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Geospatial insights of health vulnerability during the Ukraine war

Nature Health volume 1, pages 326–337 (2026)Cite this article

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Abstract

Although the devastation of war is well recognized, no study has combined conflict intensity, humanitarian access, environment and infrastructure to assess their collective impact on health vulnerability. Here, using spatial and suitability models, we evaluated multidimensional vulnerabilities in Ukraine during the Russian invasion, including mental health, environmental stressors and infrastructure disruptions. We developed a multi-source database (news sources, UNICEF and Ukrainian ministries) on conflict-related health impacts, integrating data from a national survey (4,675 Ukrainian households) on sleep, mental health and casualties. Data were cleaned, geolocated across 461 cities (hromadas) and analysed using inverse distance weighting interpolation. We applied logistic and spatial regression to assess how conflict exposure and living conditions influence mental health, sleep loss and cold-related injury, creating a composite vulnerability index via weighted principal component analysis. Areas facing intense conflict, inadequate housing, power outages, food shortages, and limited healthcare and aid access showed heightened vulnerability. Cold, damp conditions, damaged housing and scarce resources sharply worsened household living conditions in eastern and northern Ukraine. Mental health burdens varied, with cold, damp, crowded housing, food insecurity and power outages as key drivers. Post-traumatic stress disorder, depression and insomnia were highest in regions with harsh winters, poor infrastructure and limited aid. War’s effects go beyond violence, with interacting conflict, environmental stressors and infrastructure damage shaping health and well-being outcomes.

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Fig. 1: Integrated conflict severity and population vulnerability.
Fig. 2: GWR coefficients and R2.
Fig. 3: Vulnerability related to the availability of humanitarian assistance and financial support.
Fig. 4: Health vulnerabilities linked to environmental factors.
Fig. 5: Vulnerability related to housing damage.
Fig. 6: Health and food security vulnerability.

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Data availability

The data supporting this study’s findings will be available on request from the corresponding author.

Code availability

The code will be available upon request from the corresponding author.

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Acknowledgements

We thank all participants in Ukraine. This study was supported by the National Institute of Environmental Health Sciences Center (grant no. P30ES005022).

Author information

Authors and Affiliations

  1. Rutgers Global Health Institute, New Brunswick, NJ, USA

    Ubydul Haque

  2. Department of Geography, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA

    Safiyeh Tayebi

  3. Department of Statistics, Quaid-i-Azam University, Islamabad, Pakistan

    Moeen Hamid Bukhari

  4. Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA

    Shanshan Wang

  5. Environmental and Occupational Sciences Institute, Rutgers University, Piscataway, NJ, USA

    Nancy Fiedler & Emily S. Barrett

  6. Department of Environmental and Occupational Health and Justice, Rutgers School of Public Health, Piscataway, NJ, USA

    Nancy Fiedler

  7. Center for International Health, Department of Global Health and Primary Care, University of Bergen, Bergen, Norway

    Ana Lorena Ruano

  8. Theory and Methods of Physical Culture Department, Ivan Boberskyj Lviv State University of Physical Culture, Lviv, Ukraine

    Iuliia Pavlova

  9. Department of Biostatistics and Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA

    Emily S. Barrett

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Contributions

U.H. and E.S.B. contributed to the conceptualization, data curation and initial drafting of the manuscript. U.H., S.T. and M.H.B. led the formal analysis and developed the figures. S.W., N.F., A.L.R. and J.P. supported the manuscript through critical review and editing. In addition, U.H. played a central role in the study’s conceptualization, methodological design, figure development, supervision and manuscript revisions. All authors had full access to the data, with data verification performed by U.H. The decision to submit the manuscript for publication was made collectively by all authors.

Corresponding author

Correspondence to Ubydul Haque.

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Nature Health thanks John Weisz, Simon Wessely and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Primary Handling Editor: Lorenzo Righetto, in collaboration with the Nature Health team.

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Haque, U., Tayebi, S., Bukhari, M.H. et al. Geospatial insights of health vulnerability during the Ukraine war. Nat. Health 1, 326–337 (2026). https://doi.org/10.1038/s44360-026-00064-7

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