Social Vulnerability and Public Health: Developing a Metric for Medical Emergency Management in Florida
Advisor: Dr. Susan L. Cutter
Individuals and communities with pre-existing medical conditions give rise to special needs populations that may require/necessitate additional resources in preparing for, responding to, and recovering from disasters. Emerging research in hazards and epidemiology has alluded to the inherent ties between indicators of social vulnerability and the quality of public health. With disparate access to finances, insurance, transportation, and medical services, areas of elevated social vulnerability tend to compound risk in terms of medical needs during a hazard event. While the concept of social vulnerability includes some indirect measures of special needs populations, these may be insufficient in adequately defining the true pre-existing medical need and health access that correlate with the responsibilities of Emergency Support Function 8 (public health and medical services).
Consequently, this research develops the concept of medical vulnerability, an explicit construct that demonstrates those underrepresented vulnerable populations. The concept is operationalized in two subsequent analyses using the state of Florida as the research setting. First, drawing theoretical justification from the literature, an initial set of variables was culled to represent medical need (i.e. chronic or communicable disease, disability, drug dependence) and health care access (i.e. hospital beds, physicians, insurance). Using a principal component analysis, the initial collection of candidate variables was reduced to a smaller set of underlying components. These components are aggregated using a simple additive model to create a composite indicator for medical vulnerability. The second analysis combines statistics and GIS to compare the overlap between medical vulnerability and its socioeconomic counterpart using Cutter et al.'s (2003) social vulnerability index.
As this thesis contends, the inclusion of purely medical indicators in vulnerability analysis helps to describe a section of the marginalized population otherwise not acknowledged. The results of the analyses show that social vulnerability and medically vulnerability are both statistically and spatially disparate in Florida. Consequently, this thesis concludes that the Medical Vulnerability Index and the Social Vulnerability Index are indeed separate constructs measuring different aspects of vulnerable populations with little overlap.Thesis