Mujaheed Shaikh and co-researchers create vulnerability index to identify communities at risk in pandemic

Study in BMJ Open shows focusing on vulnerable communities can help mitigate threats to health systems.

A new study of the risk COVID-19 poses to health systems finds that communities where populations are ageing, underlying diseases are prevalent, and medical resources are lacking are more vulnerable to the adverse effects of a pandemic.

Using data from England’s Clinical Commissioning Groups (CCGs), the National Health Service’s delivery organisations, Hertie School Professor of Health Governance Mujaheed Shaikh and researchers from Oxford University, Bocconi University, the University of Birmingham, Brunel University and Università Ca’ Foscari Venezia created a community vulnerability index to assess communities across England. Risk factors considered in the study included the prevalence of high-risk diseases, the density of the at-risk population,the availability of medical staff and the quality of healthcare facilities.

According to their findings, 80% of CCGs in the highest quartile of vulnerability were located in the North of England (24 out of 30), where such issues are greater than in other parts of the country. Their paper, “Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability”, was published in BMJ Open, a publication of the British Medical Journal, in September.

“Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel,” the researchers write. “Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments.”

The researchers call for a stronger focus on such vulnerable communities in order to tackle future threats from widespread infectious disease. Attention until now has been directed mainly at lowering the rate of contagion, but identifying communities at greater risk can help health authorities tackle the problem more effectively, they say. 

“We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building,” the researchers say.

The paper was authored by Catia Nicodemo, Samira Barzin, Nicolo' Cavalli, Daniel Lasserson, Francesco Moscone, Stuart Redding and Mujaheed Shaikh.

You can access the paper here.

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