Social vulnerability and aging of elderly people in the United States

Abstract The southern United States is no stranger to hazard and disaster events. Intense hurricanes, drought, flooding, and other climate-sensitive hazards are commonplace and have outnumbered similar events in other areas of the United States annually in both scale and magnitude by a ratio of almost 4:1 during the past 10 years. While losses from climate-sensitive hazards are forecast to increase in the coming years, not all of the populations residing within these hazard zones have the same capacity to prepare for, respond to, cope with, and rebound from disaster events. The identification of these vulnerable populations and their location relative to zones of known or probably future hazard exposure is necessary for the development and implementation of effective adaptation, mitigation, and emergency management strategies. This paper provides an approach to regional assessments of hazards vulnerability by describing and integrating hazard zone information on four climate-sensitive hazards with socioeconomic and demographic data to create an index showing both the areal extent of hazard exposure and social vulnerability for the southern United States. When examined together, these maps provide an assessment of the likely spatial impacts of these climate-sensitive hazards and their variability. The identification of hotspots—counties with elevated exposures and elevated social vulnerability—highlights the distribution of the most at risk counties and the driving factors behind them. Results provide the evidentiary basis for developing targeted strategic initiatives for disaster risk reduction including preparedness for response and recovery and longer-term adaptation in those most vulnerable and highly impacted areas.

Download Full-text

Keyworkers for Elderly People in the Community: Case Managers and Care Co-ordinators

Journal of Social Policy ◽

10.1017/s0047279400018067 ◽

1990 ◽

Vol 19 (3) ◽

pp. 331-360 ◽

Cited By ~ 18

Author(s):

Tim Dant ◽

Brian Gearing

Keyword(s):

United States ◽

United Kingdom ◽

Case Management ◽

Elderly People ◽

Social Services ◽

The United States ◽

Case Managers ◽

The United Kingdom ◽

Frail Elderly People ◽

At Home

ABSTRACTIn the United Kingdom a range of services for elderly people in the community has developed that is delivered by a variety of professionals and administered within different organisations. This has resulted in a problem of co-ordinating services to meet the individual needs of the most frail elderly people. In the United States ‘case management’ has been introduced as a way of improving the co-ordination of care. Despite structural differences in the provision of health and social services between the United States and the United Kingdom, the concept of case management has influenced the design of a number of innovatory schemes in the United Kingdom, including the Gloucester Care for Elderly People at Home project (CEPH). These innovatory schemes have demonstrated the need for a ‘keyworker’ and clarified the tasks that are involved in taking responsibility for co-ordinating services to meet the needs of elderly people at risk of failing to cope at home. There is, however, a danger of proliferating the complexity of service provision by creating a new breed of professional; an alternative might be to alter the responsibilities, attitudes and team orientation of existing professional workers so as to include taking on the key worker role for some of their clients.

Download Full-text

Natural Gas Gathering and Transmission Pipelines and Social Vulnerability in the United States

GeoHealth ◽

10.1029/2021gh000442 ◽

2021 ◽

Author(s):

Ryan E. Emanuel ◽

Martina Angela Caretta ◽

Louie Rivers ◽

Pavithra Vasudevan

Keyword(s):

United States ◽

Natural Gas ◽

Social Vulnerability ◽

The United States ◽

Transmission Pipelines

Download Full-text

Changing Causes of Death of Elderly People in the United States, 1950–1990

Gerontology ◽

10.1159/000022037 ◽

1998 ◽

Vol 44 (6) ◽

pp. 331-335 ◽

Cited By ~ 3

Author(s):

David W.E. Smith

Keyword(s):

United States ◽

Elderly People ◽

Causes Of Death ◽

The United States

Download Full-text

Abstract 16562: Association of County-Level Social Vulnerability Index and Cardiovascular Disease in the United States, 1999-2018

Circulation ◽

10.1161/circ.142.suppl_3.16562 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Quentin R Youmans ◽

Megan E McCabe ◽

Clyde W Yancy ◽

Lucia Petito ◽

Kiarri N Kershaw ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Social Vulnerability ◽

Cardiovascular Health ◽

Vulnerability Index ◽

The United States ◽

County Level ◽

Social Vulnerability Index ◽

Cross Sectional ◽

Cvd Mortality

Introduction: Social determinants of health are multi-dimensional and span various interrelated domains. In order to inform community-engaged clinical and policy efforts, we sought to examine the association between a national social vulnerability index (SVI) and age-adjusted mortality rate (AAMR) of CVD. Hypothesis: Higher county-level SVI or greater vulnerability will be associated with higher AAMR of CVD between 1999-2018 in the United States. Methods: In this serial, cross-sectional analysis, we queried CDC WONDER for age-adjusted mortality rates (AAMRs) per 100,000 population for cardiovascular disease (I00-78) at the county-level between 1999-2018. We quantified the association of county-level SVI and CVD AAMR using Spearman correlation coefficients and examined trends in CVD AAMR stratified by median SVI at the county-level. Finally, we performed geospatial county-level analysis stratified by combined median SVI and CVD AAMR (high/high, high/low, low/high, and low/low). Results: We included data from 2766 counties (representing 95% of counties in the US) with median SVI 0.53 (IQR 0.28, 0.76). Overall SVI and the household and socioeconomic subcomponents were strongly correlated with 2018 CVD AAMR (0.47, 0.50, and 0.56, respectively with p<0.001 for all). CVD mortality declined between 1999-2011 and was stagnant between 2011-2018 with similar patterns in high and low SVI counties (FIGURE). Counties with high SVI and CVD AAMR were clustered in the South and Midwest (n=977, 35%). Conclusion: County-level social vulnerability is associated with higher CVD mortality. High SVI and CVD AAMR coexist in more than 1 in 3 US counties and have persisted over the past 2 decades. Identifying counties that are disproportionately vulnerable may inform targeted and community-based strategies to equitably improve cardiovascular health across the country.

Download Full-text