Quantitative Framework for Establishing Low-Risk Inter-District Travel Corridors During COVID-19

Aspirations to slow down the spread of novel Coronavirus (COVID-19) resulted in unprecedented restrictions on personal and work-related travels in various nations across the globe in 2020. As a consequence, economic activities within and across the countries were almost halted. As restrictions loosen and cities start to resume public and private transport to revamp the economy, it becomes critical to assess the commuters’ travel-related risk in light of the ongoing pandemic. The paper develops a generalizable quantitative framework to evaluate the commute-related risk arising from inter-district and intra-district travel by combining nonparametric data envelopment analysis for vulnerability assessment with transportation network analysis. It demonstrates the application of the proposed model for establishing travel corridors within and across Gujarat and Maharashtra, two Indian states that have reported many COVID-19 cases since early April 2020. The findings suggest that establishing travel corridors between a pair of districts solely based on the health vulnerability indices of the origin and destination discards the en-route travel risks from the prevalent pandemic, underestimating the threat. For example, while the resultant of social and health vulnerabilities of Narmada and Vadodara districts is relatively moderate, the en-route travel risk exacerbates the overall travel risk of travel between them. The study provides a quantitative framework to identify the alternate path with the least risk and hence establish low-risk travel corridors within and across states while accounting for social and health vulnerabilities in addition to transit-time related risks.

COVID-19 in Afghanistan: Evaluating Health Vulnerability and Identifying Controlling Mechanism

Background: The insistent range of coronavirus (COVID-19) crisis and its permeation into least developed countries has escalated the bar of countries fragility and susceptibility. Afghanistan is amongst the most affected countries by the COVID-19 pandemic certainly due to its poor health infrastructure and conflict affected demography. Objective: This study intends to assess the health vulnerability profile and identifying the control mechanism of the north and northeast regions of Afghanistan using the IPCC framework. Method: A pre-evaluated online questionnaire (Google form) and mobile survey of 361 households distributed in 8 provinces across the both zones to collected the primary data. Exposure, sensitivity and adaptive capacity covered the three main components of vulnerability index, weighing method of Iyenger and Sudershan is used to estimate the fabricate vulnerability index. Result: The province’s health vulnerability status was classified to the different groups based on beta distribution. Based on the vulnerability index, 62.5% of provinces were highly vulnerable, 25% moderately and 37.5% were least vulnerable. Conclusion: In north-east region people were highly vulnerable to COVID-19 in terms of sensitivity and exposure, with low copping capacity to cope with COVID-19 pandemic risks compare to the north zone. Recommendation: Enhancing health and hygiene facilities and a handful of lowcost methods such as strengthen informal safety nets and introducing small-scale regional infrastructure projects, could be most cost effective and viable options. Originality: The research work is original and has not been published in other publications. As well, no financial support has been received for the study.

Rethinking of Environmental Health Risks: A Systematic Approach of Physical–Social Health Vulnerability Assessment on Heavy-Metal Exposure through Soil and Vegetables

In the field of environmental health risk assessment and management research, heavy metals in soil are a constant focus, largely because of mining and metallurgical activities, and other manufacturing or producing. However, systematic vulnerability, and combined research of social and physical vulnerability of the crowd, have received less attention in the research literature of environmental health risk assessment. For this reason, tentative design modelling for comprehensive environmental health vulnerability, which includes the index of physical and social vulnerability, was conducted here. On the basis of experimental data of heavy-metal pollution in soil and vegetables, and population and societal survey data in Daye, China, the physical, social, and comprehensive environmental health vulnerabilities of the area were analyzed, with each village as an evaluation unit. First, the polluted and reference areas were selected. Random sampling sites were distributed in the farmland of the villages in these two areas, with two sampling sites per village. Then, 204 vegetable samples were directly collected from the farmland from which the soil samples had been collected, composed of seven kinds of vegetables: cowpea, water spinach, amaranth, sweet potato leaves, tomato, eggplant, and pepper. Moreover, 400 questionnaires were given to the local residents in these corresponding villages, and 389 valid responses were obtained. The results indicated that (1) the average physical vulnerability values of the population in the polluted and reference areas were 3.99 and 1.00, respectively; (2) the village of Weiwang (WW) had the highest physical vulnerability of 8.55; (3) vegetable intake is exposure that should be paid more attention, as it contributes more than 90% to physical vulnerability among the exposure pathways; (4) arsenic and cadmium should be the priority pollutants, with average physical vulnerability value contributions of 63.9% and 17.0%, respectively; (5) according to the social vulnerability assessment, the village of Luoqiao (LQ) had the highest social vulnerability (0.77); (6) for comprehensive environmental health vulnerability, five villages near mining activities and two villages far from mine-affected area had high physical and social vulnerability, and are the urgent areas for environmental risk management. In order to promote environmental risk management, it is necessary to prioritize identifying vulnerable populations in the village-scale dimension as an innovative discovery.

Efficiency of the primary health care policy in Brazilian municipalities: an application of the Pearl’s Structural Causal Model

ABSTRACT Background In recent years, public health policies and their effects on improving health outcomes have been gaining prominence in the economic literature and on the agenda of international organizations. Objective This study aims to evaluate the causal effect of the “Pacto pela Saúde” (Pact for Health) program on health policy performance in terms of a Health Vulnerability Index (HVI) of Brazilian municipalities from 2006 to 2013. The “Pacto pela Saúde” program is the current operational standard of the Brazilian Unified Health System (SUS). One of the main guidelines of this program was to improve health policy governance. Method The effect resulting from efficiency gains of the participation of municipalities in the health policy on the HVI was estimated by the Pearl’s Structural Causal Model. Results The results indicate a positive and significant impact of efficiency management on the reduction of health vulnerability in the municipalities. The Pearl’s Causal Model and the back-door criterion of causal identification were employed to calculate the effects of the “Pacto pela Saúde” program on the HVI. Conclusion The use of Pearl’s method in this study contributed to a more comprehensive analysis of the effects of the “Pacto pela Saúde” program on health outcomes and, therefore, its use in future research on the analysis of public policies is recommended.

HEALTH VULNERABILITY VERSUS ECONOMIC RESILIENCE TO THE COVID-19 PANDEMIC

The purpose of this study is to understand how countries have leveraged on their economic resilience to fight the COVID-19 pandemic. The focus is on a global sample of 150 countries. The study develops a health vulnerability index (HVI) and leverages on an existing economic resilience index (ERI) to provide four main scenarios from which to understand the problem statement, namely ‘low HVI-low ERI,’ ‘high HVI-low ERI,’ ‘high HVI-high ERI,’ and ‘low HVI-high ERI’ quadrants. Countries that have robustly fought the pandemic are those in the ‘low HVI-high ERI’ quadrant and, to a lesser extent, countries in the ‘low HVI-low ERI’ quadrant. Most European countries, namely one African country (Rwanda), four Asian countries (e.g., Japan, China, South Korea, and Thailand), and six American countries (e.g., United States, Canada, Uruguay, Panama, Argentina, and Costa Rica) are apparent in the ideal quadrant.

Spatialising urban health vulnerability: An analysisof NYC’s critical infrastructure during COVID-19

This paper examines how fragmentation of critical infrastructure impacts the spread of the coronavirus outbreak in New York City at the neighbourhood level. The location of transportation hubs, grocery stores, pharmacies, hospitals and parks plays an important role in shaping spatial disparities in virus spread. Using supervised machine learning and spatial regression modelling we examine how the geography of COVID-19 case rates is influenced by the spatial arrangement of four critical sectors of the built environment during the public health emergency in New York City: health care facilities, mobility networks, food and nutrition and open space. Our models suggest that an analysis of urban health vulnerability is incomplete without the inclusion of critical infrastructure metrics in dense urban geographies. Our findings show that COVID-19 risk at the zip code level is influenced by (1) socio-demographic vulnerability, (2) epidemiological risk, and (3) availability and access to critical infrastructure.

1.E. Workshop: Addressing vulnerability within climate change related health impacts

Climate change (CCh) is having an impact on people's health and health systems, directly and indirectly. Drastic and sudden changes in climatic conditions with heat waves and rapid temperature variations, an increased risk of floods, droughts and forest fires are some of the direct impacts related to CCh, with important consequences on health (e.g. heatstroke, electrolyte imbalance, kidney, respiratory as well as infectious related diseases) and mental well-being (e.g. stress and anxiety for an uncertain future). Some indirect effects include the alteration of natural ecosystems, changing vector patterns, air pollution and aeroallergens, or increased food insecurity. For certain sectors of the population and some regions, these direct and indirect impacts overlap with many other environmental and socioeconomic stressors (e.g. overcrowded megacities, poverty and poor nutrition, living in highly contaminated sites, increased dependence on a remote global market, growing gender and class inequalities), increasing the already large vulnerability of those affected populations. Low- and middle-income countries are under greater threat, but more developed economies can be- and in fact are- severely affected as well. This is of particular concern in relation to children together with the elderly, both considered the most vulnerable population groups affected by CCh as highlighted by the Intergovernmental Panel on Climate Change (IPCC). Adverse effects of altered environments during fetal or child developmental stages can result in irreversible and long-lasting health sequelae; uncertainty and loss of control in the face of CCh can have mental health consequences. Gathering best scientific evidence-based information on current and future health threats related to CCh from the perspective of the most vulnerable population subgroups is essential for an effective preparedness of the public health system, and therefore for lessening or avoiding many of those health impacts by applying well-designed and innovative adaptation measures. Health vulnerability and adaptation assessments to CCh requires establishing partnerships among different scientific domains (e.g. public health experts, environmentalists, meteorologists, social scientists), and stakeholders, including community representatives and policy makers. Present workshop, with 3 presenters and one panellist, aims at analysing and sharing expertise on the following aspects: Approaches for characterising health and well-being vulnerability and adaptation measures in the context of CCh by integrating future climatic and socio-economic drivers. Analysis of children's health vulnerability in a CCh context. European initiatives for promoting multidisciplinary scientific evidence analysis, and the interconnection with the decision-making process for the development of innovative and effective adaptation programs that enables diminishing health vulnerability against CCh. Key messages Expanded efforts in the health impact assessment of vulnerable groups against growing risks from climate change is needed for developing effective public health adaptation and preparedness programs. Addressing climate change health vulnerability requires of gathering scientific evidence and collaboration from multiple sectors and stakeholders adapted to regional/local context.