GCRI · Health Nexus
Dependencies and consequences
Health systems depend on infrastructure, people and supply chains that the health sector does not control, and health outcomes in turn shape labour, trust and public finance. This page sets out the main causal, physical, economic, social and ecological links, how stress travels along them, and how Health Nexus analyses them. A dependency map describes how systems are connected; it is not a forecast of what will happen.
- STEM methods
- 7
- Canonical methods this field applies
- Topics
- 8
- Subject pages in the field
- Counterparts
- 2
- Platforms in shared fields across the network
- Report series
- 3
- Reports series it contributes to
What care depends on.
| System | How health depends on it | Typical failure |
|---|---|---|
| Electricity | Lighting, ventilation, imaging, refrigeration, life support and information systems | Grid outage longer than backup fuel or generator capacity allows |
| Water and sanitation | Infection control, sterilisation, dialysis, cooling | Loss of pressure or contamination after floods or drought |
| Transport | Staff arrival, patient transfer, ambulance access, deliveries | Road closure, fuel shortage, public transport disruption |
| Telecommunications and data | Records, laboratory results, dispatch, telehealth | Network outage or ransomware that forces paper workarounds |
| Supply chains | Medicines, oxygen, blood, devices, protective equipment | Concentrated production, export restrictions, cold-chain breaks |
| Workforce | Clinical and support staff with scarce skills | Illness, burnout, migration, inability to travel |
Environmental exposure in Africa.
Daytime surface heat, haze and population density over Africa, from NASA GIBS. Each layer carries its own date.
The interactive map needs JavaScript; the layer list and sources are below.
Layers 3
Environmental exposure, for this page
About this layer
- Evidence
- Observed (persistent cloud still leaves gaps)
- Source
- VIIRS NOAA-20 Level 3, 8-day (NASA LANCE)
- Provider
- NASA LANCE
- Licence
- NASA open data
- Vintage
- 8-day; Satellite 8-day composite; persistent cloud still leaves gaps
- Newest at build
- 2026-09-14
- Resolution
- about 1 km grid
- Uncertainty
- Satellite skin temperature of the ground over the 8 days ending on the date shown, a heat exposure indicator; not air temperature, heat index or a heat warning.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
- Evidence
- Observed (clouds leave gaps)
- Source
- VIIRS NOAA-20 Deep Blue AOD (NASA LANCE)
- Provider
- NASA LANCE
- Licence
- NASA open data
- Vintage
- daily; Satellite retrieval; clouds leave gaps
- Newest at build
- 2026-10-14
- Resolution
- about 2 km grid
- Uncertainty
- Satellite measure of haze, smoke and dust through the whole air column on the day shown; an exposure indicator, not ground-level PM2.5, an air quality index or a health warning.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
- Evidence
- Estimated
- Source
- Gridded Population of the World v4.11 (NASA SEDAC (CIESIN, Columbia University))
- Provider
- NASA SEDAC (CIESIN, Columbia University)
- Licence
- CC BY 4.0
- Vintage
- null; Census-based estimate, static (2020)
- Resolution
- about 1 km grid
- Uncertainty
- Census-based estimate of people per square kilometre in 2020, shown as exposure context; not a count of people affected by any hazard.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
- Evidence
- Observed
- Source
- VIIRS NOAA-20 corrected reflectance (NASA LANCE)
- Provider
- NASA LANCE
- Licence
- NASA open data
- Vintage
- daily; Satellite image
- Newest at build
- 2026-10-14
- Resolution
- about 250 m grid
- Uncertainty
- Satellite image. Satellite or model raster as the provider publishes it. Clouds, swath gaps and retrieval error leave gaps and noise; values are indicators, not measurements at a place.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
- Evidence
- Observed (clouds leave gaps)
- Source
- OMI Aura (NASA GES DISC)
- Provider
- NASA GES DISC
- Licence
- NASA open data
- Vintage
- daily; Satellite retrieval; clouds leave gaps
- Newest at build
- 2026-10-10
- Resolution
- about 2 km grid
- Uncertainty
- Satellite column of nitrogen dioxide in the lower atmosphere on the day shown, mostly from combustion; not a ground-level concentration or a health warning.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
About this layer
- Evidence
- Modelled (latest year GIBS publishes)
- Source
- MODIS Terra and Aqua land cover (MCD12Q1) (NASA LP DAAC)
- Provider
- NASA LP DAAC
- Licence
- NASA open data
- Vintage
- yearly; Satellite classification; latest year GIBS publishes
- Newest at build
- 2024-01-01
- Resolution
- about 500 m grid
- Uncertainty
- Satellite land cover classes for the year shown, including croplands; a classification with known errors, not a farm register.
- Reached through
- gibs.earthdata.nasa.gov, only after you allow the live map
Keyboard, with the map focused
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Latest available
NASA GIBS / EOSDIS · ASTER GDEM (METI, NASA) · Blue Marble (NASA) · © OpenStreetMap contributors (ODbL) · Natural Earth
Loading the latest NASA imagery.
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Environmental exposure, framed on Africa.Satellite and model products as NASA publishes them, each with its own date. They are indicators, not assessments of any place.
Data: NASA GIBS · ASTER GDEM · Blue Marble · © OpenStreetMap contributors · Natural Earth · NASA EONET · ESA Copernicus Sentinel-5P TROPOMI · NASA JPL OPERA DIST-ALERTSources and licences
- We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- VIIRS near-real-time products (flood, land surface temperature, snow cover, corrected reflectance), NASA LANCE; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- MODIS and VIIRS atmosphere products, NASA LANCE and LAADS DAAC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- Center for International Earth Science Information Network (CIESIN), Columbia University. 2018. Gridded Population of the World, Version 4 (GPWv4): Population Density, Revision 11. NASA Socioeconomic Data and Applications Center (SEDAC). Licensed under CC BY 4.0. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). doi:10.7927/H49C6VHW. CC BY 4.0
- OMI nitrogen dioxide (Aura) and OMPS aerosol index (Suomi NPP), NASA; distributed by the NASA GES DISC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- MODIS land products (vegetation indices, gross primary production, land cover), NASA LP DAAC and LANCE; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- ASTER GDEM is a product of METI and NASA (ASTER Global Digital Elevation Model V003, NASA LP DAAC); imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). Cite as: NASA/METI/AIST/Japan Spacesystems and U.S./Japan ASTER Science Team (2019). ASTER Global Digital Elevation Model V003. doi:10.5067/ASTER/ASTGTM.003. NASA open data
- Made with Natural Earth. Free vector and raster map data @ naturalearthdata.com. Public domain
- © OpenStreetMap contributors (ODbL), via NASA GIBS (coastlines, boundaries, roads and place names). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). ODbL
- Blue Marble, NASA Earth Observatory; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- Context on the globe and flat map: coastlines, boundaries, roads and place names from NASA GIBS reference layers (OpenStreetMap data, ODbL, © OpenStreetMap contributors); Blue Marble imagery as an optional base; 3D terrain and the elevation read-out from the ASTER GDEM elevation colour index (5 m to 200 m classes, exaggerated for legibility). Boundaries are drawn as published and imply no position on any territory.
- Live events: NASA Earth Observatory Natural Event Tracker (EONET); events are indicative and keep their original source links.
- Observed (EO): ESA Copernicus Sentinel-5P TROPOMI (contains modified Copernicus Sentinel data 2026). We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
- Observed (EO): NASA JPL OPERA DIST-ALERT (contains modified Copernicus Sentinel data 2026). We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
- NASA GIBS: We acknowledge the use of imagery provided by services from NASA’s Global Imagery Browse Services (GIBS), part of NASA’s Earth Science Data and Information System (ESDIS).
- Air quality forecast, 5 days, PM2.5 (CAMS via Open-Meteo): Contains modified Copernicus Atmosphere Monitoring Service information 2026.
- Past year, daily temperature (ERA5 via Open-Meteo): Contains modified Copernicus Climate Change Service information 2026.
- Weather data by Open-Meteo.com (https://open-meteo.com/), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).
- Optional layers (14 sources in the layer list: live, forecast, observed and context) print their provider credit on the map and here when switched on; forecasts are model output and derived indices are estimates.
Layers and dates
- Land surface temperature, day, 8-day composite: VIIRS NOAA-20 Level 3, 8-day, NASA LANCE · 14 Sep 2026
- Aerosol optical depth, daily: VIIRS NOAA-20 Deep Blue AOD, NASA LANCE · 13 Oct 2026
- Population density, 2020: Population: CIESIN, Columbia University, Gridded Population of the World v4.11 (2018), NASA SEDAC, CC BY 4.0 · static
- True colour: VIIRS NOAA-20 corrected reflectance, NASA LANCE · 13 Oct 2026
- Nitrogen dioxide, lower atmosphere column: OMI Aura, NASA GES DISC · 10 Oct 2026
- Land cover type (IGBP), yearly: MODIS Terra and Aqua land cover (MCD12Q1), NASA LP DAAC · 2024
How stress travels.
Shared infrastructure
Floods, heat and storms damage facilities and the utilities they rely on at the same moment that injuries and illness rise.
Budgets, prices and trust
Crises raise costs and cut revenue for health systems, and lost trust reduces uptake of vaccination and screening long after the event.
Shared health
Land-use change, wildlife trade and intensive farming shape spillover risk and antimicrobial resistance, linking health to biodiversity and food systems.
Field overview.
The screen a team would use to follow this subject: its measures, states and decisions. Names are examples and values are illustrative.
What health failures cause elsewhere.
Illness removes people from work, schools and care roles, and widespread outbreaks can disrupt supply chains and essential services well beyond health. Deferred care accumulates as later disease burden. Health spending shocks reach public budgets and household finances, and health insurers and reinsurers carry part of the cost; Insurance Nexus at The Global Risks Alliance (GRA) studies how those exposures reach the industry.
These links are why health questions appear on other GCRI platforms, including Critical Infrastructure, Water Nexus and Biotechnology and Biosecurity.
How dependencies are analysed.
Dependency analysis uses complex systems and agent-based modelling to represent facilities, staff and supply flows, probability and statistics for the likelihood of joint failures, and causal inference to separate the effect of a disruption from background trends. Every map states its assumptions, data and uncertainty; see methods and uncertainty. Related topics: health system continuity and health supply chains. Back to the field overview.
Questions and answers.
Is a dependency map a forecast?
Why focus on joint failures?
Can facility operators share their own dependency data?
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