Vulnerable Communities Research Articles

Integrated environmental and clinical surveillance for the prevention of acute respiratory infections (ARIs) in indoor environments and vulnerable communities (Stell-ARI): Protocol.

The epidemiological relevance of viral acute respiratory infections (ARIs) has been dramatically highlighted by COVID-19. However, other viruses cannot be neglected, such as influenza virus, respiratory syncytial virus, human adenovirus. These viruses thrive in closed spaces, influenced by human and environmental factors. High-risk closed communities are the most vulnerable settings, where the real extent of viral ARIs is often difficult to evaluate, due to the natural disease progression and case identification complexities. During the COVID-19 pandemic, wastewater-based epidemiology has demonstrated its great potential for monitoring the circulation and evolution of the virus in the environment. The "Prevention of ARIs in indoor environments and vulnerable communities" study (Stell-ARI) addresses the urgent need for integrated surveillance and early detection of ARIs within enclosed and vulnerable communities such as long-term care facilities, prisons and primary schools. The rapid transmission of ARIs in such environments underscores the importance of comprehensive surveillance strategies to minimise the risk of outbreaks and safeguard community health, enabling proactive prevention and control strategies to protect the health of vulnerable populations. This study consists of designing and validating tools for integrated clinical and environmental-based surveillance for each setting, coupled with analytical methods for environmental matrices. The clinical surveillance involves specialized questionnaires and nasopharyngeal swabs for virus identification, while the environmental surveillance includes air and surface microbiological and chemical monitoring, and virological analysis of wastewater. Integrating this information and the collection of behavioural and environmental risk factors into predictive and risk assessment models will provide a useful tool for early warning, risk assessment and informed decision-making. The study aims to integrate clinical, behavioural, and environmental data to establish and validate a predictive model and risk assessment tool for the early warning and risk management of viral ARIs in closed and vulnerable communities prior to the onset of an outbreak.

Project: Malecón Buenaventura, Urban Regeneration For The Southern Area of The Island of Cascajal

Objective: The objective of this research is to generate the solution from the urban planning of informal settlements located in the southern area of Cascajal Island, which have been settled in an ancestral way on low-water strips which are declared as goods for public use by the Colombian State, being the same in constant illegality; establishing the following specific objectives: Interpret the current regulations, given in Law 185/59, Decree Law 2424/84 and Agreement 03/01; constituting the baseline of urban planning, to generate new urban fiscal land, and minimize the non-mitigable risk. Carry out urban planning; taking into account the instruments of complementary planning; developed through six units of urban actions. Theoretical reference: On the goods of public use (bajamares) it is impossible to establish legal processes for formal habitats; therefore, they must be converted into fiscal assets in favor of the District of Buenaventura, to solve the settlements towards the required formality, taking into account the incidence towards the normative framework of the current territorial order given by Law 185/59 and Decree Law 2324/84 Method: The methodological approach was qualitative of analytic-relational type, through the normative interpretation of Law 185/59 and Decree Law 2324/84 in relation to the current territorial order; and whose data collection instruments were the documentation of normative files and government sources of district level linked to the ownership of fiscal assets Result and conclusion: The expected results showed the proposed resolution as a dynamic of the urban law towards the specific implication for the territorial ordering; which raises that they must contemplate the particularities of the territories and from there generate the solutions that solve the socioeconomic, urban and environmental problems that by the inability of the State itself are perpetuated in time and where the same rules do not allow to generate the solutions. Implications of the research: The urban solution proposed, demonstrates the effectiveness within urban law, of the specific regulatory interpretations on the territorial ordering Originality/Value: The research on the solution of informal settlements on low-water areas in the city of Buenaventura (southern area of Cascajal Island); presents a significant originality and value for the welfare state of the poorest and most vulnerable communities, contributing to their quality of life.

Mapping Research Trends in Global Climate Change Adaptation to Flood Disasters: A Bibliometric Analysis using VOSviewer

Using a bibliometric analysis, this study aims to map the research trends and thematic developments in climate change adaptation to flood disasters. Data from 812 publications, spanning from 1996 to 2023, were retrieved from the Scopus database and analyzed using VOSviewer software to visualize keyword co-occurrence networks. The analysis identified five key thematic clusters: adaptation strategies and resilience (180 publications), urban planning and green infrastructure (150 publications), flood risk management (85 publications), early warning systems (60 publications), and socio-economic impacts such as health and displacement (100 publications). Over time, research output has significantly increased, particularly after 2015, with publications peaking at 150 in 2023. Regionally, Asia leads the research output with 200 publications, followed by Europe (180 publications) and North America (120 publications). The findings highlight a shift toward sustainable, nature-based solutions and the integration of advanced technologies such as machine learning in flood management. The increasing focus on the socio-economic dimensions of flood adaptation, particularly in vulnerable communities, underscores the need for more inclusive approaches. Future research should prioritize underrepresented regions, such as Africa and Latin America, and foster interdisciplinary collaboration to address the complex challenges of climate-induced floods.

Period poverty, menstrual health and menstrual (in)justice in the context of social work – in the opinions of students and graduates of social work

Menstruation, until recently treated as a purely biological phenomenon, is beginning to be perceived as a social phenomenon, becoming the subject of research, scientific theorizing and publications. Third-sector organizations are being formed to tackle period poverty, promote menstrual health and work for menstrual justice. Menstrual poverty and broadly understood menstrual inequalities are often experienced by socially vulnerable individuals, families, groups and communities, who become social welfare institutions and social work service users. The article presents selected results of a survey with participation of social work students (current and graduates) on their perception of the relationship between social work and the elimination of menstrual poverty, the promotion of menstrual health and the prevention of menstrual injustice.

Impact of shifting from rice to shrimp farming on migration aspirations in Bangladesh

AbstractThe Ganges–Brahmaputra–Meghna delta is one of the most populous deltas in the world, threatened by diverse environmental stressors, including salinity intrusion, causing adverse consequences on livelihood adaptation. Shrimp farming has been recognized as one of the most practiced livelihoods among various livelihood opportunities. Growing global demand and higher economic returns encouraged many farmers to convert their agricultural land to shrimp farms by intruding saline water into the farmlands to produce shrimps. In this study, we investigated whether the growing trend of shrimp farming influences the migration aspirations of the vulnerable coastal communities in Bangladesh. The study employed qualitative interviews with individuals in four villages in southwest coastal Bangladesh. Satellite images were analyzed to detect land-use changes and changes in soil salinity in the last 28 years, confirming a rapid increase in shrimp farms. Results from the qualitative interviews indicate that poor people with limited resources cannot produce paddy on their land because of increased soil salinity caused by shrimp farming. Such a situation leads them to aspire to migrate. Thus, our analysis contributes to the discourse on “aspiration and capability” in environmental migration by adding the impacts of land-use changes on livelihoods.

Exploring women's empowerment and adaptive capacity in Chepang communities of Chitwan, Nepal

Women in poorer countries are disproportionately impacted by climate change due to existing gender inequality. Empowering women is critical for building adaptive capacity to climate change and improving the resilience of families and communities. However, insufficient studies exist on the link between women, climate change, and their adaptability, leading to policies that overlook the significance of empowering women. This study examines the link between women's empowerment and adaptive capacity to climate change in a Chepang community in Nepal. Surveys of 190 households in the Chitwan district were conducted, measuring women's empowerment across six attributes and adaptive capacity across five attributes. Statistical analyses including PCA and FAMD were used to create indices for these factors. The study used OLS regression to assess the effect of women's empowerment on adaptive capacity. Results show that women's empowerment significantly impacts household adaptive capacity. This highlights the need for prioritizing women's empowerment, to enhance climate resilience in vulnerable communities. The findings have implications for policymakers and practitioners, advocating for gender-inclusive strategies to bolster community-level climate resilience.

Amplifying concerns: An exploration of community noise levels in rural communities impacted by wood pellet production

Wood pellets are increasingly promoted as a renewable and sustainable energy source, driving the global wood pellet market to a projected value of $16 billion by 2026. However, the rapid expansion of this industry disproportionately affects predominantly Black and low-income communities in the rural South, where approximately 100 pellet manufacturing plants are currently located in the United States. From August 2023 to March 2024, we conducted a noise exposure assessment in Gloster, Mississippi, a community affected by pellet production, and compared it to Mendenhall, a nearby community without industrial activity. In collaboration with a local organization, we measured noise metrics and found significantly higher A-weighted, C-weighted, and Z-weighted sound levels in Gloster, along with elevated decibels at multiple center frequencies. These findings suggest that wood pellet manufacturing can severely alter the soundscape of rural communities, raising environmental justice concerns. Our findings underscore the importance of investigating the cumulative health impacts of noise and other environmental burdens on these vulnerable communities to better inform policy.

Assessing the Implications of Deforestation and Climate Change on Rural Livelihood in Ghana: a Multidimensional Analysis and Solution-Based Approach.

The Ashanti region in Ghana, abundant in natural resources such as forests and vegetation biomes, significantly supports the livelihoods of a significant portion of the population. The sustainable management of forest resources remains a significant challenge to achieving environmental and economic growth and poverty alleviation. The study aims to identify the drivers of deforestation and assess its impact on the livelihoods of the poor and vulnerable communities in the Ashanti region. The study utilized qualitative and space-based data to examine the patterns of vegetation cover and deforestation from 2000 to 2020. The results revealed moderate to sparse vegetation in Ashanti from 2002, 2005, 2011, 2015, 2017, and 2018, with no vegetation in the northcentral part, attributed to climate change, agricultural practices, government policies, and deforestation-related disasters. The study found a significant correlation (R² = 0.8197) between years and deforestation areas, especially in 2018 at around 16,000 Sqkm, indicating an exponential increase with severe implications for sustainable livelihoods. Much of these changes were reflected in 2020 with a high peak of deforestation towards the southeastern parts of the region. Additionally, the results show that the poor groups are not passive actors but are actively involved in identifying systems and processes through which to build their adaptive capacity and resilience to environmental and climate change-induced changes. The findings provide evidence-based and all-inclusive approaches that would encourage vulnerable and marginalized groups to participate in the co-production and co-creation of policies and strategies. This outcome is geared towards transformative and sustainable communities while ensuring efficient and effective response and recovery capacities of deforested lands.

Exploring gender-specific mental health status and socioeconomic impacts of COVID-19 pandemic on slum dwellers in Khulna City corporation, Bangladesh

BackgroundCOVID-19 has devastated every aspect of life worldwide, where slum dwellers are particularly vulnerable due to persistent inequities. This study aims to explore the socioeconomic and gender-specific mental health impacts of COVID-19 on slum dwellers.MethodologyGeneralized ordered logistic regression with auto-fit was performed to identify predictors of socioeconomic and mental health conditions among the participants. Data analysis was conducted using Stata software, with a 95% confidence interval and p-value less than 0.05.ResultsThe study found that males who were smokers and lost their jobs during the pandemic were more prone to experience severe mental health problems. Over 60% of females experienced moderate mental health issues due to the use of unimproved sanitation facilities. Moreover, females who received support during the pandemic and lived in areas with fixed garbage disposal had less probability of experiencing severe mental health issues.ConclusionImplementing community-based initiatives that promote social integration, providing skill-building opportunities, and addressing economic vulnerabilities may significantly improve the mental well-being of this vulnerable community. Collaboration between the Government and stakeholders is essential to address critical needs, such as proper garbage disposal and gender-segregated sanitation facilities, to build a sustainable community.

Envisioning ecological security through local direct action: community resistance with global resonance

ABSTRACT As climate change becomes a pressing concern for policymakers and citizens around the world, a variety of security discourses have emerged framing the environment as a security issue. While dominant frameworks focus on securing national interests, the international order, or individuals, the ecological security framework presents an alternative discourse. Ecological security requires a refocusing of the security discourse onto the environment itself, vulnerable communities, and future generations, and requires the exploration of alternative, relational forms of social and economic organisation. This framework has often been discounted as an impractical and radical alternative to dominant discourses, however, I argue that ecological security can, and is, being enacted by local communities around the world through radically relational activist methodologies. I suggest that direct action methodology employed by environmental activists can enable the enactment of ecological security by local communities. By investigating the connections and overlaps between blockade-style activism, direct action methodology, and Indigenous resurgence, it is possible to envision a locally-based, radically relational, bottom-up model of ecological security. Through an investigation of the conflict between Wet’suwet’en land defenders and the Coastal GasLink pipeline, this community-activist-ecological security nexus is drawn out and examined as a possible path forward for climate security.

A development and implementation of a preconception counseling program for black women and men in the southeastern United States: a pilot protocol.

Racial/ethnic disparities in maternal mortality rates represent one of the most significant areas of disparities amongst all conventional population perinatal health measures in the U.S. The alarming trends and persistent disparities of outcomes by race/ethnicity and geographic location reinforce the need to focus on ensuring quality and safety of maternity care for all women. Despite complex multilevel factors impacting maternal mortality and morbidity, there are evidence-based interventions that, when facilitated consistently and properly, are known to improve the health of mothers before, during and after pregnancy. The objective of this project is to test implementation of pre-conception counseling with father involvement in community-based settings to improve cardiovascular health outcomes before and during pregnancy in southeastern United States. This study has two components: a comprehensive needs and assets assessment and a small-scale pilot study. We will conduct a community informed needs and assets assessment with our diverse stakeholders to identify opportunities and barriers to preconception counseling as well as develop a stakeholder-informed implementation plan. Next, we will use the implementation plan to pilot preconception counseling with father involvement in community-based settings. Finally, we will critically assess the context, identify potential barriers and facilitators, and iteratively adapt the way preconception counseling can be implemented in diverse settings. Results of this research will support future research focused on identifying barriers and opportunities for scalable and sustainable public health approaches to implementing evidence-based strategies that reduce maternal morbidity and mortality in the southeastern United States' vulnerable communities. Findings will demonstrate that preconception counseling can be implemented in community health settings in the southeastern United States. Furthermore, this study will build the capacity of community-based organizations in addressing the preconception health of their clients. We plan for this pilot to inform a larger scaled-up clinical trial across community health settings in multiple southeastern states.

A Study of Gender Perspectives on Farmers' Livelihood Resources in a Dryland Farming Community of Lombok Island, Indonesia

Aim: A case study on Lombok Island, Indonesia, examined livelihood resources among rain-fed rice farmers from a gender perspective. Study Design: Using a descriptive approach, the study purposely selected dryland and rain-fed farming communities reliant on agriculture. Place and Duration of the Study: The study was conducted in the southern part of Lombok Island between December 2023 to January 2024. Methodology: Data from 30 respondents (15 male, 15 female farmers) assessed livelihood resources across human, natural, financial, social, and physical aspects. Analysis employed categorical techniques and mode calculations. Results: Male farmers predominated in managing human resources and natural resources such as land and water ownership. Females excelled in household water use, technology adoption, and accessing financial aid. Both genders managed income and savings similarly, with males showing greater agricultural knowledge and communication skills. Conclusion: These insights underscore the nuanced gender dynamics in resource management and highlight the need for gender-responsive policies to foster sustainable livelihoods in vulnerable dryland communities.

Doing Community Amid Tension and Vulnerability: Involvement and Control in Older Adults’ Accounts of Their Neighbourhood

Rather than fixed entities, urban communities are in a constant process of making: They are practised in and through everyday relational settings and are therefore necessarily tension‐laden. Drawing from focus group interviews with older adults living in the third‐largest city in Finland, we aim to further the understanding of “doing community” amid tensions and vulnerability. We analyse older people’s accounts of their everyday dealings and doings in their neighbourhood with an emphasis on the intensities of involvement and control when relating with others. As a result, four types of relational settings are identified: being‐with others; cooperation with others; contesting and being contested by others; and ruling and being ruled by others. Through close reading of each type, we illustrate the variety in which older adults negotiate involvement and control. To conclude, we propose that, in addition to previously identified privacy and access, involvement and control are significant dimensions of the relational settings of belonging in an urban community. We suggest that focusing on involvement and control may particularly well illuminate the position of neighbourhood residents in vulnerable circumstances. Therefore, involvement and control offer a useful extension for analyses of doing community through everyday encounters and practices.

Spring Water Quality in a Flood-Prone Area of Kampala City, Uganda: Insights Furnished by Sanitary and Limnochemical Data

For millennia, springs have provided water for drinking, domestic use, balneological treatment, liminality rites as well as tourist attractions. Amidst these uses, anthropogenic activities, especially urbanization and agriculture, continue to impair the functionality of springs. With the looming decadal climate change, freshwater springs could be a sustainable source of clean water for the realisation of Sustainable Development Goal 6. This paper presents the results of the sanitary inspection and assessment of limnochemical characteristics and quality of water samples (n = 64) from four freshwater springs (coded SPR1, SPR2, SPR3, and SPR4) in Kansanga, a flash flood-prone area in the African Great Lakes region of Uganda. Each sample was analysed for 17 parameters (temperature, pH, electrical conductivity, turbidity, fluorides, sulphates, chlorides, nitrates, orthophosphates, total dissolved solids, dissolved oxygen, total alkalinity, potassium, sodium, total, magnesium and calcium hardness) following the standard methods. Water quality index (WQI) was calculated to establish the quality of the water samples based on the physicochemical parameters measured. Based on the sanitary risk assessment results, the springs had medium- to high-risk scores, but most water parameters were within the WHO guidelines for potable water, except for nitrates (in SPR1 and SPR2), hardness levels (in SPR2), and dissolved oxygen (in all the samples). Sampling season and location had significant effects on the limnochemistry of the freshwater springs (p < 0.05). The water quality indices calculated indicated that the water from the springs was of good quality (WQI = 50–57), but there was a reduction in water quality during the wet season. The best water quality was recorded in samples from SPR4, followed by those for SPR3, SPR1, and SPR2. These results provide insights into the contribution of floods and poor sanitation facilities to the deterioration of spring water quality in Kansanga, and the need to leverage additional conservation strategies to support vulnerable communities in the area. Further studies are required to establish the risk posed by trace metals and microbes that may contaminate freshwater in the studied springs, especially following flood events.

Health Workers in Sexual and Gender Based Violence (SGBV) Care for Refugees: Insights from Frontline Health and Humanitarian Professionals in Rhino Camp Refugee Settlement, Uganda

In the wake of the COVID-19 pandemic, a marked global increase in cases of Sexual and Gender Based Violence (SGBV) has been noted (Johnson et al. 2020). In the refugee settlements of Uganda, this is dramatically illustrated by an escalating crisis of teenage pregnancies (UN Women 2020; Diallo et al. 2023). During lockdowns, conflicts among families and couples increased and vulnerable community members, particularly children and young people, were exposed to heightened risks of abuse (Datzberger et al. 2023). For the humanitarian community, the escalation of the past years highlights the urgent need to sustainably improve SGBV prevention, care and case management in refugee settings.

Assessing climate trends in the Northwestern Himalayas: a comprehensive analysis of high-resolution gridded and observed datasets

Climate change poses significant challenges to the Himalayas, a region characterised by its fragile ecosystems and vulnerable communities dependent on environmental resources. Accurate climate data are crucial for understanding regional climatic variations and assessing climate change impacts, particularly in areas with limited observational networks. This study represents a pioneering effort in evaluating climatic fluctuations in the Jhelum basin, located in the North Western Himalayas, by utilising a diverse range of gridded meteorological datasets (APHRODITE, CHIRPS, CRU, and IMDAA) alongside observed climate data from the Indian Meteorological Department. The primary goal is to identify the most effective gridded climate data product for regions with limited data and to explore the potential of combining gridded data sets with observed data to understand climatic variability. Findings indicate a consistent upward trend in temperature across all datasets, with varying rates of increase. CRU records a rise of 1 °C in Tmax and 1.6 °C in Tmin, while APHRODITE shows a Tmean increase of approximately 1 °C. IMDAA reports increases in Tmax and Tmin. Observed mean annual Tmax and Tmin show net increases of 1 °C and 0.6 °C, respectively. Regarding precipitation, all datasets except IMDAA exhibit an increasing trend, contrary to observed data, which decreases from 1266 mm to 1068 mm over 40 years. CHIRPS, CRU, and APHRODITE display increasing trends, while IMDAA aligns closely with observed data but tends to overestimate precipitation by about 30%. Our research identifies IMDAA as the most suitable gridded climate data for the Jhelum basin in the North-western Himalayas. Despite some discrepancies in precipitation trends, IMDAA closely aligns with observed data, providing valuable insights for scholars and policymakers navigating climate data uncertainties in complex environments. Our findings contribute to informed decision-making and effective climate change mitigation strategies in the region.

Earthquake Risk in Bangladesh: Lesson Learned from Turkiye-Morocco Earthquake

Turkey, Morocco, and Bangladesh are all located in active seismic zones of the Earth’s surface. Recent studies have predicted catastrophic earthquakes in Bangladesh in the near future. Since disasters can act as catalysts for learning by exposing the shortcomings and vulnerabilities of communities or governments, it is believed that Bangladesh has much to learn from the 2023 mega-disasters in Turkey and Morocco. Therefore, this study aims to understand the causes of the catastrophic earthquakes in Turkey and Morocco. The main objective is to analyze the strengths and weaknesses of the disaster management stages during the 2023 earthquakes in Turkey and Morocco, and to compare these with the situation in Bangladesh to better understand potential earthquake risks there. Moreover, the study seeks to develop a framework for Disaster Learning. It follows a qualitative research methodology, with most of the necessary data gathered from existing literature and Key Informant Interviews. The findings suggest that infrastructural vulnerabilities and noncompliance with land use regulations were significant causes of the catastrophic damage in Turkey and Morocco, which are also relevant to the earthquake risks in Bangladesh. Key strengths identified in Turkey include the availability of open spaces for emergency services, wide roads, modern equipment, skilled manpower, military-civilian coordination, and a robust humanitarian response—all areas where Bangladesh has significant deficiencies. Lessons from this study reveal that climatic conditions and debris management could pose major challenges for Bangladesh in the event of a significant earthquake.

Jegingger’s Ahmad Tohari: A re-narrated based on sacrilege and social disorganization

This research examines the Jegingger, novel written by Ahmad Tohari (JAT) which highlights the banal life of a family (palm trees climbers). JAT was re-narrated as exploiting the tension between the economy and family ties, whether ideally economic activities are separate (industrial economy) or integrated with the family (subsistence). Cultural establishments are mutually contested: the subsistence culture of traditional society is challenged by the productive economy, or conversely, the productive economy is challenged by the banal subsistence economy of traditional society. The methodology of postclassical narratology—exploring and explaining cultural manifestations and then exposing chronological sequences-was used to structure the vulnerability or resilience of banal communities in maintaining social ties. A subsistence economy with its characteristics of low productivity because it tends to be a cultural activity—not economic. It contains vulnerabilities seen from two sides: 1) banal agencies that do not have literacy and competence in carrying out subsistence professions have the potential to commit malpractice; 2) low productivity limits access to health facilities. These two weaknesses become obstacles to maintaining social ties. Sacrilege—abuse of sacred symbols—which was triggered by the malpractice of coconut climbing, has caused social disorganization—the loss of basic family and community affection—becoming a hub for the idea of raising awareness of the importance of the power of knowledge and materials in supporting traditional community ties. Mastery of material, especially in massive amounts (1.5 billion diamond necklaces), can transform a banal agency into a powerful one.

Inequities in air pollution on stroke mortality among Older Americans: a U.S. nationwide analysis.

Air pollution is a known risk factor for cardiovascular diseases, including stroke. This study examines the impact of county-level air pollution on ischemic and hemorrhagic stroke mortality among U.S. individuals aged 65 and older, emphasizing racial and socioeconomic disparities. Using data from the Center for Disease Control (CDC) Interactive Atlas of Heart Disease and Stroke, we analyzed county-level ischemic stroke mortality rates for older residents between 2016 and 2020. The data on air pollution at the county level, specifically particulate matter (PM2.5) levels, were obtained from the CDC. We applied multivariable linear and logistic regression models to examine the association between PM2.5 levels and stroke mortality, as well as the probability of meeting the Environmental Protection Agency (EPA) air quality standards. County-level analysis revealed a significant correlation (R = 0.68, R2 = 0.48, p < 0.001) between PM2.5 levels and overall stroke mortality. For every 1 μg/m3 increase in PM2.5, there was an increase of 1.89 ischemic stroke deaths per 100,000 residents. Racial and socioeconomic disparities were evident. Counties with predominantly Black populations exhibited a stark disparity, with each 1 μg/m3 increase in PM2.5 correlating with a significant rise in mortality, amounting to 5.81 additional deaths per 100,000 residents. Persistently poor counties displayed vulnerability, experiencing a 4.05 increase in ischemic stroke deaths per 100,000 residents for every 1 μg/m3 increase in PM2.5 levels. Conversely, in counties with a White majority and counties without a persistent state of poverty, the associated increases in stroke mortality per 100,000 residents for every 1 μg/m3 rise in county-level PM2.5 were 1.85 and 1.60, respectively. Counties with a majority of Black residents were over twice as likely to be non-compliant with EPA air quality standards compared to predominantly White counties (aOR 2.36 95% CI: 1.27-4.38, p = 0.006). This study underscores the significant impact of county-level air pollution, particularly PM2.5, on ischemic stroke mortality among older U.S. residents. Our findings indicate that counties with predominantly Black populations and those experiencing persistent poverty not only suffer from higher mortality rates but also are more likely to be non-compliant with EPA air quality standards. Targeted interventions and policies are urgently needed to reduce air pollution in these vulnerable communities and promote equitable public health outcomes.

Risk of developing Type 2 Diabetes Mellitus in a vulnerable community in northern Argentina

Introduction: Prevention of diabetes requires sustained lifestyle changes as well as identification of groups at higher risk. Objective: The aim of this research was to estimate the risk of diabetes in vulnerable subjects from a primary care center in northern Argentina, with no known glucose abnormalities, using the FINDRISC questionnaire, investigate the relationship between survey variables and the final score, and explore its association with metabolic risk factors and body composition. Methodology: This cross-sectional design included 498 patients without type 2 diabetes or known glycemic abnormalities. All subjects underwent a complete medical history and completed the FINDRISC questionnaire. Results: The predominant age group was 18-45 years old. Around 64% were physically active and 44% reported daily consumption of fruit and vegetables. Most of them had a BMI higher than 25 kg/m2. Regarding the risk of developing type 2 diabetes in the next 10 years, 24.3% were at low risk and the remaining fraction was distributed in slightly elevated, moderate, high and very high risk. All variables influenced the individuals' variance (p &lt; 0.05). The hierarchical clustering and principal component analysis (PCA) revealed that elevated FINDRISC score was strongly associated with: age &gt; 65 years, fasting blood glucose, BMI ? 30 kg/m2 and antihypertensives use. CONCLUTION: We found a high percentage of obesity and overweight, as well as a high risk of cardiometabolic disease and of developing T2D. In addition, in the population studied, the variables that compose the FINDRISC did not influence the highest score in the same way.