Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?

Social determinants of health as drivers of fungal disease

Disparities in social determinants of health (SDOH) play a significant role in causing health inequities globally. The physical environment, including housing and workplace environment, can increase the prevalence and spread of fungal infections. A number of professions are associated with increased fungal infection risk and are associated with low pay, which may be linked to crowded and sub-optimal living conditions, exposure to fungal organisms, lack of access to quality health care, and risk for fungal infection. Those involved and displaced from areas of armed conflict have an increased risk of invasive fungal infections. Lastly, a number of fungal plant pathogens already threaten food security, which will become more problematic with global climate change. Taken together, disparities in SDOH are associated with increased risk for contracting fungal infections. More emphasis needs to be placed on systematic approaches to better understand the impact and reducing the health inequities associated with these disparities.

Effect of disaster training on knowledge regarding flood risk management amongst families with older people

The elderly population is of utmost importance amongst vulnerable populations during disasters because they experience reduced functional abilities, cognitive disturbance, dementia, weak physical conditions and various degenerative diseases. This study aimed to assess the effect of disaster preparedness training on knowledge regarding flood disaster preparedness and management in families with older people. This study was conducted using a quasi-experimental pre-post design with 30 participants in natural hazard preparedness training using purposive sampling. The results of this study showed a significant change in general knowledge on disaster and flood (12.9 and 20 points, respectively). Disaster preparedness practice was good, as reflected in actions performed before, during and after disaster. Before a flood occurs, families prepare a disaster preparedness bag for important documents as well as logistics (e.g. food) for emergencies and equipment for evacuation whilst also storing valuable goods in a safe place. During floods, families prioritise older people's evacuation whilst seeking information about the flood through neighbours, walkie-talkies, handphones, television and radio as well as ensuring that the necessary logistics are taken care of. After the disaster, families clean their properties, provide clean water and toilet facilities for the family, check the health of family members that may be impacted by the flood and make sure that all electrical panels are safe. It is concluded that disaster training affects the knowledge of flood management in families with older people.

A Literature Review on the Role of Social Determinants in Post-Disaster Public Health

Introduction: Social determinants are closely related to public health disparities, and they affect health both directly and indirectly. Furthermore, social and economic conditions are often associated with a natural disaster that impacts people’s health. Methods: This study used the Pubmed database, Science direct, and Proquest through the keywords “Determinan Sosial; Kesehatan Masyarakat; Pascabencana (Social Determinants; Public Health; Post-Disaster)”. Furthermore, the studies found are open access, not a type of review and were filtered over the last five years. The Pubmed databases found 1308 studies, which were screened based on inclusion and exclusion criteria to obtain a total of 7 studies for review. Result: The role of social support shows a significant effect on a person’s stress symptoms. Moreover, environmental factors play an important role in post-disaster public health. Therefore, policies and countermeasures in disaster recovery need to continuously focus on health issues and social relations in the long term. Conclusion: Social determinants have an important role in post-disaster public health.

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

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.

Human activity pattern implications for modeling SARS-CoV-2 transmission

BACKGROUND AND OBJECTIVES

SARS-CoV-2 emerged in December 2019 and rapidly spread into a global pandemic. Designing optimal community responses (social distancing, vaccination) is dependent on the stage of the disease progression, discovery of asymptomatic individuals, changes in virulence of the pathogen, and current levels of herd immunity. Community strategies may have severe and undesirable social and economic side effects. Modeling is the only available scientific approach to develop effective strategies that can minimize these unwanted side effects while retaining the effectiveness of the interventions.

METHODS

We extended the agent-based model, SpatioTemporal Human Activity Model (STHAM), for simulating SARS-CoV-2 transmission dynamics.

RESULTS

Here we present preliminary STHAM simulation results that reproduce the overall trends observed in the Wasatch Front (Utah, United States of America) for the general population. The results presented here clearly indicate that human activity patterns are important in predicting the rate of infection for different demographic groups in the population.

CONCLUSIONS

Future work in pandemic simulations should use empirical human activity data for agent-based techniques.

"We only have the one": Mapping the prevalence of people with high body mass to aid regional emergency management planning in aotearoa New Zealand

INTRODUCTION

People have been left behind in disasters directly associated with their size, shape, and weight and are disproportionately impacted in pandemics. Despite alignment with known vulnerabilities such as poverty, age, and disability, the literature is inaudible on body mass. Emergency managers report little or no information on body mass prevalence. This exploratory study aimed to illustrate population prevalence of high body mass for emergency planning.

METHODS

Cross-sectional data from the New Zealand Health Survey were pooled for the years 2013/14-2017/18 (n = 68 053 adults aged ≥15 years). Height and weight were measured and used to calculate body mass index. The prevalence of high body mass were mapped to emergency management boundary shapefiles. The resulting maps were piloted with emergency managers.

RESULTS

Maps highlight the population prevalence of high body mass across emergency management regions, providing a visual tool. A pilot with 14 emergency managers assessed the utility of such mapping. On the basis of the visual information, the tool prompted 12 emergency managers to consider such groups in regional planning and to discuss needs.

CONCLUSIONS

Visual mapping is a useful tool to highlight population prevalence of groups likely to be at higher risk in disasters. This is believed to be the first study to map high body mass for the purposes of emergency planning. Future research is required to identify prevalence at a finer geographical scale. More features in the local context such as physical location features, risk and vulnerability features could also be included in future research.

Promoting Integrated Mental Health Care Services in Disaster Response Programs: Lessons Learned After the Impact of Hurricane María in Puerto Rico

Meteorological and even human-made disasters are increasing every year in frequency and magnitude. The passage of a disaster affects a society without distinction, but groups with social vulnerability (low socioeconomic status, chronic medical, or psychological conditions, limited access to resources) face the most significant impact. As a result, psychological and behavioral symptoms (eg, depression and anxiety) can ensue, making the immediate response of mental health services crucial. Secondary data from a database of a temporary healthcare unit were analyzed. A total of 54 records were reviewed to collect information; univariate and bivariate analyses were done. The purpose of this article is to present our experience regarding the incorporation of a mental health services model, with its respective benefits and challenges, into a temporary healthcare unit, after Hurricane Maria in 2017.

Social deprivation, gender and obesity: multiple stigma? Results of a population survey from Germany

OBJECTIVES

Individuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories.

DESIGN

Representative cross-sectional telephone survey.

PARTICIPANTS

692 randomly selected adults (≥ 18 years) in Germany.

METHODS

Different vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses.

RESULTS

A low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES.

CONCLUSIONS

Results support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.