Measuring Health Vulnerability: An Interdisciplinary Indicator Applied to Mainland Portugal

Abstract

Health promotion and inequality reduction are specific goals of the United Nations 2030 Agenda, which are interconnected with several dimensions of life. This work proposes a composite index SEHVI—socioeconomic health vulnerability index—to address Portuguese population socioeconomic determinants that affect health outcomes. Variables composing SEHVI are aligned with the sustainable development goals considering data and times series availability to enable progress monitoring, and variables adequacy to translate populations’ life conditions affecting health outcomes. Data for 35 variables and three periods were collected from official national databases. All variables are part of one of the groups: Health determinants (social, economic, cultural, and environmental factors) and health outcomes (mortality indicators). Variables were standardized and normalized by “Distance to a reference” method and then aggregated into the SEHVI formula. Several statistical procedures for validation of SEHVI revealed the internal consistency of the index. For all municipalities, SEHVI was calculated and cartographically represented. Results were analyzed by statistical tests and compared for three years and territory typologies. SEHVI differences were found as a function of population density, suggesting inequalities of communities’ life conditions and in vulnerability to health.

How Will COVID-19 Impact on the Governance of Global Health in the 2030 Agenda Framework? The Opinion of Experts

“…Some countries are showing disruptive conduct that hides their real intentions and behavior and helps to increase the level of uncertainty about the state of the world (7,19), such as, but not only, China and Russia, which seem to be deploying their disinformation arsenal to further destabilize democratic regimes and extend their influence on the world (44,61,67,68,112,124), thus eroding trust and hindering international organizations' efforts (some of which have even been cyberattacked during the worst moments of the crisis, (87)) which are needed to deal globally with the coronavirus (61, 112). On the other hand, the consequences of COVID-19 will make it more difficult to properly manage current and future threats (105).…”

“…Regarding domestic regime-type asymmetries, experts fear a general drift towards more autocratic regimes, a trend that was evident before the outbreak of the pandemic (19,66,68,69), and not only those states already showing certain levels of authoritarianism are likely to lose democratic freedoms (7,131). The fearful populations of democratic countries will be willing to accept more political control and citizen surveillance if these guarantee a better fight against pandemics (50).…”

“…However, the private sector can play a relevant role in the crisis (56, 59), both directly and through public-private partnerships (4,87). It is also clear that the involvement of civil society groups, the scientific community and other types of international organizations is paramount (4,7,12,56,120). As a result, the membership rules of the 2030 Agenda should change to recognize different levels of participants with dissimilar rights and responsibilities.…”

“…What about global health issues? Experts mostly agree that, given the systemic nature of health, holistic approaches to deal with the coronavirus should be encouraged (7,150). Many voices warn about the links between poverty and health (16) in a diverse array of areas.…”

Development and validation of a nursing instrument for triage in occupational health services

“…The internal consistency reliability was assessed by the Cronbach's coefficient alpha (a) and by the Pearson correlations among dimensions extracted by the factor analysis. These steps are described in the literature as the common use to validate instruments (Bonato et al, 2020;Nora et al, 2020;Oliveira et al, 2019;Viterbo et al, 2020). All statistical tests were performed by IBM® SPSS® Statistics vs.25.0 (IBM Corporation, 2018).…”