中国省域突发公共卫生事件应急系统脆弱性评价及驱动因素分析

Vulnerability Evaluation and Driving Factors Analysis of Provincial Public Health Emergency System in China

目的:构建突发公共卫生事件应急系统脆弱性(以下简称“公共卫生应急系统脆弱性”)评估模型,并从时空角度研究我国省域公共卫生应急系统脆弱性的分布特征及主要驱动要素,为破解我国公共卫生应急系统脆弱性提供参考依据。方法:基于压力与释放模型,构建公共卫生应急系统脆弱性指标体系,运用脆弱性评价指数模型和地理探测器对我国公共卫生应急系统脆弱性的时空分异特征及驱动因素进行分析。结果:我国脆弱性水平日益趋于均衡,且呈波动式下降趋势,年均下降0.23%。西部脆弱性(均值0.0891)和敏感性最高(均值0.1571),中部暴露性(均值0.1102)和适应性(均值0.1679)最高。脆弱性等级分布在空间上呈“核心—边缘”圈层结构,且随着时间的推移,西南及北部边境有所加强,东南沿海明显减弱。15岁及以上人口文盲率、生活垃圾无害化处理率等因子是不同时期影响脆弱性的共性主导驱动因子。结论:我国公共卫生应急系统脆弱性存在明显的时空分异特征,且受人口、环境治理、公共卫生资源及防范能力等多种要素的共同影响,未来应继续强化公共卫生资源供给,加大卫生监督与环境整治专项工作力度,提升公众防范意识和能力等。

Objective To construct the vulnerability assessment model of public health emergency system,and study the distribution characteristics and main driving factors of the vulnerability of provincial public health emergency system in China from the perspective of time and space,so as to provide reference for solving the vulnerability of public health emergency system in China.Methods Based on the pressure and release model,the vulnerability index system of public health emergency system was constructed.the spatial and temporal differentiation characteristics and driving factors of the vulnerability of public health emergency system in China were analyzed by using the vulnerability evaluation index model and geographic detector.Results the vulnerability level in China tends to be increasingly balanced,and shows a fluctuating downward trend,with an average annual decline of 0.23%.the west region had the highest vulnerability and sensitivity,and the middle had the highest exposure and adaptability.the vulnerability level is distributed as a“core-periphery”circle structure in space,and the southwest and northern borders have strengthened over time,while the southeast coast has weakened significantly.the driving factors such as the illiteracy rate of the population aged 15 and above,and the harmless treatment rate of domestic waste are the common dominant driving factors affecting vulnerability in different periods.Conclusion the vulnerability of China’s public health emergency system has obvious spatial and temporal heterogeneity,and is influenced by a variety of factors such as population,environmental governance,public health resources and preparedness.It is suggested to continue to strengthen the supply of public health resources,intensify health supervision and environmental remediation,and improve the public awareness and preparedness.