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Vulnerable Populations in Public Health

October is Vulnerable Populations month in the American Public Health Association’s (APHA) Year of Climate Change and Health. The month focuses on those populations that are disproportionately affected by climate change health effects and are less climate-resilient. While APHA focuses on children, other vulnerable populations include the elderly, minority communities, and economically disadvantaged communities.

Minority communities and those of low-income are particularly vulnerable to flooding, food insecurities, and damage to infrastructure from natural disasters that can lead to increased displacement, cardiovascular complications, stress, and malnutrition. These populations are made more vulnerable to these conditions due to structural racism which has resulted in inadequately climate-resilient infrastructure and established health disparities. Language barriers also continue to increase vulnerability of communities whose first language is not English. The increased risk of these communities has been painfully demonstrated by past and present natural disasters such as Hurricane Katrina in New Orleans, Hurricane Sandy in New Jersey, and now Hurricane Irma and Maria in Puerto Rico and Florida.

In the wake of recent devastation, the excessive effect that climate change has on already vulnerable populations continues to be apparent. After Hurricane Sandy, low-income and minority communities were more vulnerable to flooding, infrastructure damage, and extended periods of electricity outages. Additionally, the rate hospitalization for dehydration for the general public increased by 66% after the hurricane, compared to that of people over the age of 65 which was nearly 80%.  Now, after Hurricane Irma and Maria, Puerto Rico suffers from massive power outages, water sanitation problems, and multitudes of other public health issues.

In November 2014, Ralph Rivera-Gutiérrez, the dean of the University of Puerto Rico Graduate School of Public Health, presented a paper on vulnerable populations in Puerto Rico. In his paper, he stressed the importance of increased emergency preparedness and capacity in an island where close to half the population was living below the poverty line and twenty percent of its population was elderly. While public health academics are pushing for a greater focus on vulnerable populations, local health policy officials and public health organizations must help these at-risk communities anticipate and prepare for climate change health effects.

The CDC has developed the Building Resilience Against Climate Effects (BRACE) Framework in order to guide public health officials in preparing for climate change health effects in their communities and the first step involves identifying vulnerable populations and locations. They also released a guide on assessing vulnerability to climate change. In 2016, the U.S. Global Change Research Program released Climate and Health Assessment: Populations of Concern which enumerates the various factors which make some populations more vulnerable to the health effects of climate change. The report also names geographic information systems (GIS) a particularly important tool for identifying and mapping vulnerable areas and their health risks.  GIS is especially useful when combined with demographic and environmental data to pinpoint vulnerable communities and develop sites for intervention and climate change readiness. Successful application of such tools has been illustrated in a 2014 case study on heat-related illnesses in Georgia in which researchers successfully mapped out zones of high vulnerability.

These innovative mapping tools, along with the support of local public health officials and community leaders, will serve a vital role in preparing communities for the health effects of climate change in the coming years. As we aim to address the needs of more vulnerable communities, perhaps we can mitigate the health effects climate change that Puerto Rico continues to deal with weeks after Hurricane Irma and Maria.


For more information, go to the WHO’s climate change and human health or the CDC’s climate and health

Also follow the APHA for new monthly themes at #Climatechangeshealth


by Donald Clermont, MPH Candidate ’18

Filed under: Disparities, Environment

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