Report Launch: The World Risk Report 2013 – Health and Healthcare

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  • 2014•03•28     Bonn

    When do extreme weather events such as floods, heat waves and hurricanes turn into a disaster claiming tens of thousands of lives and millions of dollars in damage?

    Whether or not populations become victims of extreme events depends not only on the magnitude or frequency of natural events such as floods or storms, but also on a country’s social, economic, ecological and institutional characteristics, which determines a populations’ vulnerability.

    The 2013 World Risk Index (WRI 2013) is calculated by the United Nations University for Environment and Human Security (UNU-EHS) and featured in the 2013 World Risk Report (WRR 2013) published by the Alliance Development Works/Bündnis Entwicklung Hilft (BEH). The report systematically considers a country’s vulnerability, and its exposure to natural hazards to determine a ranking of countries around the world based on their disaster risk. This edition focuses on health and healthcare as decisive factors in determining the extent of harm countries will experience in the wake of a natural hazard. The research focus on health was supported by the University of Bonn and the 2013 edition was financially supported by the “Stiftung Umwelt und Entwicklung Nordrhein-Westfalen.”

    The World Risk Index: A worldwide ranking of natural disaster risk

    The WRI, developed by UNU-EHS and BEH, is the main feature of the WRR and determines the risk of becoming a victim of a disaster as a result of vulnerability and natural hazards such as earthquakes, storms, floods, droughts and sea level rise for 173 countries worldwide. The WRI is based on 28 indicators and research data which are globally freely available and results in a global risk ranking and maps which allow for comparison between countries. Risk is at its highest where a high level of exposure to natural hazards coincides with very vulnerable societies.

    If a person lives in the Netherlands and their relative lives in Bangladesh, which of them is more likely to be negatively affected by a natural hazard? Both are low lying countries that are facing sea level rise and have a similar level of exposure, but according the to the WRI 2013 the person living in Bangladesh (ranked 5th on the index) is much more likely suffer harm than his relative living in the Netherlands (ranked 46th) due to a higher vulnerability in Bangladesh compared to the Netherlands.

    The risk hotspots in the WRI 2013, as in previous years, are in Oceania, Southeast Asia, Central America and the Southern Sahel. In the current report the Pacific Island nation of Vanuatu has the highest risk, followed by the Polynesian state of Tonga and the Philippines. On the other end of the spectrum lies Malta and Qatar whose populations are the least likely to be victims of natural hazards. This is due to Vanuatu, Tonga and the Philippines having higher exposure to natural hazards compared to Malta and Qatar but also based on different vulnerability patterns in those countries. For example only 57 per cent of the people in Vanuatu have access to improved sanitation compared to Qatar where everyone has access. In addition there is a discrepancy in the adult literacy rate, where 96 per cent of the adults in Qatar are able to read and write compared to 82 per cent in Vanuatu.

    By multiplying exposure by vulnerability, researchers determined a specific country’s risk. The calculation is made up of four components: exposure to natural hazards (including frequency) and vulnerability encompassed by: susceptibility, coping and adaptation. Exposure refers to when populations are exposed to the impacts of natural hazards. Susceptibility is the likelihood of being harmed if a natural hazard occurs. Coping refers to the ability of societies to minimize the negative impacts of natural hazards through direct actions and resources. Finally, adaptation is a more long-term process that involves structural changes and strategies to better deal with the negative impacts of natural hazards (e.g. improved literacy and gender equity).

    As the WRI is recalculated every year with updated indicators, key social, political, economic and environmental events that occur around the world are also reflected in changes in WRI ranking. For instance, the civil war in Libya, and the effect of the global economic crisis on Greece, have all resulted in higher risk values for these countries. This arose from a decline in the governance indicators, such as the Corruption Perception Index and the Failed State Index. For instance, Libya has fallen about 61 ranks in the Failed State Index.

    Health and healthcare: Decisive factors in risk assessment 

    The 2013 report pays special attention to the effects of the global financial crisis on health systems worldwide. Health care services are increasingly being subjected to economic pressures. This is likely to widen health inequality as it is often the most vulnerable in society who suffer most from austerity and privatization measures. This could be represented through the impacts of comparable flooding in Pakistan 2010 and Germany 2012, which caused 1760 fatalities in Pakistan and 8 in Germany. The crucial factor is the lower vulnerability in Germany compared to Pakistan, which can be partially explained by a higher number of physicians per 10000 inhabitants (Germany: 37 and Pakistan: 8), a higher number of hospital beds per 10000 inhabitants (Germany: 83 and Pakistan: 6) and more money spent on public health care per person (Germany: 3316 USD and Pakistan: 18 USD).

    The effects of the global economic crisis on healthcare is also being felt in more developed countries such as Greece, which has cut their health budget by almost half, leading to a lack of medicine and dressing material, an exodus of health specialists and increased influenza mortality.

    The WRR 2013 also highlights the importance of the availability of clean water, sanitary infrastructure and hygiene (WASH) as crucial health and disease factors. While there are nearly no deaths from diarrheal related diseases in a country such as Germany, worldwide diarrheal diseases cause 1.4 million deaths a year among children. The report stresses that it is especially preventable infectious diseases that have the most disastrous impacts on a vulnerable society’s health.

    Insufficient access to healthcare and prevention programs, under-developed health promotion and a lack of infrastructure for the provision of clean water and sanitation pose a constant risk to societal well-being; however, during or after a natural hazard event the effects can be disastrous.

    The way forward

    By mapping the vulnerability of countries to natural hazard exposure, the WRI offers a new approach to risk assessment, which can helpimprove both policies and practices of disaster risk reduction. The interactions between exposure to natural hazards and components of vulnerability,such as susceptibility, coping capacities and adaptive capacities  point to the urgent need to link disaster relief, disaster risk reduction, development strategies and policies more closely with each other. Hurricanes cannot be prevented, but vulnerability tothem can be reduced.

    For more information, please visit the official World Risk Report website here.