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

Júlia Alves Menezes,Ana Paula Madureira,Martha Macêdo De Lima Barata,Isabela De Brito Duval,Pedro Regoto,Rhavena Barbosa Dos Santos,Carina Margonari,Ulisses Confalonieri

doi:10.3390/ijerph18126262

Abstract

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.

Highlights

The authors showed that physical characteristics of dry regions do not necessarily imply high social vulnerability, but rather a historical political environment that defines the social construction of risk associated with droughts in Brazil
The fact that the drought indicator was not among the largest loads in Factor 2 points in the same direction— the whole Semiarid experiences the impacts of droughts at diverse intensities, are the aspects of infrastructure, services, employment, income, and social conditions more important in shaping the Health Vulnerability Index (HVI)
This study developed a health vulnerability index for the Brazilian Semiarid region from a factor analysis that showed the connections between different aspects influencing the health vulnerabilities in the context of drought

Summary

Introduction

The importance of socio-economic status and other underlying living conditions of the population has been considered relevant to public health policies and the reduction of health inequalities worldwide, especially after the Commission on Social Determinants of Health established by the World Health Organization in 2005 [1,2,3,4]. This approach recognizes the interaction between social, economic, cultural, ethnic, psychological, environmental, and behavioral factors that influence the occurrence of health problems and their risk factors in the population, creating health inequities among different strata.

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