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Int. J. Environ. Res. Public Health 2019, 16(3), 380;

Health Vulnerability Index for Disaster Risk Reduction: Application in Belt and Road Initiative (BRI) Region

Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response (CCOUC), JC (Jockey Club) school of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China
Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
François-Xavier Bagnoud Center for Health & Human Rights, Harvard University, Boston, MA 02138, USA
Institute of Mountain Hazards and Environment, Chinese Academy of Science, Chengdu 610041, China
Author to whom correspondence should be addressed.
Received: 27 December 2018 / Revised: 23 January 2019 / Accepted: 25 January 2019 / Published: 29 January 2019
(This article belongs to the Special Issue Health-Related Emergency Disaster Risk Management (Health-EDRM))
PDF [2745 KB, uploaded 29 January 2019]


Despite the importance of health vulnerability in disaster risk assessment, most of the existing disaster vulnerability indicators only emphasize economic and social vulnerability. Important underlying health risks such as non-communicable disease are not included in vulnerability measures. A three-phase methodology approach was used to construct a disaster risk model that includes a number of key health indicators which might be missing in global disaster risk analysis. This study describes the development of an integrated health vulnerability index and explains how the proposed vulnerability index may be incorporated into an all-hazard based disaster risk index in the Belt and Road Initiative (BRI), also known as the “Silk Road Economic Belt”, region. Relevant indicators were identified and reviewed in the published literature in PubMed/Medline. A two-stage dimension reduction statistical method was used to determine the weightings of relevant dimensions to the construction of the overall vulnerability index. The proposed final health vulnerability index included nine indicators, including the proportion of the population below 15 and above 65 years, under-five mortality ratio, maternal mortality ratio, tuberculosis prevalence, age-standardized raised blood pressure, physician ratio, hospital bed ratio, and coverage of the measles-containing-vaccine first-dose (MCV1) and diphtheria tetanus toxoid and pertussis (DTP3) vaccines. This proposed index, which has a better reflection of the health vulnerability in communities, may serve as a policy and implementation tool to facilitate the capacity-building of Health-Emergency Disaster Risk management (Health-EDRM). View Full-Text
Keywords: Health vulnerability; Health-EDRM; disaster risk; Silk Road Economic Belt; map; Belt and Road Initiative Health vulnerability; Health-EDRM; disaster risk; Silk Road Economic Belt; map; Belt and Road Initiative

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Chan, E.Y.Y.; Huang, Z.; Lam, H.C.Y.; Wong, C.K.P.; Zou, Q. Health Vulnerability Index for Disaster Risk Reduction: Application in Belt and Road Initiative (BRI) Region. Int. J. Environ. Res. Public Health 2019, 16, 380.

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