Vulnerability in the South African context Presented at CSIR Innovation Conference Juanette John...

Vulnerability in the South African context

Presented at

CSIR Innovation Conference

Juanette John

Environmental Health Scientist

28 February 2006

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Our focus

Air pollution

Exposure

Impacts/Health effects on humans

Externalfactors

Externalfactors

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Vulnerability: an introduction

• What is vulnerability?’characteristics of a person or group in terms of their capacity to anticipate, cope with, resist and recover from the impact of natural or man made hazards’

• The important question: Vulnerable to what?

• Why is vulnerability significant in the air pollution context?

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What is the focus of the presentation?

• Risk vs vulnerability• Categories of vulnerability• Some Vulnerability factors affecting SA communities in

relation to air pollution.• A conceptual framework for integrating health risk

assessment and vulnerability• Challenges associated with integrating these concepts

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Risk vs vulnerability

• Risk: likelihood of an event following exposure• Determination of health impacts of air pollution through

• Epidemiology and toxicological studies• Health risk assessments• Environmental health impacts studies

• Data on risk factors lacking risk management• Realisation that risks cannot be considered within the

boundaries of traditional risk assessment framework• Risk = f{Hazard, Vulnerability}

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Categories associated with vulnerability

• Susceptibility/sensitivity• Differential exposure• Differential preparedness • Differential ability to recover

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Categories and factors associated with vulnerability

Susceptibility Differentialexposure

Differential abilityto

recover/copeIntrinsic Acquired

Life/developmentalstage

Nutrition Occupation Access to health careImmunisation

Genetics Drug/alcohol use Cultural/behaviouralpractices

Education

Race Fitness Backgroundexposure

Socio-economicstatus

Gender Obesity Body burden Cultural practices

Disease state Disease Fuel use Employment

Vulnerability: The South African context

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Susceptibility factors

• Life/developmental stage (age)• Genetics• Race• Gender• Disease state

• Respiratory diseases• HIV/AIDS and opportunistic

infections• Nutritional status

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Gender

The Prevalence of Chronic Conditions by Sex, South Africa (1998)

0

5

10

15

20

25

30

Diabetes Ischaemic Heart Disease Hypertension ChronicBronchitis/Emphysema

Cancer

%

Men Women

Source: DoH, MRC & MacroInt, 2001

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Differential exposure factors

• Fuel use• Occupation• Cultural and behavioural practices• Background exposure• Body burden

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Behavioural practices

Source: DoH, MRC & MacroInt, 2001

The Prevalence of Smoking by Population Group and Sex, South Africa (1998)

0

20

40

60

80

African Coloured White Asian Total

%

Men Women

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Differential ability to recover/cope

• Education• Access to health care• Socio-economic status• Cultural practices• Employment

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Education

Source: DoH, MRC & MacroInt, 2001

Percentage of Household Population Education Levels by gender, South Africa (1998)

0

5

10

15

No School Std 10 Std 10+

%

Male Female

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Integration of vulnerability and risk: a methodological framework

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Challenges

• Aim: to provide a true reflection of the health risks of community to environmental stressors

• Methodological challenges• Pilot test challenges• Standardisation challenges