Social Vulnerability, Climate Change and Health: Scoping review.

 Very happy to see this new scoping review published in The Lancet Plenatary Health.

The recent IPCC assessment report argued that lack of ability to identify social vulnerability at a local and urban level was a critical barrier to climate adaptation planning.

We conducted a scoping review of 230 studies that examined social vulnerability to the health effects of climate change in order to understand the main foci of the literature and potential gaps.

We found that the main share of the research focused on high-income settings – the United States, Western Europe, Australia, Japan etc. China was the exception to that rule being the most researched country after the United States. The most vulnerable countries are lest studied. This is an issue for climate justice.

We found that most research focuses on a narrow set of socio-demographic variables. Age, sex, ethnicity, education, income being amongst the most used indicators of social vulnerability.

We found a relative paucity in the number of studies that address or measure broader structural dimensions of social vulnerability – issues of housing, access to community facilities beyond health services, governance are less researched.

We argued that a lot of the research is very descriptive rather than explanatory. Drawing on more social science understandings of vulnerability and a broader range of indicators could help explain how group membership/social category translates to vulnerability and help identify leverage points for interventions.

Here is the abstract for the paper: 

The need to assess and measure how social vulnerability influences the health impacts of climate change has resulted in a rapidly growing body of research literature. To date, there has been no overarching, systematic examination of where this evidence is concentrated and what inferences can be made. This scoping review provides an overview of studies published between 2012 and 2022 on social vulnerability to the negative health effects of climate change. Of the 2115 studies identified from four bibliographic databases (Scopus, Web of Science, PubMed, and CAB Direct), 230 that considered indicators of social vulnerability to climate change impacts on health outcomes were selected for review. Frequency and thematic analyses were conducted to establish the scope of the social vulnerability indicators, climate change impacts, and health conditions studied, and the substantive themes and findings of this research. 113 indicators of social vulnerability covering 15 themes were identified, with a small set of indicators receiving most of the research attention, including age, sex, ethnicity, education, income, poverty, unemployment, access to green and blue spaces, access to health services, social isolation, and population density. The results reveal an undertheorisation and few indicators that conceptualise and operationalise social vulnerability beyond individual sociodemographic characteristics by identifying structural and institutional dimensions of vulnerability, and a preponderance of social vulnerability research in high-income countries. This Review highlights the need for future research, data infrastructure, and policy attention to address structural, institutional, and sociopolitical conditions, which will better support climate resilience and adaptation planning.  

Vaccine Sentiments and Under-vaccination: New Paper

.@ANGLIhere and my paper "Vaccine sentiments and under-vaccination" is now out about in the world and online for everyone to see: https://t.co/bEn4HBE75w

— Mathew Toll (@MGHToll) November 18, 2020

New paper out co-authored with Ang Li on the issue of vaccine hesitancy and under-vaccination that looks at the factors associated with vaccine attitudes (very strongly agree with vaccines to very strongly disagree with vaccines) and vaccine behaviours around the MMR vaccine (full dosage, partial dosage, no dosage).  And the consistency between factors associated with attitudes and behaviours, showing when practical barriers impede the translation of positive vaccine attitudes into full uptake. 

Title: “Vaccinesentiments and under-vaccination: Attitudes and behaviour around Measles,Mumps, and Rubella vaccine (MMR) in an Australian cohort”

Abstract: 

Objective

The study aimed to examine the consistency in factors associated with attitudes towards vaccination and MMR vaccination status.

Methods

Using the nationally representative Longitudinal Study of Australian Children matched with the Australian Childhood Immunisation Register, 4,779 children were included from 2004-2005 to 2010–11. Different MMR vaccine dosages and general attitude towards vaccination were modelled individually with multinomial logit regressions, controlling for demographic, socioeconomic, and health related factors of the children and their primary carers.

Results

The group with non-vaccination and negative attitudes was characterised by more siblings and older parents; the group with under-vaccination but positive attitudes was characterised by younger parental age; and the group with under-vaccination and neutral attitudes was characterised by less socioeconomically advantaged areas. The presence of parental medical condition(s), being private or public renters, and higher parental education were associated with under-vaccination but not with attitudes towards vaccination, whilst parental religion was associated with attitudes towards vaccination but not reflected in the vaccine uptake.

Conclusions

Vaccine attitudes were largely consistent with MRR vaccine outcomes. However, there was variation in the associations of factors with vaccine attitudes and uptake. The results have implications for different policy designs that target subgroups with consistent or inconsistent vaccination attitudes and behaviour. Parents with intentional and unintentional under-vaccination are of policy concern and require different policy solutions.

------

Here is a share link that allows free access for the first 50 days: https://t.co/XJlSK3Jcix?amp=1