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
01Upstream dependencies

What care depends on.

SystemHow health depends on itTypical failure
ElectricityLighting, ventilation, imaging, refrigeration, life support and information systemsGrid outage longer than backup fuel or generator capacity allows
Water and sanitationInfection control, sterilisation, dialysis, coolingLoss of pressure or contamination after floods or drought
TransportStaff arrival, patient transfer, ambulance access, deliveriesRoad closure, fuel shortage, public transport disruption
Telecommunications and dataRecords, laboratory results, dispatch, telehealthNetwork outage or ransomware that forces paper workarounds
Supply chainsMedicines, oxygen, blood, devices, protective equipmentConcentrated production, export restrictions, cold-chain breaks
WorkforceClinical and support staff with scarce skillsIllness, burnout, migration, inability to travel
02Geography

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

Latest available

NASA GIBS / EOSDIS · ASTER GDEM (METI, NASA) · Blue Marble (NASA) · © OpenStreetMap contributors (ODbL) · Natural Earth

Loading the latest NASA imagery.

Drag to move. Ctrl or ⌘ and scroll, pinch or the buttons to zoom; hover for the values under the pointer; reset returns to the region.

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

04Monitor

Field overview.

The screen a team would use to follow this subject: its measures, states and decisions. Names are examples and values are illustrative.

Field overview: the screen’s structure, terms and states for Health.Example names and illustrative values; a design, not a record or a live system.
05Downstream consequences

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.

06Method

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.

07Questions

Questions and answers.

Is a dependency map a forecast?
No. It describes how systems are connected and how stress could travel. Forecasts and scenarios are labelled as such and carry their assumptions.
Why focus on joint failures?
Because backup arrangements are usually designed for one failure at a time. The most damaging events, such as a heatwave that coincides with a grid outage, defeat several safeguards together.
Can facility operators share their own dependency data?
Data is used only on terms that its owner sets and that are recorded in the source and data register. Write to the research collaboration form to discuss it.
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