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在评估北极的大流行风险时纳入弹性:以阿拉斯加为例。

Incorporating resilience when assessing pandemic risk in the Arctic: a case study of Alaska.

机构信息

ARCTICenter, College of Social & Behavioral Sciences, University of Northern Iowa, Cedar Falls, Iowa, USA

ARCTICenter, University of Northern Iowa, Cedar Falls, Iowa, USA.

出版信息

BMJ Glob Health. 2023 Jun;8(6). doi: 10.1136/bmjgh-2022-011646.

DOI:10.1136/bmjgh-2022-011646
PMID:37286235
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10254803/
Abstract

The discourse on vulnerability to COVID-19 or any other pandemic is about the susceptibility to the effects of disease outbreaks. Over time, vulnerability has been assessed through various indices calculated using a confluence of societal factors. However, categorising Arctic communities, without considering their socioeconomic, cultural and demographic uniqueness, into the high and low continuum of vulnerability using universal indicators will undoubtedly result in the underestimation of the communities' capacity to withstand and recover from pandemic exposure. By recognising vulnerability and resilience as two separate but interrelated dimensions, this study reviews the Arctic communities' ability to cope with pandemic risks. In particular, we have developed a pandemic vulnerability-resilience framework for Alaska to examine the potential community-level risks of COVID-19 or future pandemics. Based on the combined assessment of the vulnerability and resilience indices, we found that not all highly vulnerable census areas and boroughs had experienced COVID-19 epidemiological outcomes with similar severity. The more resilient a census area or borough is, the lower the cumulative death per 100 000 and case fatality ratio in that area. The insight that pandemic risks are the result of the interaction between vulnerability and resilience could help public officials and concerned parties to accurately identify the populations and communities at most risk or with the greatest need, which, in turn, helps in the efficient allocation of resources and services before, during and after a pandemic. A resilience-vulnerability-focused approach described in this paper can be applied to assess the potential effect of COVID-19 and similar future health crises in remote regions or regions with large Indigenous populations in other parts of the world.

摘要

对 COVID-19 或其他任何大流行病的脆弱性的讨论是指对疾病爆发影响的易感性。随着时间的推移,脆弱性已经通过使用多种社会因素融合计算的各种指数来评估。然而,将北极社区归类为高脆弱性和低脆弱性连续体,而不考虑其社会经济、文化和人口的独特性,使用通用指标无疑会低估社区抵御和从大流行病中恢复的能力。通过认识到脆弱性和弹性是两个独立但相互关联的维度,本研究审查了北极社区应对大流行病风险的能力。特别是,我们为阿拉斯加制定了一个大流行病脆弱性-弹性框架,以检查 COVID-19 或未来大流行病的潜在社区级风险。基于脆弱性和弹性指数的综合评估,我们发现并非所有高脆弱性的普查区和自治市镇都经历了 COVID-19 流行病学结果的严重程度相似。一个普查区或自治市镇的弹性越高,该地区每 10 万人的累计死亡人数和病死率就越低。大流行病风险是脆弱性和弹性相互作用的结果的观点可以帮助政府官员和有关方面准确地识别最脆弱或最需要的人群和社区,从而有助于在大流行病之前、期间和之后有效地分配资源和服务。本文所述的以弹性-脆弱性为重点的方法可用于评估 COVID-19 及世界其他地区类似未来卫生危机对偏远地区或大型土著人口地区的潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/3f1950bc9bbe/bmjgh-2022-011646f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/99d7b8deb6a8/bmjgh-2022-011646f01.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/51dece6e2d11/bmjgh-2022-011646f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/3f1950bc9bbe/bmjgh-2022-011646f08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/99d7b8deb6a8/bmjgh-2022-011646f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/ec112e3c0cb1/bmjgh-2022-011646f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/63475cd17bb0/bmjgh-2022-011646f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/498a7beb73a6/bmjgh-2022-011646f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/a643ecba0240/bmjgh-2022-011646f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/cc2e47539a85/bmjgh-2022-011646f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/51dece6e2d11/bmjgh-2022-011646f07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f198/10254803/3f1950bc9bbe/bmjgh-2022-011646f08.jpg

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COVID-19 mortality and deprivation: pandemic, syndemic, and endemic health inequalities.
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JAMA Health Forum. 2022 Jan 21;3(1):e214501. doi: 10.1001/jamahealthforum.2021.4501. eCollection 2022 Jan.
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Indigenous peoples and pandemics.原住民与大流行病。
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