Health system resilience and the health impacts of environmental degradation: A global analysis

Shimaa Elkomy and Tim Jackson
Public Health | December 2025

Summary

This study by Shimaa Elkomy and Tim Jackson explores how environmental degradation—particularly air pollution and CO₂ emissions—shapes global health outcomes, and whether stronger healthcare systems can help buffer these effects. Drawing on panel data from 145 countries between 2009 and 2017, the research examines links between pollution exposure, mortality and disability-adjusted life years (DALYs), while also assessing how healthcare infrastructure, accessibility, quality and policy contribute to climate resilience.

The analysis confirms that higher levels of air pollution are strongly associated with increased mortality and greater disease burden. Although countries with better healthcare systems are able to mitigate some of the immediate health risks linked to air pollution, the study finds that these advantages do not extend to the long-term effects of CO₂ emissions. Interaction tests show that even well-functioning healthcare systems cannot compensate for the deeper structural harms caused by rising emissions.

Overall, the findings underscore the limits of healthcare resilience in the face of accelerating environmental stress. Strengthening health systems remains crucial, but it must be paired with emission reduction strategies and stricter environmental regulations to effectively safeguard public health.

Further Reading