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Vulnerability in the South African context
Presented at
CSIR Innovation Conference
Juanette John
Environmental Health Scientist
28 February 2006
Slide 2 © CSIR 2006 www.csir.co.za
Our focus
Air pollution
Exposure
Impacts/Health effects on humans
Externalfactors
Externalfactors
Slide 3 © CSIR 2006 www.csir.co.za
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?
Slide 4 © CSIR 2006 www.csir.co.za
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
Slide 5 © CSIR 2006 www.csir.co.za
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}
Slide 6 © CSIR 2006 www.csir.co.za
Categories associated with vulnerability
• Susceptibility/sensitivity• Differential exposure• Differential preparedness • Differential ability to recover
Slide 7 © CSIR 2006 www.csir.co.za
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
Slide 9 © CSIR 2006 www.csir.co.za
Susceptibility factors
• Life/developmental stage (age)• Genetics• Race• Gender• Disease state
• Respiratory diseases• HIV/AIDS and opportunistic
infections• Nutritional status
Slide 10 © CSIR 2006 www.csir.co.za
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
Slide 11 © CSIR 2006 www.csir.co.za
Differential exposure factors
• Fuel use• Occupation• Cultural and behavioural practices• Background exposure• Body burden
Slide 12 © CSIR 2006 www.csir.co.za
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
Slide 13 © CSIR 2006 www.csir.co.za
Differential ability to recover/cope
• Education• Access to health care• Socio-economic status• Cultural practices• Employment
Slide 14 © CSIR 2006 www.csir.co.za
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
Slide 15 © CSIR 2006 www.csir.co.za
Integration of vulnerability and risk: a methodological framework
Slide 16 © CSIR 2006 www.csir.co.za
Challenges
• Aim: to provide a true reflection of the health risks of community to environmental stressors
• Methodological challenges• Pilot test challenges• Standardisation challenges
