RESUMO
BACKGROUND: Although the frequency and magnitude of climate change-related health hazards (CCRHHs) are likely to increase, the population vulnerabilities and corresponding health impacts are dependent on a community's exposures, pre-existing sensitivities, and adaptive capacities in response to a hazard's impact. To evaluate spatial variability in relative vulnerability, we: 1) identified climate change-related risk factors at the dissemination area level; 2) created actionable health vulnerability index scores to map community risks to extreme heat, flooding, wildfire smoke, and ground-level ozone; and 3) spatially evaluated vulnerability patterns and priority areas of action to address inequity. METHODS: A systematic literature review was conducted to identify the determinants of health hazards among populations impacted by CCRHHs. Identified determinants were then grouped into categories of exposure, sensitivity, and adaptive capacity and aligned with available data. Data were aggregated to 4188 Census dissemination areas within two health authorities in British Columbia, Canada. A two-step principal component analysis (PCA) was then used to select and weight variables for each relative vulnerability score. In addition to an overall vulnerability score, exposure, adaptive capacity, and sensitivity sub-scores were computed for each hazard. Scores were then categorised into quintiles and mapped. RESULTS: Two hundred eighty-one epidemiological papers met the study criteria and were used to identify 36 determinant indicators that were operationalized across all hazards. For each hazard, 3 to 5 principal components explaining 72 to 94% of the total variance were retained. Sensitivity was weighted much higher for extreme heat, wildfire smoke and ground-level ozone, and adaptive capacity was highly weighted for flooding vulnerability. There was overall varied contribution of adaptive capacity (16-49%) across all hazards. Distinct spatial patterns were observed - for example, although patterns varied by hazard, vulnerability was generally higher in more deprived and more outlying neighbourhoods of the study region. CONCLUSIONS: The creation of hazard and category-specific vulnerability indices (exposure, adaptive capacity and sensitivity sub-scores) supports evidence-based approaches to prioritize public health responses to climate-related hazards and to reduce inequity by assessing relative differences in vulnerability along with absolute impacts. Future studies can build upon this methodology to further understand the spatial variation in vulnerability and to identify and prioritise actionable areas for adaptation.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Mudança Climática , Inundações , Temperatura Alta/efeitos adversos , Ozônio/efeitos adversos , Fumaça , Incêndios Florestais , Colúmbia Britânica , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Características de Residência , Fatores de RiscoRESUMO
Using open-source data, we show that despite significant reductions in global public transit during the COVID-19 pandemic, â¼20% of ridership continues during social distancing measures. Current urban transport data collection methods do not account for the distinct behavioural and psychological experiences of the population. Therefore, little is known about the travel experience of vulnerable citizens that continue to rely on public transit and their concerns over risk, safety and other stressors that could negatively affect their health and well-being. We develop a machine learning approach to augment conventional transport data collection methods by curating a population segmented Twitter dataset representing the travel experiences of â¼120,000 transit riders before and during the pandemic in Metro Vancouver, Canada. Results show a heightened increase in negative sentiments, differentiated by age, gender and ethnicity associated with public transit indicating signs of psychological stress among travellers during the first and second waves of COVID-19. Our results provide empirical evidence of existing inequalities and additional risks faced by citizens using public transit during the pandemic, and can help raise awareness of the differential risks faced by travellers. Our data collection methods can help inform more targeted social-distancing measures, public health announcements, and transit monitoring services during times of transport disruptions and closures.
RESUMO
BACKGROUND: Understanding and managing the impacts of population growth and densification are important steps for sustainable development. This study sought to evaluate the health trade-offs associated with increasing densification and to identify the optimal balance of neighbourhood densification for health. METHODS: We linked population density with a 27-year mortality dataset in Metro Vancouver that includes census-tract levels of life expectancy (LE), cause-specific mortalities, and area-level deprivation. We applied two methods: (1) difference-in-differences (DID) models to study the impacts of densification changes from the early 1990s on changes in mortality over a 27-year period; and (2) smoothed cubic splines to identify thresholds of densification at which mortality rates accelerated. RESULTS: At densities above ~9400 persons per km2, LE began to decrease more rapidly. By cause, densification was linked to decreased mortality for major causes of mortality in the region, such as cardiovascular diseases, neoplasms, and diabetes. Greater inequality with increasing density was observed for causes such as human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS), sexually transmitted infections, and self-harm and interpersonal violence. CONCLUSIONS: Areas with higher population densities generally have lower rates of mortality from the major causes, but these environments are also associated with higher relative inequality from largely preventable causes of death.
Assuntos
Síndrome da Imunodeficiência Adquirida , Expectativa de Vida , Canadá/epidemiologia , Causas de Morte , Humanos , Mortalidade , Características de ResidênciaRESUMO
Spatially varying baseline data can help identify and prioritise actions directed to determinants of intra-urban health inequalities. Twenty-seven years (1990-2016) of cause-specific mortality data in British Columbia, Canada were linked to three demographic data sources. Bayesian small area estimation models were used to estimate life expectancy (LE) at birth and 20 cause-specific mortality rates by sex and year. The gaps in LE for males and females ranged from 6.9 years to 9.5 years with widening inequality in more recent years. Inequality ratios increased for almost all causes, especially for HIV/AIDS and sexually transmitted infections, maternal and neonatal disorders, and neoplasms.