Understanding vulnerability in the context of climate change – a Health impact Assessment Framework

Abstract

The climate emergency is resulting in differential exposures to health risks across populations. Where the 'standard' determinants of (ill) health are already socio-economically distributed, the impacts of a changing climate will have even greater effects on the most vulnerable in society and further exacerbate health equity gaps. Building on a conceptualisation of health inequity as 'the unfair and avoidable differences in health between groups in the population' we argue that phenomena like high temperatures, extreme weather and rising sea levels do not affect everyone equally; and that policies and interventions need to be cognisant of distributed and differential patterns of health risk exposure and responses.Vulnerability can be conceptualised across three dimensions. Firstly, some populations are vulnerable because they have higher levels of exposure. Secondly, some populations have higher levels of vulnerability because they are more sensitive. The final type of vulnerability is particularly important and relates to health equity adaptive capacity - people's ability to prepare for and respond to health threats. For example, people who are economically less well-off are: more likely to live in poor quality housing and in areas with relatively less access to resources; less likely to know how to respond (health literacy), or if they do know, less likely to be able to acquire and afford mitigation measures; have less capacity to advocate; and are less likely to be listened to. These vulnerabilities tend to cluster and accumulate, reinforcing and exacerbating health inequities. These same communities also have capacities and assets that can support recovery and resilience.We can utilise Health Impact Assessments to understand context specific climate emergency vulnerabilities and to develop strategies to respond. In this presentation a climate vulnerability framework and associated tools for HIA will be described and discussed.