Long-distance cycling may promote physiologic changes in the deep branch of the ulnar nerve and exacerbate symptoms of carpal tunnel syndrome.

Social vulnerability indicators are a valuable tool for understanding which population groups are more vulnerable to experiencing negative impacts from disasters, and where these groups live, to inform disaster risk management activities. While many approaches have been used to measure social vulnerability to natural hazards, there is no single method or universally agreed approach. This paper proposes a novel approach to developing social vulnerability indicators, using the example of flooding in Aotearoa New Zealand. A conceptual framework was developed to guide selection of the social vulnerability indicators, based on previous frameworks (including the MOVE framework), consideration of climate change, and a holistic view of health and wellbeing. Using this framework, ten dimensions relating to social vulnerability were identified: exposure; children; older adults; health and disability status; money to cope with crises/losses; social connectedness; knowledge, skills and awareness of natural hazards; safe, secure and healthy housing; food and water to cope with shortage; and decision making and participation. For each dimension, key indicators were identified and implemented, mostly using national Census population data. After development, the indicators were assessed by end users using a case study of Porirua City, New Zealand, then implemented for the whole of New Zealand. These indicators will provide useful data about social vulnerability to floods in New Zealand, and these methods could potentially be adapted for other jurisdictions and other natural hazards, including those relating to climate change.

This article describes an approach to evaluating a community-based public health intervention that considers the social systems in which the initiative is being implemented to be complex. The evaluation case example provides a unique opportunity to operationalize and test these methods, while extending their more frequent use within other fields to the field of public health.

Developing environmental health indicators is challenging and applying a conceptual framework and indicator selection criteria may not be sufficient to prioritise potential indicators to monitor. This study developed a new approach for prioritising potential environmental health indicators, using the example of the indoor environment for New Zealand. A three-stage process of scoping, selection, and design was implemented. A set of potential indicators (including 4 exposure indicators and 20 health indicators) were initially identified and evaluated against indicator selection criteria. The health indicators were then further prioritised according to their public health impact and assessed by the five following sub-criteria: number of people affected (based on environmental burden of disease statistics); severity of health impact; whether vulnerable populations were affected and/or large inequalities were apparent; whether the indicator related to multiple environmental exposures; and policy relevance. Eight core indicators were ultimately selected, as follows: living in crowded households, second-hand smoke exposure, maternal smoking at two weeks post-natal, asthma prevalence, asthma hospitalisations, lower respiratory tract infection hospitalisations, meningococcal disease notifications, and sudden unexpected death in infancy (SUDI). Additionally, indicators on living in damp and mouldy housing and children’s injuries in the home, were identified as potential indicators, along with attributable burden indicators. Using public health impact criteria and an environmental burden of disease approach was valuable in prioritising and selecting the most important health impacts to monitor, using robust evidence and objective criteria.