Assessment of urban population health resilience guided by cardiovascular and cerebrovascular diseases: A case study of Henan Province

Abstract

Resilience and vulnerability thinking are commonly used to study urban systems, but few apply both to urban population health research. Therefore, this study aims to evaluate urban population health resilience (UPHR) from both positive and negative perspectives by combining resilience and vulnerability thinking, and to explore the current situation and influencing factors of UPHR. We constructed a comprehensive resilience index and a relative vulnerability index for urban population health by using a socio-economic-demographic-environmental complex system (SEDECE) and a pressure-state-response (PSR) model. We used a combination of four methods, including entropy weight method (EWM), the criteria importance through intercriteria correlation (CRITIC), simple additive weighting (SAW), and technique for order preference by similarity to an ideal solution (TOPSIS), to ensure the robustness of the indices. Finally, the effectiveness and practicality of the index by studying the spatial relationship and correlation between the incidence of cardiovascular and cerebrovascular diseases (CCVD) and the index in 122 counties of Henan Province. The results show that the indicators and calculation methods are robust and effective, and the comprehensive resilience index and vulnerability index reflect the resilience of urban population health from positive and negative perspectives, respectively, and emphasize the important role of air quality in both indices. In addition, urbanization rate, health facilities, medical and social security, and the proportion of elderly population have a greater contribution to the comprehensive resilience index (CRI), and industrial structure has a greater impact on the relative vulnerability index (RVI). This study can provide reference for relevant regions to improve the resilience of their population health and reduce health pressure.