Summary

While the health sector’s operational role in emergencies and disasters is well- acknowledged and respected, health has also contributed substantially to the historical, conceptual, and methodological maturation of the disaster risk domain, especially since the 1970s. From 1970 to 2020, this evolution of the health–disaster risk knowledge interface can be understood through four phases. The first, from the late 1970s until 1989, was characterized by a surge in emergency health responses across a succession of disasters triggered by hydrometeorological and geophysical processes as well as humanitarian emergencies. The 1970–1989 period also saw the establishment of new health-specific emergency architectures and knowledge domains. The second phase, from 1990 until the early 2000s, was substantially influenced by global mechanisms, including the United Nations designation of the 1990s as the International Decade for Natural Disaster Reduction. The third phase, emerging in the early 2000s, profiled the changing global configuration of risk and disaster, with disaster impacts, including health effects, becoming more pronounced in high-income countries. The onset of the fourth phase was signaled by the 2015 global landmark agreements: the Sendai Framework for Disaster Risk Reduction, the Paris Agreement on climate change, and the 2030 Agenda for Sustainable Development.

The Sendai Framework for Disaster Risk Reduction is recognized for exceeding the scope of its predecessor agreements by foregrounding health as an integral concern of disaster risk reduction. Health’s enhanced visibility through the Sendai Framework was paralleled by other processes that reinforced understanding of the health–disaster risk interface. These included initiatives on One Health and Planetary Health, as well as growing awareness of the health implications of climate change.

This synergistic potential of the health–disaster risk knowledge interface draws from the strong conceptual alignment across both domains. This reflects explicit coherence between the core concept of “health determinants” (the social, physical, and other forces) that shape health outcomes and the disaster risk-related concepts of hazard, vulnerability, exposure, and capacity, which similarly configure disaster risk.

Since 2015, recognition of the significance of this alignment has accelerated efforts to promote more resilient health systems as well as cross-field initiatives such as Health Emergency and Disaster Risk Management. With hazard processes, especially those linked to climate extremes, exacting increased demands on health care systems, there is urgency for even greater innovation at the health–disaster risk knowledge interface.