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Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal.

ABSTRACT: Health promotion and inequality reduction are specific goals of the United Nations 2030 Agenda, which are interconnected with several dimensions of life. This work proposes a composite index SEHVI-socioeconomic health vulnerability index-to address Portuguese population socioeconomic determinants that affect health outcomes. Variables composing SEHVI are aligned with the sustainable development goals considering data and times series availability to enable progress monitoring, and variables adequacy to translate populations' life conditions affecting health outcomes. Data for 35 variables and three periods were collected from official national databases. All variables are part of one of the groups: Health determinants (social, economic, cultural, and environmental factors) and health outcomes (mortality indicators). Variables were standardized and normalized by "Distance to a reference" method and then aggregated into the SEHVI formula. Several statistical procedures for validation of SEHVI revealed the internal consistency of the index. For all municipalities, SEHVI was calculated and cartographically represented. Results were analyzed by statistical tests and compared for three years and territory typologies. SEHVI differences were found as a function of population density, suggesting inequalities of communities' life conditions and in vulnerability to health.

SUBMITTER: Oliveira GM

PROVIDER: S-EPMC6862183 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal.

Oliveira Gisela M GM Vidal Diogo Guedes DG Ferraz Maria Pia MP Cabeda José Manuel JM Pontes Manuela M Maia Rui Leandro RL Calheiros José Manuel JM Barreira Esmeralda E

International journal of environmental research and public health 20191025 21

Health promotion and inequality reduction are specific goals of the United Nations 2030 Agenda, which are interconnected with several dimensions of life. This work proposes a composite index <i>SEHVI</i>-socioeconomic health vulnerability index-to address Portuguese population socioeconomic determinants that affect health outcomes. Variables composing <i>SEHVI</i> are aligned with the sustainable development goals considering data and times series availability to enable progress monitoring, and ...[more]

PMID: 31731572

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Project description:BackgroundThe Iberian Peninsula is a diverse region that contains several different bioclimatic areas within one confined space, leading to high biodiversity. Portugal distinguishes itself in this regard by having a high count of spider species (829) and a remarkable number of endemic spider species (42) for its size (approximately 88,890 km2). However, only one non-endemic species (Macrothele calpeiana) is currently protected by the Natura 2000 network and no endemic spider species (aside from Anapistula ataecina) has been assessed according to the IUCN Red List criteria. The objective of this paper is to assess all non-assessed endemic species (41) as well as M. calpeiana.New informationThe 43 assessed species belong to 15 families, the richest being Zodariidae, Dysderidae, Linyphiidae and Gnaphosidae. In general and despite the lack of information on more than half the species, general patterns and trends could be found.Only 18 species (including M. calpeiana and A. ataecina) had enough data to allow their EOO (extent of occurrence) and AOO (area of occurrence) to be quantified. Of these, we modelled the distribution of 14 epigean species, eight of which were found to be widespread. The remaining six fulfilled at least one of the criteria for threatened species. Four species are troglobiont, all of which meet the EOO and AOO thresholds for threatened species. The remaining 25 Portuguese endemics had no reliable information on their range. Only nine species out of the 43 are estimated to be in decline and 11 are stable, with the majority of species having no information on trends (23 species).Forest areas, sand dunes, shrublands and caves host the majority of species. As such, the threats to Portuguese endemics reflect the diversity of habitats they occupy. Urbanisation and climate change seem to be the most important threats to these species, although other factors are also important and represented across the data.A considerable proportion of the currently known Portuguese endemic species can be found in national protected areas, with higher prominence to the Serras de Aire e Candeeiros, Douro Internacional, Vale do Guadiana, Sudoeste Alentejano e Costa Vicentina and Arrábida Natural Parks. These correspond mostly to areas that have been particularly well sampled during the last two decades.

Project description:ObjectivesThe growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during a pandemic. In this paper, we present data on these factors and combine them to create an index to show which areas are more exposed. This technique can help policy makers to moderate the impact of similar pandemics.DesignWe combine several sources of data, which describe specific risk factors linked with the outbreak of a respiratory pathogen, that could leave local areas vulnerable to the harmful consequences of large-scale outbreaks of contagious diseases. We combine these measures to generate an index of community-level vulnerability.Setting91 Clinical Commissioning Groups (CCGs) in England.Main outcome measuresWe merge 15 measures spatially to generate an index of community-level vulnerability. These measures cover prevalence rates of high-risk diseases; proxies for the at-risk population density; availability of staff and quality of healthcare facilities.ResultsWe find that 80% of CCGs that score in the highest quartile of vulnerability are located in the North of England (24 out of 30). Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel. Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments.ConclusionsEvidence-based policy is crucial to mitigate the health impact of pandemics such as COVID-19. While current attention focuses on curbing rates of contagion, we introduce a vulnerability index combining data that can help policy makers identify the most vulnerable communities. We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building. These results suggest that a stronger focus on deprived and vulnerable communities is needed to tackle future threats from emerging and re-emerging infectious disease.

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Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal.

Publications

Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal.

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