Dataset Information

Analyzing Spatial Patterns of Health Vulnerability to Drought in the Brazilian Semiarid Region.

ABSTRACT: Health determinants might play an important role in shaping the impacts related to long-term disasters such as droughts. Understanding their distribution in populated dry regions may help to map vulnerabilities and set coping strategies for current and future threats to human health. The aim of the study was to identify the most vulnerable municipalities of the Brazilian semiarid region when it comes to the relationship between drought, health, and their determinants using a multidimensional index. From a place-based framework, epidemiological, socio-economic, rural, and health infrastructure data were obtained for 1135 municipalities in the Brazilian semiarid region. An exploratory factor analysis was used to reduce 32 variables to four independent factors and compute a Health Vulnerability Index. The health vulnerability was modulated by social determinants, rural characteristics, and access to water in this semiarid region. There was a clear distinction between municipalities with the highest human welfare and economic development and those municipalities with the worst living conditions and health status. Spatial patterns showed a cluster of the most vulnerable municipalities in the western, eastern, and northeastern portions of the semiarid region. The spatial visualization of the associated vulnerabilities supports decision making on health promotion policies that should focus on reducing social inequality. In addition, policymakers are presented with a simple tool to identify populations or areas with the worst socioeconomic and health conditions, which can facilitate the targeting of actions and resources on a more equitable basis. Further, the results contribute to the understanding of social determinants that may be related to medium- and long-term health outcomes in the region.

SUBMITTER: Menezes JA

PROVIDER: S-EPMC8296049 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The frequency and intensity of extreme precipitation events and severe drought are predicted to increase in semiarid areas due to global climate change. Plant morphological traits can reflect plant responses to a changing environment, such as altered precipitation or drought patterns. In this study, we examined the response of morphological traits of root, stem, leaf and reproduction meristems of annual herbaceous species to altered precipitation and drought patterns in a semiarid sandy grassland. The study involved a control treatment (100% of background precipitation) and the following six altered precipitation treatments: (1) P(+): precipitation increased by 30%, (2) P(++): precipitation increased by 60%, (3) P(-): precipitation decreased by 30%, (4) P(--): precipitation decreased by 60%, (5) drought 1 (D1): 46-day drought from May 1st to June 15th, and (6) drought 2 (D2): 46-day drought from July 1st to August 15th. P(++) significantly increased root length, flower length-to-width ratio, both P(+) and P(++) significantly increased stem length and flower number in the plant growing seasons, while all of them decreased under P(-) and P(--). The annual herbaceous plants marginally increased the number of second-level stem branches and stem diameter in order to better resist the severe drought stress under P(--). P(+) and P(++) increased the root, stem, leaf, and flower dry weight, with the flower dry weight accounting for a larger proportion than the other aboveground parts. Under D2, the plants used the limited water resources more efficiently by increasing the root-to-shoot ratio compared with P(-), P(--) and D1, which reflects biomass allocation to belowground increased. The linear mixed-effects models and redundancy analysis showed that the root-to-shoot ratio and the dry weight of various plant components were significantly affected by morphological traits and altered precipitation magnitude. Our results showed that the herbaceous species have evolved morphological trait responses that allow them to adapt to climate change. Such differences in morphological traits may ultimately affect the growing patterns of annual herbaceous species, enhancing their drought-tolerant capacity in semiarid sandy grassland during the ongoing climate change.

Project description:BackgroundThe "Mais Médicos (More Doctors) Program" established in 2013 by the Brazilian Government aimed to reduce inequalities by means of an emergency provision of physicians, the improvement of medical care service in the Brazilian Unified Health System, and the expansion of medical education training in Brazil. In this context, equity should be considered when defining priorities and allocating resources. This study describes the distribution of physicians for the Program in five Brazilian metropolitan regions (MRs) and analyses whether the most vulnerable areas within each one of these regions had been prioritized in compliance with the legislation framework of the program.MethodsThis is a quantitative cross-sectional study. Official secondary data was analyzed to verify the relationship between the Index of Social Vulnerability, set up by the Institute of Applied Economic Research, and the physician allocation provided by the Program. The data were organized into categories and quintiles. For spatialization purposes, the QGIS 3.4 Madeira software was used.ResultsThere are 2592 primary health care units, (in Portuguese, UBS), within the five MRs studied; 981 of these hosted at least one physician from the Program. In the Manaus, Recife, and the DF MRs, the 4th and 5th quintiles (the most vulnerable ones) hosted physicians in more significant proportions than the other quintiles, namely, 71.4%, 71.4%, and 52.2%, respectively, exceeding the national average (51.7%). It is worth mentioning that in the São Paulo MR, the units located in the most vulnerable quintiles (4th and 5th) also hosted physicians in proportions significantly higher than others (45.8%); however, this proportion did not reach 50%. There was no significant difference in the allocation of physicians in the Porto Alegre MR, indicating that there was no prioritization of the UBS according to vulnerability.ConclusionsThese results appoint to the enormous gaps of vulnerability existing both between the analyzed MRs and internally in each one of them. It emphasizes the need for criteria for the allocation of physicians so as not to increase inequities. It also highlights the importance of the continuity of the "Mais Médicos (More Doctors) Program" in the metropolitan regions, above all, in areas of extreme vulnerabilities. On the other hand, they contribute to the national debate about the importance of public policies regarding constitutional rights related to access to health care and the relevance of primary care and the "Mais Médicos (More Doctors) Program" for the reduction of disparities regarding access to health care, especially for the citizens who live in regions of greater vulnerability, whether it is inside or outside large metropolitan regions.

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Analyzing Spatial Patterns of Health Vulnerability to Drought in the Brazilian Semiarid Region.

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