Identifying Non-Traditional Epidemic Disease Risk Factors Associated to Major Health Events from WHO and World Bank Open Data

Abstract

Objectives: Health events emerge from a multifactorial milieu involving host, community, environment, and pathogen factors. Therefore, developing accurate forecasting models to improve epidemic prediction towards better prevention and capabilities management is a complex task. Here, we describe an exploratory analysis to identify non-health risk factors that could improve the forecast and events risk signals using a feasible and practical approach by combining surveillance report data with non-health data from open data sources. Methods: A line listing was developed using the World Health Organization Disease Outbreaks News from 2016-2018 and merged with non-health indicators data from the World Bank. Poisson regression models employing forward imputations were used to establish relationships and predict values over the dependent variable (health event frequency). Findings: The resulting regression model provided evidence that changes in non-health factors important to community experiences impact the risk of the number of major health events that a country could experience. Three non-health indicators (extrinsic factors) were associated significantly to event frequency (population urban change, gross domestic product change per capita—a novel factor, and average forest area). An exploratory analysis of the current COVID-19 pandemic suggested similar associations, but confounding by global disease burden is likely. Interpretation: Continued development of forecasting approaches capturing available whole-of-society extrinsic factors (non-health factors); could improve the risk management process through earlier hazard identification, and as importantly inform strategic decision processes in multisectoral strategies to preventing, detecting, and responding to pandemic-threat events.Funding: USUHS intramural funding to a Henry M. Jackson Foundation post-doctoral fellowship award.Declaration of Interests: The authors declare no conflicts of interest.Ethics Approval Statement: This manuscript was approved by USUHS clearance publication committee.