One health, Human-animal-environment health relationships, Coupling coordination degree, Sustainable development goals, Medicine (General), R5-920

The One Health (OH) approach aims to sustainably balance and optimise the health of people, animals, and ecosystems. However, there is a lack of robustly quantified insights into its spatiotemporal coupling and coordination. This study employs the OH index, which incorporates Sustainable Development Goals (SDGs), to examine the coupling and coordination relationships among three health subsystems, elucidate their four spatiotemporal patterns, and identify key driving factors. Our results indicate that the degree of OH coupling coordination is improving, despite spatial unevenness across SDG regions. Countries with varying economic levels often exhibit similar coupling coordination patterns, suggesting the potential for policy coherence to foster regionally uniform development. Key factors for breaking the cycle of poverty include increased health spending, improved education, and better dietary balance. In regions facing significant economic and environmental pressures, promoting animal and environmental health through biodiversity conservation and habitat preservation is essential for achieving OH coupling coordination. Nevertheless, the absence of governance mechanisms, along with factors such as climate change, military conflicts, and fragile alliances, poses serious obstacles to achieving uniform OH. Therefore, this study underscores the necessity of targeted policy interventions, interdisciplinary collaboration, and comprehensive governance to address this unevenness, promote coordination, and advance global health governance.