giving priority to dealing with low-temperature exposure.
本研究将卫生系统能力纳入了温度适应型卫生系统的评估框架，并考虑了系统间的相互作用。
根据世界卫生组织提供的指南，采用了气候适应型卫生系统的概念框架。利用《国际卫生条例》评估了2011年至2019年期间171个国家的卫生系统能力。进行了探索性因素分析和可靠性测试，以确认该框架的有效性和可靠性。此外，采用了数据驱动的决策试验与评价实验室方法，对结构化方面之间的相互作用进行量化。
评估框架包括五个方面，即高温敏感风险、低温敏感风险、低温暴露、脆弱性因素和卫生系统能力。在全球范围内，应对前四个方面的均值（标准差）分别为0.77（0.14）、0.87（0.13）、0.88（0.21）、0.72（0.17），卫生系统能力达到0.67（0.17）。本研究确定卫生系统能力是主要驱动力。它与其他方面之间的相互作用需要多部门协调行动。在全球范围内，应优先考虑低温暴露及其健康风险，因为其依赖性最强，以提高温度适应能力，特别是在高收入国家。为了减轻这些风险，可能有必要利用协调和多部门沟通的能力，打破低温暴露导致的级联效应。值得注意的是，低收入国家受高温暴露的影响更大，因此需要灵活的方式来增强温度适应能力。
我们的研究强调了卫生系统能力在加强温度适应型卫生系统方面的重要性。毫无疑问，温度适应型卫生系统的发展应该采取协调和灵活的方法，优先处理低温暴露问题。
