Knowledge and Awareness of Pediatric Obstructive Sleep Apnea Among the Adult Population in Al-Ahsa, Saudi Arabia: A Cross-Sectional Study.

The 21st century’s landscape of frequent public health emergencies—from SARS and H1N1 to MERS, Ebola, and COVID-19—has evolved into a persistent stress test for global socio-economic systems and governance models (). These crises expose a critical dilemma in global health security: the tension between the need for swift, collective action and the diverse cultural, political, and economic contexts in which such action must be implemented (). While the International Health Regulations (IHR) provide a legal framework for coordination, their effectiveness ultimately depends on national implementation and public adherence (). This implementation gap highlights a central challenge for sustainability science and health policy: how to design health governance systems that are not only effective in suppressing pathogens but also resilient, equitable, and socially sustainable across different cultural settings (). Recent research in health economics and management has increasingly recognized the importance of intergenerational solidarity and social capital as critical determinants of health outcomes and health system resilience. For instance, studies have shown that intergenerational contact and support networks significantly influence health equity among older adults, particularly during public health crises when formal care systems are strained (). However, the role of cultural capital—specifically, deeply embedded family-based ethical systems—in shaping public health compliance remains underexplored. This gap is particularly salient in contexts where family structures serve as the primary locus of care, support, and social regulation. Drawing on intergenerational solidarity theory () and the concept of social capital (), we approach this challenge by conceptualizing Confucian family identity as a form of cultural capital that can be strategically leveraged to enhance public health compliance. Intergenerational solidarity theory identifies multiple dimensions—structural, associational, functional, normative, and affectional—through which family relationships influence individual behavior and well-being. Among these, normative solidarity (shared values and obligations) and functional solidarity (exchange of resources and support) are particularly relevant for understanding compliance with public health mandates during crises. When individuals internalize family-based norms of care and protection, they are more likely to perceive compliance not merely as a personal burden but as an expression of filial duty and family responsibility.