Vulnerable Situation Research Articles

The devastating effect of the COVID-19 pandemic on the lives of women and children in 2023

Purpose Current issues (such as health and economy-related) emerged due to the impact of COVID-19 on women’s and children’s health. The purpose of this opinion paper is to understand the world’s health issues after COVID-19. Design/methodology/approach The authors study the devastating effect of the COVID-19 pandemic on the lives of women and children in 2023. The authors have applied the content analysis method and reviewed the post-COVID-19 impacts on women’s and children’s health. As a result of unemployment or financial instability, the fear of economic insecurity increases cases of women and child violence, child labour and other health issues. According to the study, the authors find that post-COVID-19-related health issues increase at a high level. Findings After COVID-19, across the world, children and women have gone through domestic violence and health issues (i.e. stress, anxiety and so on) and the vulnerable situation of children and women has badly impacted their mental and physical health. Originality/value Many children were orphaned, and the poor died due to poverty. COVID-19 has had a direct or indirect effect on children and women all over the world till today. This opinion paper focuses on post-COVID-19 issues that we all have forgotten to include in our current discourse.

Considerations for Correction of Micronutrient Deficiencies Through Supplementation in Pregnant Women and Children Under-5 in Latin America.

Micronutrient deficiencies in Latin America are a public health concern, nonetheless, lack of information still exists in many countries, so that the true magnitude of the problem remains uncertain. To summarise experiences that can inform the development of policies and programs to address micronutrient deficiencies throung supplementation in pregnant women and chlidren under five years of age in Latin American. Review of the most evidence on the effects of micronutrients supplementation, focusing on pregnant women and children under five years of age. Certain population groups, as women of reproductive age and children under 2 years of age, are at increased risk for deficiency due to their high micronutrient requirements. This is compounded by the limited access to micronutrient-rich foods for many people living in vulnerable situations. Micronutrient supplementation is an effective intervention to prevent and treat deficiency and to mitigate its adverse effects on health, nutrition, and pregnancy outcomes in micronutrient-deficient populations. The potential benefits of supplementation programs, however, are realized only when they reach those who have the potential to benefit, that is, with inadequate intakes of micronutrients from dietary sources, and when the quality of design and delivery of the programs aresufficient to reach that population timely, regularly, and effectively to enable and motivate consumption. Several resources and experiences exist that can help favor the development of programs that can realize this biological and programmatic potential. There is need for continuous efforts to augment coverage and achieve results that can translate into economic benefits for individuals, families, and nations.

The everyday life occupations of older women in social vulnerability in Brazil

ABSTRACT Population aging is widely discussed due to the impacts of increased life expectancy, especially in socially vulnerable populations. This descriptive-exploratory qualitative study aims to understand older women’s perceptions of their occupations in a socially vulnerable community. The participants were 11 women, aged 60 years or older, living in Vila Marçola, Aglomerado da Serra, Minas Gerais, Brazil. Semi-structured interviews were carried out and the content was analyzed by using thematic analysis. Findings indicated four care dimensions: 1) Household care and caring for other people, 2) Community care, 3) Self-care, and 4) Expanding the experiences of care in old age. Older, mostly black, and poor women from Vila Marçola highlighted the unequal living conditions in Brazil. These women were overloaded with occupations, especially paid and unpaid household care, and did not have access to or stability in other occupations. However, retirement allowed them to participate in educational and social projects, increasing their occupational repertoire. This study contributes to the construction of intersectional knowledge in the field of occupational science, expanding the understanding of the socio-cultural dimensions that involve the diversity of people around the world, especially in situations of social vulnerability.

Preconception health among migrant women in England: A cross-sectional analysis of maternity services data 2018–2019

BackgroundPerinatal outcomes are poor among migrant women in vulnerable situations, but little is known about their health preconception. We investigated preconception health inequalities between migrant women in vulnerable situations and non-migrant women. MethodsThis national cross-sectional study used data from the NHS Maternity Services Data Set (MSDS) version 1.5, incorporating NHS maternity services in England. All 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Migration category data were available for 66.2 % (n = 432,022). Odds ratios were calculated comparing preconception indicators among probable migrants in vulnerable situations (English not their first language with complex social factors (CSF)), probable migrants not in vulnerable situations (English not their first language without CSF), probable non-migrants in vulnerable situations (English their first language with CSF) and probable non-migrants not in vulnerable situations (English their first language without CSF). CSF include recent migrants, asylum seekers, refugees, difficulty reading/speaking English; alcohol and/or drugs misuse; aged under 20; and/or experiencing domestic abuse. FindingsWe identified 3.8 % (25,070 women) of the study population as probable migrants in vulnerable situations, 10.2 % (66,783 women) as probable migrants not in vulnerable situations, 5.6 % (36,433 women) as probable non-migrants in vulnerable situations, 46.5 % (303,737 women) as probable non-migrants not in vulnerable situations, and 33.8 % as having missing migration category data. Probable migrants in vulnerable situations (n = 25,070) had over twice the odds of not taking folic acid preconception compared to probable non-migrants not in vulnerable situations (odds ratio 2.15, 95 % confidence interval 2.06–2.25). They had increased odds of previous obstetric complications and being underweight, but lower odds of physical and mental health conditions (apart from diabetes and hepatitis b), smoking and overweight or obesity. InterpretationInequalities exist across many preconception indicators, highlighting opportunities to improve preconception health in this population to reduce health inequalities and improve perinatal and neonatal outcomes. FundingMedical Research Council.

Factors of negative psychic state, anxiety, and depression of waterlogged farmers in Bangladesh: A farming disaster

Farmers undergo severe mental pressure due to socioeconomic crises during waterlogging. This study explores the factors of mental agonies of waterlogged farmers. It was a quantitative study, and a survey research design was employed. Data were collected from 480 waterlogged farmers from March to May 2023 based on simple random sampling. A five-point Likert scale for negative psychic states and a four-point Likert scale for anxiety and depression were used to understand the measurement of the mental health state of the farmers. Data were analyzed with descriptive and inferential statistics such as the Mann-Whitney U and the Kruskal-Wallis H tests to indicate the differences in negative psychic state, anxiety, and depression of the waterlogged farmers. The study revealed that 99% of the farmers were worried, nearly 72% were anxious about heavy rainfall, and more than 81% fell asleep while working during waterlogging. The negative psychic state of the farmers was moderate (19-29), anxiety was high (12≥), and depression was mild (≤7). Aged farmers were more nervous (z = -5.93) and tired (z = -5.08). Farmers living in Kaccha houses were found to be more restless (H = 15.89). Anxiety with heavy rainfall (z = -9.23) was more prevalent among those farmers who suffered from waterlogging for 6 months a year. Farmers who suffered ≤6 months of waterlogging (z = -5.41) were more depressed with poor appetite. Different types of psychosocial health problems (i.e., anxiety and depression) were prevalent among the waterlogged farmers, and heavy rainfall, living houses, and duration of waterlogging assisted these. The opportunities for employment and arrangements for medical treatment during waterlogging should be available for them. GO-NGO intervention can alleviate the waterlogged farmers' vulnerable situations.

“Nós buscamos transformação social”: narrativas de experiências de profissionais da terapia ocupacional social

Abstract Introduction Social injustices and inequalities have become more prevalent worldwide, in recognition of this, occupational therapy and occupational science adopted and developed a social, transformative and critical practices. This has become more prevalent in Brazil, where social occupational therapy professionals, grounded in critical and ethical-political standpoints, have been working with groups and populations to enable justice and rights. Objective This study aims to understand the social occupational therapy professionals’ reasoning regarding their practices, and since Social Occupational Therapy (SOT) is a practice from the Global South, we draw some possible links between occupational science and social occupational therapy, which can contribute to the social relevance and impact of the occupational therapy profession in both Western and developing countries. Method This study utilized Polkinghorne's interpretive, narrative approach to interviewing 5 social occupational therapists from different regions and work environments in Brazil. Results The participants narrative interviews revealed how social occupational therapists focus on the social dimension of their professional reasoning. They have come to embrace a critical perspective, acknowledging the socio-political context of the communities and groups of people they work with, often in situations of vulnerability. This can be understood by the growing discussion of the role of occupational science as critical and socially responsive practice. Conclusion These findings can facilitate an intercultural dialogue with other frameworks that also advocate for social transformative work and collective action.

Violência doméstica, obesidade e desnutrição em pessoas idosas de uma capital do Sul do Brasil - Estudo EpiFloripa Idoso

Abstract The objective of this article was to verify the association between domestic violence and obesity and malnutrition in elderly people in Florianópolis, Santa Catarina, Brazil. Cross-sectional study evaluated in the EpiFloripa Elderly cohort in 2013/2014. The outcomes were body mass index (BMI) and abdominal obesity (increased WC). Violence against elderly people was measured using the HawlekSengstock Elder Abuse Screening Test (H-S/EAST) instrument, and IPV using the Conflict Tatics Scales Form R (CTS-1) instrument. Logistic regression and multinomial logistic regression models were used. It was observed that men had a greater chance of abdominal obesity when in situations of violence and in the potential abuse dimension. Women were more likely to have abdominal obesity in the dimension of violation of personal rights or abuse, when they suffered IPV and when they were perpetrators of IPV. In relation to BMI, elderly women in situations of violence were associated with a greater chance of being overweight and those who suffered IPV. On the other hand, men in vulnerable situations were more likely to be underweight. It is concluded that violence against elderly people and IPV generate an asymmetric impact on nutritional status in relation to sex.

The Perspectives of Family Foster Care in the Czech Republic, Hungary, Poland and Slovakia

Reforms of the child protection systems, provision of family- and community-based alternative care has been developed to a certain level in all countries in Central and Eastern Europe and has increased the role of care provided by foster families replacing institutions to ensure that the best interests principle is taken into consideration when children are separated from their families. The research describes the foster care system in the so-called Visegrád countries: the Czech Republic, Hungary, Poland and Slovakia, and the results based on at least 50 interviews in each country conducted by local experts on subjective well-being of foster parents, their perceptions about their roles and place in their respective countries and their needs. The article includes the legal framework, recruitment, preparation and support to foster families, their subjective well-being and needs in the four countries, including the history of their child protection systems to better understand the current situation. The outcomes show differences in approach to foster care, the perception on the roles, responsibilities and needs based on the different traditions, earlier and current policies and practices. Understanding the attitude changes related to the rights of children, those in vulnerable situations, and to their families of origin would be essential to further develop and improve the child welfare and protection systems, and listening to children on their perceptions and the realisation of their rights.

From symptoms to surgery-A pathway through uncertainty and hope: An interview study of women facing ovarian surgery.

Diagnosis of an adnexal mass might be a sign of ovarian cancer, with an overall poor prognosis. This study aimed to explore women's experiences and perceptions of facing ovarian surgery due to an adnexal mass, and expectations on life after surgery. Individual in-depth interviews with 15 women facing ovarian surgery due to an adnexal mass. Interviews were analysed using qualitative content analysis. An overarching theme, From symptoms to surgery-a pathway through uncertainty and hope, was identified. The theme was made up of three categories; I. The road to diagnosis, II. Striving for information and guidance, and III. Balancing emotions of hope and fear. The period between discovering the adnexal mass and surgery was often described as chaotic and difficult to manage. However, the diagnostic procedures were mostly described as timely and efficient, and participants felt safe and cared for. Person-centred care was considered crucial when being in this vulnerable situation, and the nurse navigator was described as a key person to approach for any queries. While participants expressed overall satisfaction with the information provided by health professionals, some reported a lack of information regarding the surgery's potential impact on hormonal production and sexuality. Restrictions during the COVID-19 pandemic forced participants to attend healthcare visits alone, and some wished that health professionals had taken more responsibility for informing their relatives. Many participants focused on the positive aspects of the information gained about the adnexal mass, and that the entire situation gave perspective of what was important in life. Waiting for surgery on a possibly malignant adnexal mass can be very stressful, however person-centred care and the guidance of a nurse navigator can make the process more manageable. To improve women's experience, health professionals may involve relatives more often and make sure to inform of potential hormonal loss and sexuality after ovarian surgery.

Integrated Place-Based Primary Interventions: Levers and Tensions Related to Multilevel Governance for Community Integrated Pathways, A Multiple Case Study.

Integrated Place-Based Primary Interventions (IPPIs) are considered an innovative response to the challenges and complex issues faced in disadvantaged areas where traditional institutional services have difficulty reaching people in vulnerable situations. IPPIs are an innovative approach to the delivery of in services, conceived as an original community-based local care and service pathways. However, these intervention practices require adaptive modes of governance. In this article, we explore how and to what extent the mode of governance of IPPIs influences the performance of community-integrated pathways. To this end, using a qualitative exploratory multiple-case study design (observation and semi-structured interviews), we describe 4 IPPIs in 3 territories in Quebec. This includes an examination of the levers of action and tensions related to their governance and the performance levels of the community-integrated pathways. We conclude that collaborative and shared multilevel governance, despite its demanding nature, appears to contribute to the longevity of the actions and benefits of IPPIs and could prevent their relevance from being questioned.

Vulnerability in Inclusive Research: Exploring Co- and Professional Researchers’ Experiences in a Community-Based Participatory Project on the Disability Family

In the transition to a less protectionist research ethics paradigm—in which vulnerable groups are no longer excluded from participating in research—academic researchers need to think differently about vulnerability. By means of a collective autoethnographic investigation of professional and co-researcher’s experiences in a community-based participatory research (CBPR) project, this article explores how vulnerability is experienced and perceived in the work process and how to respond to vulnerability. It finds that vulnerability manifests in two main ways—that of feeling “emotional hurt” and “epistemic self-doubt”—and that it comes from two main layers: the lived life and from working within CBPR. The main argument in the article is that vulnerability is inevitable in qualitative research like CBPR, when involving persons in vulnerable life situations. We propose four key recommendations for future research: (a) accept vulnerability as an inevitable part of CBPR, (b) balance protection with participant autonomy in situ and together as a team, (c) use a processual approach because ethical risks in the research context might alter over time, and (d) accept that placing co-researchers at the center of interpretative authority can increase professional researcher’s vulnerability. The article expands existing understandings of ethical issues and risk in inclusive research through a combined and innovative focus on both professional and co-researcher’s lived experiences.

Queer vulnerability and disaster situations

<abstract> <p>The appropriateness of branding certain disaster events as a natural disaster continues to be academically debated, given that few disasters are solely the result of uncontrollable forces of nature, and are instead anthropogenic in their creation, or exacerbated by the relationship humans have with actual and potential hazards. Therefore, this socially constructed nature of disasters also makes groups that are marginalized within society, such as queer people, more vulnerable to these disasters. Utilizing a Bourdieusian framework, the field of disaster preparedness, management, and recovery is examined for queer vulnerability, which is deconstructed here as a product of global and local cultures, in their distribution of economic, social, cultural, and symbolic capital away from queer people. The concepts of habitus and subsidiary concepts of ethos and doxa are deployed to understand the ingrained ways of doing and being that perpetuate discrimination against queer individuals through said inequitable distributions of capital. It is argued that the field is privileged for heteronormative lives, thus leading to heteronormative assumptions and actions that further marginalize queer experiences before, during, and after disasters during disasters. In light of this, we call for a more social justice informed approach to disaster risk reduction and relief, in which heteronormativity is consciously decentered to ensure all groups are kept safe from disasters, which can arguably never be natural.</p> </abstract>

Prep provision in community organizations: a comparative study with conventional services.

To evaluate whether adolescents from sexual minorities who initiated pre-exposure prophylaxis (PrEP) in community-based organizations (COs) are more socially and HIV-vulnerable compared with their counterparts from a conventional health service. In addition, to evaluate whether these adolescents had more timely access to prophylaxis. A PrEP demonstration study was conducted in the city of São Paulo in two COs, located in the center (CO-center) and the outskirts (CO-outskirts), and a conventional HIV testing service (CTA-center). Between 2020 and 2022, cisgender male adolescents who have sex with men (aMSM), transgender and gender diverse adolescents (aTTrans) aged 15 to 19 years, HIV-negative, with higher-risk practices for HIV were eligible for PrEP. Indicators of timely access and vulnerabilities of adolescents initiating PrEP in COs were analyzed using CTA-center as a reference and multinomial logistic regression. 608 adolescents initiated PrEP in COs and CTA-center. Adolescents from COs were associated with a shorter time to PrEP initiation (1-7 days; CO-outskirts: ORa=2.91; 95%CI 1.22-6.92; CO-center: ORa=1.91; 95%CI 1.10-3.31); and a lower housing Human Development Index (HDI) (CO-center: ORa = 0.97; 95%CI 0.94-1.00; CO-outskirts: ORa=0.82; 95%CI 0.78-0.86). In CO-outskirts, there was an increased chance of adolescents being younger (ORa=3.06; 95%CI 1.63-5.75) and living closer to the service (ORa=0.82; 95%CI 0.78-0.86, mean 7.8 km). While adolescents from the CO-center were associated with greater prior knowledge of PrEP (ORa=2.01; 95%CI 1.10-3.91) and high-risk perception (ORa=2.02; 95%CI 1.18-3.44), adolescents from the COs were not associated with higher-risk sexual practices and situations of vulnerability to HIV. The provision of PrEP in the COs facilitated access for vulnerable adolescents and may contribute to reducing inequities.

A contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres: um protocolo de revisão de escopo

Abstract Introduction Disasters bring human, socioeconomic, and environmental consequences and exacerbate situations of vulnerability. Both highly industrialized core countries and those facing economic difficulties are subject to these events. In Brazil, the COVID-19 pandemic and the collapse of dams highlight difficulties in anticipating and responding to these types of events. Actions of occupational therapy in the field of emergencies and disasters are scarce in the literature, notably in the sphere of prevention. Objective To explore the evidence of the contribution of occupational therapists in the field of risk management and disasters based on the characteristics, priorities, and main areas of interest of intellectual production in occupational therapy. Method A comprehensive search will be conducted in the journals Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction, and Journal of Contingencies and Crisis Management, as well as in the databases Occupational Therapy Literature Search Service (OTDBASE), PubMed, and Web of Science. Inclusion Criteria Actions and experiences in the field of occupational therapy, notably those of occupational therapists in risk and disaster management, found in peer-reviewed studies adopting quantitative, qualitative, and mixed methods, in Spanish, English, and Portuguese, without temporal restriction. The approach advocated by the Joanna Briggs Institute (JBI) for study selection, critical appraisal, and data collection and synthesis will be used.

Mental health of parents of children and adolescents who require special health care.

To identify the manifestations presented by parents of children and adolescents who require special health attention that can impact their mental health. exploratory, qualitative research, based on the concept of vulnerability, with data collection carried out through interviews with 18 parents of children and adolescents with special health care needs, hospitalized in the pediatric ward of a hospital in Paraná, between May/2017 and May/ 2018. Data analyzed by inductive thematic analysis. parents experienced situations of vulnerability when providing care at home, with repercussions on their mental health, expressed by manifestations of lack of protection, anxiety and depression. It is important that health professionals seek to expand actions to promote care and reduce situations that generate threats, insecurities, concerns and damage to the health of parents, which can impact and further weaken care for children and adolescents who need attention especially health.

Cross-cultural nursing care for immigrant women during pregnancy and childbirth: experiences and vulnerabilities.

To understand the experiences and vulnerabilities for cross-cultural nursing care for immigrant women during pregnancy and delivery. Exploratory, qualitative research, in the light of the Theory of Diversity and Universality of Cultural Care, in Foz do Iguaçu, Brazil, through interviews with eight postpartum woman and 18 nurses, between February and September 2022. The interpretation of meanings was adopted for analysis. The categories of analysis emerged: Experiences, vulnerabilities and acculturation of immigrant women during pregnancy and delivery; Cross-cultural care and vulnerabilities experienced by immigrants in Brazilian health services. Vulnerabilities were identified in Cultural and Social Structure Dimensions expressed in access to work, low socioeconomic conditions, lack of family and social support and specific services for this population. The potentialities experienced included good care provided by health services, quality of the multidisciplinary team and appreciation of professional knowledge, however, the understanding of expectations and cultural aspects needs to be deepened. Understand that immigrant women experience situations of vulnerability in pregnancy and childbirth, in the Brazilian context, mainly related to social and programmatic dimensions. However, potentialities were also experienced, evidenced by positive aspects in cross-cultural nursing care in Brazil.

Vocal Self-Perception of Singers During COVID-19 Pandemic.

to compare the self-perception of vocal fatigue and use of singing voice during the COVID-19 pandemic between professional and amateur singers and to relate this self-perception with vocal use characteristics during this period. Participants were 121 singers divided into professional singers group (PSG) (12 men and 20 women) comprising singers who depended exclusively on singing as a profession and an amateur singers group (ASG) (37 men and 52 women) of singers who did not depend exclusively on singing for their livelihood. All answered online questionnaires through Google Forms ®. Sociodemographic and vocal characteristics were investigated before and during the pandemic; symptoms of vocal fatigue were assessed through the vocal fatigue index (VFI); and self-perception of use of singing voice through the evaluation of the ability to sing easily protocol for Brazil (EASE-Br). In the comparison between groups, the PSG presented higher scores of vocal fatigue in fatigue and vocal limitation (P=0.045), vocal restriction (P=0.002), and recovery with vocal rest (P=0.008) domains than did the ASG. There was no difference between the groups regarding the use of singing voice. Based on the relationship between self-perception and vocal use characteristics during the pandemic, it was observed that the presence of vocal complaint was the only factor associated with self-perception of fatigue symptomatology in both groups. Regarding the self-perception of the current status of the singing voice, singing time, the presence of vocal complaints, the need to increase visual concentration, and the perception of vocal worsening during the pandemic were considered predictive for amateur singers. For professional singers, vocal complaints and vocal training were predictors for self-perception of the current status of the singing voice. Professional singers presented with higher scores of vocal fatigue than did amateur singers. The symptomatology of vocal fatigue was associated with the presence of vocal complaints in both groups. However, self-perception of the current status of the singing voice was different between the groups and was associated with vocal training for professional singers and characteristics of vocal demand of singing voice during the pandemic period for amateur singers.

A Narrative Review on Human Anxiety Detection in Social Media using Natural Language Processing

Currently, with the boundless proliferation of social media platforms, it is undoubted that the world is in the middle of a significant phase of social media evolution. These virtually created user environments allow users to create, share, and interact with content. Most people who interact with social media make a pitch to share their mood, tension, feelings, and behaviour unhesitatingly with the community. Mostly, these data can be taken as a mirror that reflects the mental health status of a person, such as stress, anxiety, and suffering. With increased social media penetration, people tend to share their disturbances rather than suffer alone. Anxiety can be taken as an ordinary human emotion which prepares the human body for potentially vulnerable situations. It would be beneficial if there were any system that could predict if a person is anxious before going through a critical situation that would have to be clinically treated. This study is a narrative review of anxiety detection over the past ten years. Furthermore, this qualitative study discusses an overview of anxiety detection using Natural Language Processing (NLP) and key concepts highlighting emerging trends. We conclude that the existing state-of-the-art social media anxiety detection mechanisms can be outperformed using deep learning based on large pre-trained language models. Furthermore, it can be safely stated that a specific pre-trained large language model for social media anxiety detection is a crucial necessity yet to be fulfilled.

Coastal Vulnerability Assessment of Kanthi Coast, India by the Geospatial Technology

Since ancient times, most of the world’s civilization flourished along the banks of rivers and the coastal region. So the coastal region plays a vital role for human economic activities as well as their livelihood. The Kanthi coast, the northernmost part of the North Circus coast of India stretches in West Bengal and northern Odisha. The 45 km stretched coast land is associated with a dense population and faces the tropical cyclone emerging from the Bay of Bengal. The prime objective of the paper is to assess the coastal vulnerability of the study area. With the help of several indicators, viz. shoreline change rate, rate of sea level change, slope of the beach, wave height, tidal range, regional elevation, geomorphic features, sediment properties, coastal regulation zone (CRZ) violation ratio, the research work assess the Coastal Vulnerability Zone (CVZ) of the Kanthi Coastal region. The weightage sum method and Coastal Vulnerability Index (CVI) are being used. From this research work, it has been revealed that the western segment especially, Digha and Shankarpur are experiencing a high vulnerability situation.

Spatial Hotspots and Sociodemographic Profiles Associated With Traumatic Brain Injury in Nova Scotia.

Traumatic brain injury (TBI) is a leading cause of death and disability, primarily caused by falls and motor vehicle collisions (MVCs). Although many TBIs are preventable, there is a notable lack of studies exploring the association of geographically defined TBI hotspots with social deprivation. Geographic information systems (GIS) can be used to identify at-risk neighborhoods (hotspots) for targeted interventions. This study aims to determine the spatial distribution of TBI by major causes and to explore the sociodemographic and economic characteristics of TBI hotspots and cold spots in Nova Scotia. Patient data for TBIs from 2003 to 2019 were obtained from the Nova Scotia Trauma Registry. Residential postal codes were geocoded and assigned to dissemination areas (DA). Area-based risk factors and deprivation status (residential instability [RI], economic dependency [ED], ethnocultural composition [EC], and situational vulnerability [SV]) from the national census data were linked to DAs. Spatial autocorrelation was assessed using Moran's I, and hotspot analysis was performed using Getis-Ord Gi* statistic. Differences in risk factors between hot and cold spots were evaluated using the Mann-Whitney U test for numerical variables and the χ2 test or Fisher's exact test for categorical variables. A total of 5394 TBI patients were eligible for inclusion in the study. The distribution of hotspots for falls exhibited no significant difference between urban and rural areas (p = 0.71). Conversely, hotspots related to violence were predominantly urban (p = 0.001), whereas hotspots for MVCs were mostly rural (p < 0.001). Distinct dimensions of deprivation were associated with falls, MVCs, and violent hotspots. Fall hotspots were significantly associated with areas characterized by higher RI (p < 0.001) and greater ethnocultural diversity (p < 0.001). Conversely, the same domains exhibited an inverse relationship with MVC hotspots; areas with low RI and ethnic homogeneity displayed a higher proportion of MVC hotspots. ED and SV exhibited a strong gradient with MVC hotspots; the most deprived quintiles displayed the highest proportion of MVC hotspots compared with cold spots (ED; p = 0.002, SV; p < 0.001). Areas with the highest levels of ethnocultural diversity were found to have a significantly higher proportion of violence-related hotspots than cold spots (p = 0.005). This study offers two significant contributions to spatial epidemiology. First, it demonstrates the distribution of TBI hotspots by major injury causes using the smallest available geographical unit. Second, we disentangle the various pathways through which deprivation impacts the risk of main mechanisms of TBI. These findings provide valuable insights for public health officials to design targeted injury prevention strategies in high-risk areas.