Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?

Abstract

Severe and morbid obesity are associated with highly elevated risks of adverse health outcomes and the prevalence of severe obesity is increasing globally. To date, disaster literature has not considered severe and morbid obesity as a specific vulnerability, despite reports of people being left behind during disasters because of their body size, shape or weight. The complex causes of obesity are associated with the social determinants of health and one’s potential vulnerability to disasters. The absence of appropriate considerations may lead to people being exposed to disproportionate and potentially avoidable risk. The intersection of the social determinants of health, disaster vulnerability, severe and morbid obesity is explored. Previously identified vulnerable groups are also represented in severe and morbid obesity data. This poses the prospect for ‘triple jeopardy’ compounding the social determinants of health, disaster vulnerability and considerations with and for people with morbid obesity. When working to reduce disaster risk for vulnerable groups, the author proposes specific consideration is required to ensure ‘all-of-society engagement and partnership’ in an inclusive, accessible and non-discriminatory manner, to ensure no one is left behind.

Five Years Later: Assessing the Implementation of the Four Priorities of the Sendai Framework for Inclusion of People with Disabilities

“…Moving beyond an understanding of all the dimensions of vulnerability to ''all-of-society engagement and partnership'' may be the way to move forward (Gray 2017). Accomplishing this type of collaboration in ''an inclusive, accessible, and non-discriminatory manner would help to ensure no one is left behind'' (Gray 2017(Gray , p. 1452. Furthermore, moving from just understanding to a targeted engagement and partnership would ensure that policymakers and future practices would be developed (at least in part) by people with disabilities.…”

“…Research and reports over the last 5 years not only have highlighted the need to empower people with disabilities (Phibbs et al 2016;Castro et al 2017;Quaill et al 2019), but also note that inclusivity has not been fully achieved by all Grant 2018;King et al 2019). People with disabilities, disability organizations, and care providers can and should contribute to disaster risk reduction and mitigation (Bennett et al 2017;Castro et al 2017;Gray 2017;Maini et al 2017;Grant 2018;Lunga et al 2019). Their risk perception may present new issues and, thus, deserves more attention from researchers, disaster practitioners, and policymakers (Castro et al 2017); for instance, ''Disability support groups could provide a forum for people with disabilities to share their cyclone knowledge and exchange ideas for managing wellbeing with each other to minimize vulnerability and enhance personal resilience'' (Quaill et al 2019, p. 64).…”

“…Similar considerations are related to the intersection of health and disability. Gray (2017) pointed out the prospect of ''triple jeopardy'' compounding the social determinants of health, disaster vulnerability, and considerations with and for people with morbid obesity. Meanwhile, the measurement of health-related indicators is challenging by itself (Maini et al 2017).…”

Promoting Integrated Mental Health Care Services in Disaster Response Programs: Lessons Learned After the Impact of Hurricane María in Puerto Rico

“…Clearly, the passage of a disaster affects a society without distinction, but groups that are socially vulnerable (eg, those whose members have low socioeconomic status) and those composed of individuals who have chronic physical and mental conditions sustain the most significant impact. [49][50][51][52] These characteristics were present in all the patients admitted to the THCU. These were people with limited economic resources, low educational levels, and at least 1 chronic disease.…”

“We only have the one”: Mapping the prevalence of people with high body mass to aid regional emergency management planning in Aotearoa New Zealand

“…While everyone is at risk of harm in a disaster, some people have been identified at higher risk in relation to their particular circumstances before, during, and following a disaster: this includes, but is not limited to, people from socioeconomically deprived areas, adults with severe mental illness, older people, people with chronic health conditions, gender minorities and people with disabilities [ [18] , [19] , [20] , [21] ]. Gray identified that many such populations also intersect with increased prevalence of high body mass and refers to this as ‘triple jeopardy’ [ 22 ]. Of concern, recent research shows that emergency managers, planners and responders (EMs) may underestimate prevalence of high body mass in their area of responsibility, recalling only those individuals where prior or intensive assistance had been involved, such as movement from home to hospital in relation to health care needs.…”