Wypych-Ślusarska Agata, Krupa-Kotara Karolina, Słowinski Jerzy, Yanakieva Antoniya, Grajek Mateusz
Department of Epidemiology, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, 40-055 Katowice, Poland.
Health Promotion Faculty, Cracow Higher School of Health Promotion Having Its Registered Office in Cracow, 31-158 Cracow, Poland.
Healthcare (Basel). 2025 Aug 14;13(16):1998. doi: 10.3390/healthcare13161998.
In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises-collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses.
为应对新冠疫情、气候变化、武装冲突和经济不稳定等当代挑战，全球医疗系统日益面临多方面且相互重叠的危机——统称为多重危机。这些相互关联的威胁相互加剧，给医疗基础设施、治理和公平性带来了前所未有的压力。仅新冠疫情就在2020年导致约1630万例住院治疗被延误，2021年为1470万例，揭示了系统漏洞并加深了社会不平等。叙利亚和加沙等地的武装冲突摧毁了医疗服务可及性。在加沙，到2024年年中，85%的人口被迫流离失所，36家医院中只有17家部分运转，超过885名医护人员丧生。气候变化进一步加重了健康负担，全球超过86%的城市居民暴露于有害空气污染中，每年造成180万人死亡。本研究通过将社会流行病学应用于多重危机分析引入了一个新视角。虽然现有文献往往强调政治或经济层面，但我们的方法突出了重叠危机如何影响人群健康、社会脆弱性和系统恢复力。通过整合社会人口学和环境数据，社会流行病学支持具有危机恢复力的护理模式、有针对性的干预措施和公平的卫生政策。我们主张赋予更强有力的使命，投资数据基础设施、加强监测，并将社会决定因素纳入卫生系统应对措施中。
