Higher Levels Of Social Vulnerability Research Articles

The role of families in the response of inclusive schools: A case study from teacher’s perspectives

Some families identified as being at risk, including families of immigrant origin, demonstrate a lower degree of participation in school communities. This constitutes a major challenge for educational institutions. In this research, a case study including three public schools affected by school segregation was carried out. The aim was to analyze and disseminate teachers’ experiences and contributions around the question of family-school relationships, particularly measures they take to promote the participation of families in the daily life of schools. This included a particular focus on schools characterized by high degree of segregation and pupils with higher levels of social vulnerability. The study was carried out as a multi-local ethnographic project in three schools in the Basque Country, Spain, through participant observation, interviews, and focus groups with teachers, pupils, school leadership teams and psycho-pedagogical teams. The results obtained show that schools condition the participation of families, especially those most at risk, and that this has an impact on the socio-emotional development of children. They also highlight the importance of building communication and relationship channels between families and schools. In the current age of globalization, the need to create a network of collaborative and trusting relationships between families and teachers is more evident than ever. Only by these means can children be properly supported to achieve their maximum potential.

Testicular torsion disparities in the pediatric population

BackgroundThere are disparate findings in the literature on the impact of race and insurance status on gonadal loss in testicular torsion. We sought to determine if race or levels of social vulnerability influence the rate of torsion or gonadal loss. MethodsRetrospective cross-sectional review between December 2017 and September 2019. Social vulnerability index was dichotomized using the 75th percentile. Primary outcome was the diagnosis of testicular torsion. Results515 patients were included. There was no difference in median age, torsion diagnosis, and orchiectomy rate between the two institutions. Black/African American patients were >3 times more likely than Caucasian patients to be diagnosed with TT when controlled for dichotomized SVI, insurance, and age (OR 3.39, 95% CI 1.74 - 6.61, p < 0.01). ConclusionBlack/African American children have an increased risk of testicular torsion. Despite these patients having higher levels of social vulnerability, it was not associated.

Duration of Behavioral Policy Interventions and Incidence of COVID-19 by Social Vulnerability of US Counties, April-December 2020.

State-issued behavioral policy interventions (BPIs) can limit community spread of COVID-19, but their effects on COVID-19 transmission may vary by level of social vulnerability in the community. We examined the association between the duration of BPIs and the incidence of COVID-19 across levels of social vulnerability in US counties. We used COVID-19 case counts from USAFacts and policy data on BPIs (face mask mandates, stay-at-home orders, gathering bans) in place from April through December 2020 and the 2018 Social Vulnerability Index (SVI) from the Centers for Disease Control and Prevention. We conducted multilevel linear regression to estimate the associations between duration of each BPI and monthly incidence of COVID-19 (cases per 100 000 population) by SVI quartiles (grouped as low, moderate low, moderate high, and high social vulnerability) for 3141 US counties. Having a BPI in place for longer durations (ie, ≥2 months) was associated with lower incidence of COVID-19 compared with having a BPI in place for <1 month. Compared with having no BPI in place or a BPI in place for <1 month, differences in marginal mean monthly incidence of COVID-19 per 100 000 population for a BPI in place for ≥2 months ranged from -4 cases in counties with low SVI to -401 cases in counties with high SVI for face mask mandates, from -31 cases in counties with low SVI to -208 cases in counties with high SVI for stay-at-home orders, and from -227 cases in counties with low SVI to -628 cases in counties with high SVI for gathering bans. Establishing COVID-19 prevention measures for longer durations may help reduce COVID-19 transmission, especially in communities with high levels of social vulnerability.

Disparities in Care Access to Liver-Directed Therapy Among Medicare Beneficiaries with Colorectal Cancer Liver Metastasis.

BackgroundLiver-directed therapies (LDT) are important components of the multidisciplinary care of patients with colorectal cancer liver metastases (CRCLM) that contribute to improved long-term outcomes. Factors associated with receipt of LDT are poorly understood.Patients and MethodsPatients > 65 years old diagnosed with CRCLM were identified within the Medicare Standard Analytic File (2013–2017). Patients with extrahepatic metastatic disease were excluded. Mixed-effects analyses were used to assess patient factors associated with the primary outcome of LDT, defined as hepatectomy, ablation, and/or hepatic artery infusion chemotherapy (HAIC), as well as the secondary outcome of hepatectomy.ResultsAmong 23,484 patients with isolated CRCLM, only 2004 (8.5%) received LDT, although resectability status could not be determined for the entire cohort. Among patients who received LDT, 61.7% underwent hepatectomy alone, 28.1% received ablation alone, 8.5% underwent hepatectomy and ablation, and 1.8% received HAIC either alone (0.8%) or in combination with hepatectomy and/or ablation (0.9%). Patient factors independently associated with lower odds of LDT included older age, female sex, Black race, greater comorbidity burden, higher social vulnerability index, primary rectal cancer, synchronous liver metastasis, and further distance from a high-volume liver surgery center (p < 0.05). Results were similar for receipt of hepatectomy.ConclusionsDespite the well-accepted role of LDT for CRCLM, only a small proportion of Medicare beneficiaries with CRCLM receive LDT. Increasing access to specialized centers with expertise in LDT, particularly for Black patients, female patients, and those with higher levels of social vulnerability or long travel distances, may improve outcomes for patients with CRCLM.

Social vulnerability, COVID-19 impact, and decision making among adults in a low-resource community

Socially vulnerable individuals, including those with greater exposure to adversity and social instability, are at greater risk for a variety of negative outcomes following exposure to public health crises. One hypothesized mechanism linking social vulnerability to poor health outcomes is delay discounting, the behavioral tendency to select smaller immediately available rewards relative to larger delayed rewards. However, little research has examined the impact of real-world disease outbreaks, such as the COVID-19 pandemic, on the relation between social vulnerability and delay discounting. This study examined whether the severity of COVID-19 impact moderated the association between social vulnerability and delay discounting in a diverse sample of 72 human adults (Mage = 42.4; 69% Black; 87% female) drawn from two low-resource urban areas. Contrary to hypotheses, results indicated that exposure to more severe COVID-19 impacts did not affect decision making among individuals with higher levels of social vulnerability. Conversely, findings suggest that individuals with lower levels of social vulnerability who reported more significant impacts of COVID-19 evidenced a greater tendency to select larger, delayed rewards relative to individuals with greater social vulnerability. Findings suggest the recent pandemic may influence the relation between social vulnerability and behavioral processes underlying health decision-making.

1210-P: Associations between HbA1c, Area Level Social Vulnerability, and Poor COVID-Outcomes

Background: HbA1c has been associated with COVID-poor outcomes in diabetic and non-diabetic populations, while patients living in census tracts with high levels of social vulnerability [measured using the CDC’s Social Vulnerability Index (SVI) ] have experienced poorer outcomes. Objective: To examine associations between HbA1c, area level social vulnerability and poor COVID outcomes in patients who tested positive for COVID and were captured in the electronic medical record (EMR) at a large academic institution in the Southeastern United States. Methods: HbA1c and SVI, collected up to 3 years prior to a positive COVID test, were extracted from the EMR. HbA1c and SVI were compared by poor outcome status [hospitalization, intensive care unit (ICU) admission, and mortality]. Bayesian logistic regression was used to examine associations between HbA1c [≤5.7%; 5.7%-&amp;lt;6.5%; and ≥6.5%], SVI [living in high SVI census tract vs low SVI tract] and each COVID outcome separately. Multivariable models were adjusted for sex, age, race, body mass index and diabetes status. Results presented as odds ratios (OR) and 95% confidence intervals (95% CI) . Results: N=3,7patients were identified [mean age: 54 years (SD 16.3) , 60% female, 47% Black]. Patients with HbA1c ≥ 6.5% and those living in a high SVI census tract were more likely to experience a poor COVID outcome (p’s&amp;lt;0.0001) . In multivariable models, patients with HbA1c ≥ 6.5% had higher odds of hospitalization (OR 1.79, 95% CI 1.44-2.22) ; ICU admission (OR 2.13, 95% CI 1.78-2.55) ; and mortality (OR 1.60, 95% CI 1.12-2.28) . Patients living in a high SVI census tract had higher odds of hospitalization (OR 2.47, 95% CI 1.94-3.15) ; ICU admission (OR 2.58, 95% CI 2.12-3.14) ; and mortality (OR 2.07, 95% CI 1.39-3.09) . Conclusion: HbA1c ≥6.5% and living in a census tract with high social vulnerability were independently associated with poor COVID-outcomes. Findings highlight the need to assess HbA1c and area level social determinants in the context of COVID. Disclosure C.R.Howell: None. L.Zhang: None. S.Williams: None. N.Yi: None. W.Garvey: Other Relationship; Boehringer Ingelheim International GmbH, Eli Lilly and Company, Epitomee, JAZZ Pharmaceuticals, Novo Nordisk, Novo Nordisk, Pfizer Inc., Pfizer Inc. A.Cherrington: Consultant; Bayer AG, Other Relationship; Novo Nordisk. Funding This work was supported by funding from the National Institute on Minority Health and Health Disparities (U54MD008176) .

Measuring residential segregation in multi‐ethnic and unequal European cities

AbstractImmigration flows and social inequalities reflect increased social and multi‐ethnic segregation in contemporary urban Europe. For a better understanding of these processes, the present study investigates the main strengths of the multi‐group residential indices, testing sensitivity and reliability under different metropolitan contexts in five European countries. These indices focus on different research dimensions and approach multi‐group residential segregation conceptually and mathematically in a different way. A multivariate exploratory data analysis was adopted to classify the observed segregation patterns into a few homogeneous types and to delineate the multivariate relationship between the indices. The results of principal component analysis demonstrate that the indices assessing uniformity and disproportionality of the social groups analysed (H and D) contribute largely to the diversification in today's multi‐ethnic communities, clarifying the importance of the dimension of evenness. Our results highlight how segregation is more evident in economically disadvantaged metropolitan regions with high levels of social vulnerability.

Flooding and emergency department visits: Effect modification by the CDC/ATSDR Social Vulnerability Index

The Centers for Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR) Social Vulnerability Index (SVI) is a census-based metric that includes 15 socioeconomic and demographic factors split into four themes relevant to disaster planning, response, and recovery. Using CDC/ATSDR SVI, health outcomes, and remote sensing data, we sought to understand the differences in the occurrence of overall and cause-specific emergency department (ED) visits before and after a 2017 flood event in Texas following Hurricane Harvey, modified by different levels of social vulnerability. We used a controlled before-after study design to estimate the association between flooding and overall and cause-specific ED visits after adjusting for the baseline period, seasonal trends, and individual-level characteristics. We estimated rate ratios stratified by CDC/ATSDR SVI quartiles (overall and 4 themes separately) and tested for the presence of effect modification. Positive effect modification was found such that total ED visits from flooded census tracts with moderate, high, and very high levels of social vulnerability were less reduced compared to tracts with the least vulnerability during flooding and the month following the flood event. The CDC/ATSDR SVI socioeconomic status theme, household composition and disability theme, and housing and transportation type theme explained this result. We found predominantly negative effect modification with higher ED visits among tracts with the least vulnerability for ED visits related to insect bites, dehydration, and intestinal infectious diseases.

Retention in Care, Mortality, Loss-to-Follow-Up, and Viral Suppression among Antiretroviral Treatment-Naïve and Experienced Persons Participating in a Nationally Representative HIV Pre-Treatment Drug Resistance Survey in Mexico

We describe associations of pretreatment drug resistance (PDR) with clinical outcomes such as remaining in care, loss to follow-up (LTFU), viral suppression, and death in Mexico, in real-life clinical settings. We analyzed clinical outcomes after a two-year follow up period in participants of a large 2017–2018 nationally representative PDR survey cross-referenced with information of the national ministry of health HIV database. Participants were stratified according to prior ART exposure and presence of efavirenz/nevirapine PDR. Using a Fine-Gray model, we evaluated virological suppression among resistant patients, in a context of competing risk with lost to follow-up and death. A total of 1823 participants were followed-up by a median of 1.88 years (Interquartile Range (IQR): 1.59–2.02): 20 (1%) were classified as experienced + resistant; 165 (9%) naïve + resistant; 211 (11%) experienced + non-resistant; and 1427 (78%) as naïve + non-resistant. Being ART-experienced was associated with a lower probability of remaining in care (adjusted Hazard Ratio(aHR) = 0.68, 0.53–0.86, for the non-resistant group and aHR = 0.37, 0.17–0.84, for the resistant group, compared to the naïve + non-resistant group). Heterosexual cisgender women compared to men who have sex with men [MSM], had a lower viral suppression (aHR = 0.84, 0.70–1.01, p = 0.06) ART-experienced persons with NNRTI-PDR showed the worst clinical outcomes. This group was enriched with women and persons with lower education and unemployed, which suggests higher levels of social vulnerability.

Spatial Disparities of COVID-19 Cases and Fatalities in United States Counties.

This paper examines the spatial and temporal trends in county-level COVID-19 cases and fatalities in the United States during the first year of the pandemic (January 2020–January 2021). Statistical and geospatial analyses highlight greater impacts in the Great Plains, Southwestern and Southern regions based on cases and fatalities per 100,000 population. Significant case and fatality spatial clusters were most prevalent between November 2020 and January 2021. Distinct urban–rural differences in COVID-19 experiences uncovered higher rural cases and fatalities per 100,000 population and fewer government mitigation actions enacted in rural counties. High levels of social vulnerability and the absence of mitigation policies were significantly associated with higher fatalities, while existing community resilience had more influential spatial explanatory power. Using differences in percentage unemployment changes between 2019 and 2020 as a proxy for pre-emergent recovery revealed urban counties were hit harder in the early months of the pandemic, corresponding with imposed government mitigation policies. This longitudinal, place-based study confirms some early urban–rural patterns initially observed in the pandemic, as well as the disparate COVID-19 experiences among socially vulnerable populations. The results are critical in identifying geographic disparities in COVID-19 exposures and outcomes and providing the evidentiary basis for targeting pandemic recovery.

Simulation of social resilience affected by extreme events in ancient China

This study identifies historical extreme events and analyzes their impacts on social vulnerability, stability, and resilience in ancient China. We reconstructed extreme event sequences, simulated social resilience response using our proposed Cascade Catastrophe-Resilience Dynamic Model, and discussed interaction of social vulnerability and stability. We found the following conclusions. First, historical extreme events had cyclic and periodic fluctuations, and usually led to cascade disasters. Cascade disasters enhanced risk and greatly reduced societal stability, while three types of disaster chains were observed: climatic extremes (flood/drought)-famines-wars (uprising/invasions)-epidemic plagues; climatic extremes (flood/drought)-famines -migrations; and droughts-locust plagues-famines. A climate extreme-earthquake chain was also recorded although the mechanism remains unknown. Second, extreme events were synchronous with dynastic changes, although strong social resilience enhanced the opportunity for dynastic survival and modified the stochastic magnitude–frequency relationship between extreme events and social vulnerability. The high frequency of extreme events is consistent with high hazard indices, declining population, high levels of social vulnerability, and low levels of social stability and resilience. However, the strong correlation between high levels of social vulnerability and high frequency of extreme events occurred at the end of dynasties but not when dynasties were thriving. Third, quick response to disasters, efficient disaster relief systems, and sufficient food supplies were essential parts of social resilience to disasters. Extreme events play important roles in shaping agricultural production, and thus food supply. Population fluctuation and migration, economic center shifts, and social and economic structure changes contributed to cascade disasters, which often led to societal instability throughout Chinese history.

14 Living in an area with high social vulnerability during pregnancy is associated with preterm birth

We sought to determine if women living in census tracts with high levels of social vulnerability have increased odds of preterm birth (PTB). This was a retrospective cohort study of women carrying non-anomalous singleton or twin gestations identified from electronic medical record data from a large university health system, 2014-2020. Women at high-risk for spontaneous and/or medically indicated PTB were included in a 1:2 ratio with randomly selected low-risk controls. Each woman’s home address was geocoded and assigned to a census tract, and then linked at the census tract level to the CDC’s Social Vulnerability Index (SVI). The SVI integrates 15 census variables to produce composite scores across 4 major domains (socioeconomic, household composition & disability, minority status & language, and housing type & transportation) in addition to an overall composite SVI score. Higher scores indicate greater social vulnerability. The primary outcome was PTB <37 wks; secondary outcomes were PTB <34 and <28 wks. Data were analyzed using chi2, t-test, and logistic regression. 50,998 women met inclusion criteria; 8.6% delivered < 37, 2.8% < 34, and 1.0% < 28 wks. Population characteristics are shown in the Table. Women delivering preterm < 37, < 34, and < 28 wks were more likely to live in an area with a higher overall SVI and higher social vulnerability in each SVI domain (Table). In regression models, the aOR of PTB increased as the overall SVI and social vulnerabilities in each domain increased; these effects were greatest at the earliest GAs (Figure). The association between PTB and SVI were largest for domains 1 (socioeconomic – which includes poverty, unemployment, education) and 2 (household composition & disability – which includes single-parent households and individuals < 17 or > 65 living in the household). Census-tract level social vulnerabilities in a woman’s area of residence during pregnancy are associated with PTB <37, <34, and <28 weeks’ gestation. Supporting communities to reduce these specific social vulnerabilities has the potential to reduce prematurity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Relationship Between Social Vulnerability and COVID-19 Incidence Among Louisiana Census Tracts.

Objective: To examine the association between the Centers for Disease Control and Prevention (CDC)'s Social Vulnerability Index (SVI) and COVID-19 incidence among Louisiana census tracts.Methods: An ecological study comparing the CDC SVI and census tract-level COVID-19 case counts was conducted. Choropleth maps were used to identify census tracts with high levels of both social vulnerability and COVID-19 incidence. Negative binomial regression with random intercepts was used to compare the relationship between overall CDC SVI percentile and its four sub-themes and COVID-19 incidence, adjusting for population density.Results: In a crude stratified analysis, all four CDC SVI sub-themes were significantly associated with COVID-19 incidence. Census tracts with higher levels of social vulnerability were associated with higher COVID-19 incidence after adjusting for population density (adjusted RR: 1.52, 95% CI: 1.41-1.65).Conclusions: The results of this study indicate that increased social vulnerability is linked with COVID-19 incidence. Additional resources should be allocated to areas of increased social disadvantage to reduce the incidence of COVID-19 in vulnerable populations.

RELAÇÕES DE GÊNERO E VIOLÊNCIA CONTRA A MULHER NA MICRORREGIÃO BICO DO PAPAGAIO/TO: CONTRIBUIÇÕES DO CENTRO DE REFERÊNCIA EM CIDADANIA E DIREITOS HUMANOS

Citizenship, human rights and diversity are subjects of urgent debates in societies seeking to consolidate democratic advances. Human rights and citizenship are historical, therefore, contextual. Consequently, the dissemination of citizenship rights based on the recognition of political, social, civil and cultural rights is interdependent on multiple social configurations. It was the aforementioned perspectives that guided the implementation of &nbsp;the “Reference Center for Citizenship and Human Rights”, in the micro-region of Bico do Papagaio, in the extreme north of the state of Tocantins. The region, marked by ethnic and racial diversity, also presents high levels of social vulnerability, which allows us some reflections on the role of public institutions as promoters of citizenship and human rights, specifically regarding the guarantee and advances related to gender and combating violence against women.

Removing Incivility from Google: What determines the number of government content take-down requests?

Requesting Internet platform providers to remove content is one of the common approaches for government worldwide to regulate online incivility. This study investigates the driving forces behind the variation in the number of uncivil content removal requests across countries. By connecting data from the 2017 Google transparency report to a host of societal level indicators, this study finds that the quantity of uncivil content removal requests is related to both social reality and political value factors. Countries with high levels of social vulnerability and low levels of freedom of speech tend to send more requests to Google for removing online incivility. However, democratic and non-democratic societies show different patterns: social reality and political values play important roles in democratic societies while in non-democratic societies, social reality is the only determining factor.

Social Vulnerability Index: Barbados – A Case Study

A Social Vulnerability Index (SVI) was developed for Barbados to identify geospatial variations in social vulnerability. The SVI focused on socioeconomic status, gender, age, special needs and property type - represented by eight variables selected from census data. For the purposes of overlaying with hazard exposure mapping to assess hazard risk, the SVI that was developed is widely applicable and flexible. However, primarily because of the limitations of available georeferenced social data, the SVI provides only a very general indicator of the spatial distribution of vulnerability. Medium and high levels of social vulnerability appear to be widespread across Barbados with no discernible spatial pattern, reinforcing the importance of island-wide efforts to reduce vulnerability. Ultimately, the SVI is a useful starting point for further investigation of social vulnerability; the analysis showed what can and, perhaps as importantly, what cannot be determined about the spatial distribution of social vulnerability using existing available data. There is a need to validate the SVI, and improved data collection to record and evaluate post-disaster social impacts would enhance predictive tools. More extensive georeferenced social data collected during the decennial census would provide robust data to support the development of SVIs. However, census data may not offer solutions unless it is possible to spatially aggregate the data by smaller units that are more demographically homogeneous, and therefore, cross referencing with other data and/or strategically collecting additional data using the SVI as a framework.

Heatwave-induced human health risk assessment in megacities based on heat stress-social vulnerability-human exposure framework

Assessing heatwave-induced human health risk is of critical importance in order to mitigate hazards caused by extreme environmental events. Air temperature or land surface temperature in previous studies was often used to characterize the severity of heatwaves, and human perception of the thermal environment was neglected as a key component in the heatwave-induced risk assessment. In order to redress this issue, in this study we applied the Universal Thermal Climate Index (UTCI) to represent human thermal comfort perception and embedded the measure within an assessment framework of heat stress-social vulnerability-human exposure. The heatwave-induced human health risk was then evaluated in Wuhan City, China across 177 blocks covering the entire city area and local risk governance measures were also explored based on risk zoning. The results showed that spatial patterns of heatwave-induced human health risk followed a decreasing trend from the city center towards the surrounding areas, with the average risk of the main urban area being 1.6 times that beyond the metropolitan development area. Through the heatwave-induced human health risk zoning, about 73.45% of the 177 blocks in Wuhan City demonstrated a positive relationship between heat stress and human exposure, and both were opposite with social vulnerability. Multiple linear regression between UTCI and the proportion of greenspace, water body and construction land indicated that, more blue or green infrastructure should be integrated within the urban fabric to help mitigate heat stress particularly in the main urban area, while in the metropolitan development area construction land dominating heat stress should be strictly regulated. Furthermore, protecting vulnerable groups such as left-behind children and elderly people should be a priority in rural areas that were generally associated with higher levels of social vulnerability. This study proposed a new heatwave-induced human health risk framework with a local evidence in Wuhan City, and further emphasized that risk zoning could be used as a basic yet important approach to facilitating more effective urban planning guidelines for risk governance.

Spatiotemporal clustering, social vulnerability and risk of congenital syphilis in northeast Brazil: an ecological study.

To investigate the spatial distribution of congenital syphilis (CS) and its association to social vulnerability indexes in northeast Brazil. This was an ecological study referring to all cases of CS and CS deaths recorded in the northeast region of Brazil from 2008 to 2015. Data were obtained from three Brazilian information systems. We examined statistical correlations between CS indicators by state and municipality and their socioeconomic and social vulnerability characteristics. We used Bayesian empirical local models to identify fluctuations of the indicators. Spatial statistical tests were used to identify spatial clusters and the municipalities at high risk of CS. The incidence of CS ranged from 2.1 cases/1000 live births (LB) in 2008 to 6.9/1000 LB in 2015, with an annual increase of 19.9% (p<0.001). The mortality coefficient of CS ranged from 2.9/1000 LB in 2008 to 6.5/1000 LB in 2015, resulting in an annual increase of 15.1% (p<0.001). Nine spatial clusters were identified. Cases of congenital syphilis occurred in well-defined spatiotemporal clusters and in areas with high levels of social vulnerability. CS incidence is associated with social vulnerability. CS control programmes should target spatial clusters and populations with high levels of social vulnerability.

Social vulnerability in a high-risk flood-affected rural region of NSW, Australia

We describe factors related to the social vulnerability of populations that experienced major river flooding in northern New South Wales (NSW), Australia. Using geographical information system methods, maps of 2017 flood-affected areas in the Lismore and Murwillumbah regions were combined with 2016 National census data to compare aspects of social vulnerability with the wider region and the region with Sydney. We also used individual-level data from the NSW 45 and Up Study to compare lifestyle, behavioural and health characteristics of residents of these flood-affected areas with the broader region (n = 13,561). Populations living in the Lismore Town Centre flood footprint exhibited significantly higher levels of social vulnerability over a range of factors; in particular, almost 82% resided in the most disadvantaged socio-economic quintile neighbourhoods. The flood-affected areas of Murwillumbah and Lismore regions included 47% and 60% of residents in the most disadvantaged quintile neighbourhoods compared to 27% for whole region and 16% for Sydney. This pattern of increased vulnerability was also apparent from the 45 and Up study; participants residing in the Lismore Town Centre flood footprint had significantly higher rates of riskier lifestyle-related behaviours (smoking, alcohol consumption), pre-existing mental health conditions (depression and anxiety) and poorer health. This detailed case study demonstrates extreme local vulnerability of flood-exposed populations, over and above the already highly vulnerable regional rural populations. This information is important to inform disaster planning and response and also reinforces the importance of having a detailed understanding of affected populations.

Plans that Disrupt Development: Equity Policies and Social Vulnerability in Six Coastal Cities

Urban plans often ignore the uneven impacts of hazards on socially vulnerable populations. We evaluate the degree to which equity policies in local networks of plans support risk reduction for socially vulnerable populations, and examine the relationship between equity policies scores and the level of social vulnerability in six cities exposed to floods and projected sea level rise. We find high variability in equity policy support for risk reduction, and that equity policies in plans actually actively increase risk of loss in neighborhoods with high levels of social vulnerability, which in turn could disrupt further development.