HOPE E-COURSE FORMAL CAREGIVERS -GR
Module 2 – week 4 Vulnerable populations
Goal 4: The student knows which part of
the population is vulnerable to heat stress
In this module and module 1 we have learned that heat extremes have serious impacts on public health worldwide. The effects of heat mostly occur on the same day and in the following three days. In this module, we are going to distinguish which part of the population is vulnerable to heat stress. One of them are elderly people are a group who have a high risk of negative health effects due to the increase of the frequency and intensity of heatwaves in combination with the presence of (co)morbidity. If you want to learn more about vulnerable populations to heat stress it is helpful to read paragraph 6.2 of the WHO report or the article by Mayrhuber et all (2018).
Figure 1 describes the relationship between climate change, heat, vulnerability and related health risks.
Figure 1: climate, change, vulnerability and climate-sensitive health risks
Source: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health
Factors that define vulnerability to health risks due to climate change and/or heat are demographic factors, geographic factors, biological factors, health status, sociopolitical conditions and socio-economic factors. The YouTube video is illustrated how some people are more vulnerable than others to the negative effects of heat waves.
Figure 2 sums up the different persons who are considered as vulnerable to heat.
Figure 2:
Source: Heat and Health
(who.int)
Age is considered a crucial risk factor for vulnerability to heat stress, owing to diminished physiological and behavioral responses to heat. Additionally, warnings encompass individuals with compromised medical conditions, such as those with chronic diseases ( such as cardiorespiratory diseases, endocrine system disorders, metabolic disorders and kidney disorders) using specific medications, individuals who are obese or physically unfit, people with disabilities, individuals coping with mental illnesses, or substance abusers. Another vulnerable group are "people in need of, or dependent on care," bedridden individuals, institutionalized persons, and their caregivers. The risk among institutionalized individuals is attributed to a blend of exposure, susceptibility, and limited control over thermal comfort. Young children are also identified as vulnerable due to weaker thermoregulation and potential increased outdoor exposure. Another group to be mentioned is those who have occupations with high risks, such as those involving heavy physical exertion, outdoor labour, or construction work, municipal police officers. But also the type of housing may determine a vulnerable situation, such as residents of informal settlements, slums homeless persons or top-floor apartment dwellers, occupants of high-rise buildings, or row homes. People living in cities have a larger risk of negative health effects because of so-called heat islands which are often located in socially and economically deprived areas. At last, we mention people with a small social network, living in isolation or living in an unsafe neighbourhood.
Vulnerability mapping
Methodology for mapping of population vulnerability and exposure to heat waves (youtube.com)
Vulnerability mapping is used in many settings as an instrument to identify or predict where to find populations at risk during heat waves. It is also helpful to target specific interventions (see also modules 3, 4 and 5).
Questions:
1. Can you describe the factors that define vulnerability to heat?
We distinguish between factors at the individual level such as age, gender and health status. Then there are factors related to the physical environment such as living environment, working conditions, the availability of green areas, level of air pollution or type of building for working or living. And socio-economic/-demographic factors such as socioeconomic status, level of education, ethnic minority groups, and homelessness.
2. Why are pregnant women more susceptible to heat?
Heat is related to adverse birth outcomes such as low birth weight and premature deliveries. This is because of the extra release of hormones triggered by the heat. Also, pregnant women are more susceptible to heat because of their weight gain and face difficulties in thermoregulation.
#. References
Chapter 6 paragraph 6.2 of the WHO report Heat and health in the WHO European Region: updated evidence for effective prevention (2021).
Mayrhuber, E. , Dückers, M., Wallner, P., Arnberger, A., Allex, B., Wiesböck, L., Wanka, A., Koland, F., Eder, R., Hutter, H. and R. Kutalek (2018). Vulnerability to heatwaves and implications for public health interventions – A scoping review. In Environmental Research, Volume 166, October 2018, Pages 42-54. https://doi.org/10.1016/j.envres.2018.05.021