An early warning precision public health approach for assessing COVID-19 vulnerability in the UK: the Moore-Hill Vulnerability Index (MHVI).

BACKGROUND: Most COVID-19 vulnerability indices rely on measures that are biased by rates of exposure or are retrospective like mortality rates that offer little opportunity for intervention. The Moore-Hill Vulnerability Index (MHVI) is a precision public health early warning alternative to traditional infection fatality rates that presents avenues for mortality prevention. METHODS: We produced an infection-severity vulnerability index by calculating the proportion of all recorded positive cases that were severe and attended by ambulances at small area scale for the East Midlands of the UK between May 2020 and April 2022. We produced maps identifying regions with high and low vulnerability, investigated the accuracy of the index over shorter and longer time periods, and explored the utility of the MHVI compared to other common proxy measures and indices. Analysis included exploring the correlation between our novel index and the Index of Multiple Deprivation (IMD). RESULTS: The MHVI captures geospatial dynamics that single metrics alone often overlook, including the compound health challenges associated with disadvantaged and declining coastal towns inhabited by communities with post-industrial health legacies. A moderate negative correlation between MHVI and IMD reflects spatial analysis which suggests that high vulnerability occurs in affluent rural as well as deprived coastal and urban communities. Further, the MHVI estimates of severity rates are comparable to infection fatality rates for COVID-19. CONCLUSIONS: The MHVI identifies regions with known high rates of poor health outcomes prior to the pandemic that case rates or mortality rates alone fail to identify. Pre-hospital early warning measures could be utilised to prevent mortality during a novel pandemic.

After Coal: Affective-Temporal Processes of Belonging and Alienation in the Deindustrializing Nottinghamshire Coalfield, UK.

This article advances conceptualizations of belonging and alienation among deindustrializing people toward (i) pluralistic temporal and (ii) affective processes. The focus is on belonging and alienation among a deindustrialized generation in the Nottinghamshire coalfield, UK, exploring how various affective-temporal processes mediate capacities, claims, and senses of belonging and alienation. Extant studies suggest that multiple temporal processes constitute deindustrialized places, particularly intergenerational transmissions, declarative memory, and place-histories. Recent work has explored the affective, emotional, and embodied dynamics of these temporal processes. While these literatures are insightful in locating affective and temporal processes of belonging, studies do not have much to say on the relational dynamics of affective-temporal processes in everyday becoming lives and experiences of deindustrializing places. The significance of foregrounding multiple affective-temporal processes of belonging and alienation is because of their relational nature. Advancing understandings of belonging is critical as a coherent sense of belonging is fundamental for individual and social well-being, and the loss of belonging, namely, alienation, informs how former industrial places are lived. Based on autoethnographic, interview and Observant Participation research with participants born between 1984 and 1994, I use ethnographic vignettes to delineate multiple relating affective-temporal processes of belonging and alienation of a generation that came after coal. The first vignette concerns the embodied and affective relationalities of intergenerational transmission and becoming in a deindustrialized world through the lens of masculinity, place and belonging. The second vignette examines nostalgic and traumatic shared declarative memories contingent of living through and with deindustrialization. The third vignette looks at intersections of place histories, silenced memory and local pride and shame, drawing out the significance of space and place to class-based experiences. Weaved through the stories are thematic threads of class, place, alienation, belonging, and temporality. Bringing these threads together, the paper then discusses the relationalities between issues covered, emphasizing the mutual contingencies between affective-temporal processes of belonging and alienation. I end by calling for shared affective-temporal processes of belonging and alienation to form the basis of a renewed solidarity, attenuation of alienation and a means to belong.