Measuring Social Vulnerability Dennis Holt, MPH Health Data Analyst, Environmental Public Health Tracking Program, NH DHHS Abstract Social Vulnerability Index (SVI) Measures Public health professionals need to track socioeconomic characteristics in SVI using 2008-2012 ACS Socioeconomic Status: order to better understand susceptibility to health risks. Examples include: 0 Least 1 Poverty, population living below Federal poverty level (%) poverty, education, minority status, age, vehicle availability, and housing Pittsburg 2 Unemployed, age 16 and over and seeking work (%) 1 conditions. 3 Per capita income (in 2012 inflation-adjusted $)

Clarksville ton man l t Objectives: Gi an nd n a 2 so my Gr kin de At Aca 4 Education, age 25+ without a high school diploma (%) Stewartstown Second • Meet the need for environmental risk indicators at the NH town level Dixs College Grant Grant 3 Vulnerable Colebrook 5 Health Insurance, age less than 65 without insurance (%) • Develop the capability to analyze and report census tract data Dixville Wentworths Columbia Location

n s Household Composition / Disability:

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E Relevance: L Millsfield Errol 6 Children, population age less than 18 (%) 6 - 7 Odell • Supports emergency preparedness and public health planning by Stratford 7 Elderly, population age 65 and over (%) identifying vulnerable populations Dummer Cambridge 8 - 9 8 Disability, age 5 or more with a disability (%) • Apply Social Determinants of Health Stark Milan

10 - 14 Most Northumberland 9 Single parent, percent of households with children (%)

y n Success n e Methods: k l i Berlin Lancaster K Minority Status / Language: • Replicate the 15-item Social Vulnerability Index (SVI) developed by NH Towns Jefferson Randolph Gorham 10 Minority, Hispanic or non-white race (%) Dalton d Shelburne Public Health Networks fiel CDC/ATSDR (Flanagan et al. 2011) add health insurance coverage hite W nt ra G Ma rtin s Littleton ks 11 Limited English, age 5 and over who speak English less n Loc ation ba ur B e nd an d Gree ns a sons o Carroll w omp h ase Gran t r Lo Th Purc Beans Purchase • Use American Community Survey 5 year estimates which are available by n C es v h r se t a e M n o s n a rd d r l o e M f e e G s r w s s Lyman a a P s than "Well" (%) r h m c u C r a r u c a h P h k a n h i s P Lisbon Bethlehem e c Sugar Beans r census tract and updated annually u Grant P Hill Cutts s Grant t Map shows census tracts by n Housing / Transportation: Bath Franconia e Jackson g th H r

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d S • Flag tracts where measure is above 90 percentile for NH Landaff r l t e s y s

L number of unusually vulnerable P Easton o u r 12 Large apt. bldgs, housing units 10 or more per building (%) c c h a a

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th n Conclusion: Bartlett measures (exceeding the 90 Haverhill Lincoln

H 13 Mobile homes, percent of housing units (%) Livermore a l Benton e s • Identifies areas where population may be at increased risk for poor health percentile within NH). Woodstock Conway 14 Crowding, housing units with more than one person per Piermont Albany • Has the ability to examine single vulnerability measures which is Warren Waterville Valley As an example, Of the 292 Thornton Madison room (%) Eaton important for interpretation Orford Ellsworth populated census tracts, 63 of Wentworth Tamworth 15 No vehicle, households with no vehicle available (%) Sandwich Rumney Campton Freedom these are above the 90 th Lyme 16 Group Quarters, population living in group quarters (%) Dorchester Holderness Effingham Groton Plymouth Ash Ossipee Moultonborough percentile in 3 or more Hanover la n or d rb Introduction Hebron Ha r er te Canaan t en wa C Tuftonboro ge vulnerability characteristics. id Orange Br Meredith Lebanon

Alexandria Wa Bristol Wolfeboro Hampton Enfield B k e These tracts contain about r o Vulnerability is the extent to which people are likely to be affected f New i Laconia o e Conclusions Grafton k l d f i Plainfield Gilford e l d m (Flanagan, 2011). 256,000 people or 19.5% of a Danbury Hill Sanbornton h t n N n o a e t r e G Springfield Alton w l d F D id The Social Vulnerability Index (SVI) is a useful tool for emergency Cornish r a Tilton Belmont u M the NH 2010 population. Wilmot n r h k Croydon Andover l a i There are many social characteristics that have been logically and in m Milton n Gilmanton New London Northfield preparedness and public-health planning. It helps identify e

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p a Salisbury some cases empirically connected to human vulnerability. Claremont n Newport u Farmington S B Canterbury Barnstead demographic groups and geographic locations with higher o Sutton s c a Loudon Newbury w e Rochester Knowledge of social vulnerability characteristics can help Unity Webster n Strafford Goshen r vulnerability to environmental and public health hazards. Pittsfield n te w Warner s o e t h Somers- s ic worth le h in public health, especially in emergency preparedness. r Bradford C a Lempster Rollins- h Acworth Concord ford C Epsom Barrington An overall social vulnerability index has some usefulness in Northwood e Hopkinton k M Dover ro ad Henniker b bu Washington m ry Social vulnerability impacts a population’s response in all n Hillsborough e w Langdon P to identifying locations with populations having generally higher s Marlow W n Deerfield i Bow lle Durham n A Nottingham Alstead d Lee s n o to r g phases of disaster management: Hooksett in New Castle Dunbarton w Weare e h vulnerability to environmental hazards. Stoddard Deering N t Newmarket G u Candia re o Walpole Gilsum Antrim Raymond Epping e m n ts la r Newfields m n o n d P o a t Surry g th Sullivan n Goffstown • Mitigation: reducing the potential risk i M a n a d r n n t Rye e Francestown New Boston c o Using annually updated measures from the American Community h o S Nelson B North es Auburn tw Exeter ter n Hancock Chester Fremont re Hampton ry G B u re b e S K H Westmoreland Keene x nf a e a Hampton o ie h nd K E n m ld g n in a s F p Survey facilitates ease of maintaining an up-to-date and useful SVI. • Preparedness: getting plans and resources ready R Harrisville o i a M u w o g s n t t g ll o h o n s t s n a r Bedford L s t to r g o Mont o g o n l u n b b n H Danville n o i o r e d am Dublin d Vernon p K Se r o o Derry s outh ab M r o b n n te S ton oo y L a p k Chesterfield u r d d n am e o H g e L i e t t t P h e r c w Swanzey Amherst r r la h r P i e • Response: protecting and rescuing m y This iteration of the SVI is an exercise designed to test a f is N i At e k a to H ins c l o i Jaffrey Wilton d n w n Troy k s d Sharon Milford a Windham l Temple e methodology that will lead to an index useful to NH planners. It Winchester G Salem

r e • Recovery: rebuilding B Richmond e r n Hudson Fitzwilliam o v Rindge o Hollis New Ipswich i Nashua l Mason l k e l i Pelham n should not be used to infer conclusions about NH communities. A social vulnerability index (SVI) and measures can help: e Because most health and safety concerns have different sensitivity • Program planning and performance Allenstown, NH May, 2006 Flood Source: American Community Survey 2008-2012 5 year estimates. to social vulnerability characteristics planners and policy makers • Health and social service agency budgeting and policy Census tracts ranked for each measure across New Hampshire. need to access and consider the component measures. • Engage community organizations in emergency preparedness The SVI is not a substitute for qualitative experts especially those NH hazard events include: floods, forest fires, power outages, cold familiar with local areas and populations. The SVI is best used as a weather, winter storms starting point for discussion and not the basis for conclusions. Limitations References Acknowledgments

The research literature is not in agreement on which social vulnerability • Flanagan, B.E., Gregory, E.W., Hallisey, E.J., Heitgerd, J.L., and Lewis, B. (2011). A Project support: NH Environmental Public Health Tracking program: measures are most relevant or on their correlation with health outcomes. social vulnerability index for disaster management. Journal of Homeland Security and John Colby, PhD Emergency Management: Vol. 8: Iss. 1, Article 3. Some population groups, such as college students, have unique • U.S. Census Bureau. American Community Survey. http://www.census.gov/acs/www/ This work was funded by the CDC Environmental Public Health characteristics that cause anomalies in the measures requiring careful • CDC/ATSDR The Social Vulnerability Index (SVI) http://svi.cdc.gov Tracking Program (Grant: 1U38EH000947-01) interpretation. • Cutter, S.L., Boruff, B.J., Shirley, W.L. (2003). Social vulnerability to environmental For more information contact: Dennis Holt at: Some measures, such as minority status, are more relevant to some NH hazards. Social Science Quarterly 84(2):242-261. [email protected] or Phone: 603 271-8990 communities than others. Additional bibliography available upon request.