Abstract
The concept of vulnerability is delimited by dynamic social and multigenerational processes involving at least three dimensions: exposure to risk trajectories, internal and external capabilities of reaction and possibilities of adaptation based on both the intensity of risk and the resilience of people. In order to identify and describe the synthetic indices of vulnerability, there was an integrative literature review. We consulted free access articles indexed in the following databases: BioMed, Bireme, PubMed, Reldalyc, SciELO and Web of Science; and we used controlled descriptors in English and Portuguese for all time slots available with selection and analysis of 47 studies that reported results of 23 synthetic indices of vulnerability. The results showed that the synthetic indices of vulnerability address four themes: social determinants of health; environmental and climatic conditions; family and course of life; territories and specific geographic areas. It was concluded that the definition of the components and indicators, as well as the methodologies adopted for the construction of synthetic indices need to be evaluated by means of the limitations and advantages of reporting the vulnerability through summary measures in policy formulation and decision-making aimed at human development.
Key words
Vulnerability Analysis; Risk
Resumo
O conceito de vulnerabilidade é delimitado por processos sociais dinâmicos e multigeracionais que envolvem pelo menos três dimensões: exposição a trajetórias de riscos, capacidades internas e externas de reação e possibilidades de adaptação baseada tanto na intensidade do risco quanto na resiliência das pessoas. Com o objetivo de identificar e descrever os índices sintéticos de vulnerabilidade, realizou-se uma revisão integrativa de literatura. Foram consultados artigos de acesso livre indexados nas bases de dados Bio-Med, Bireme, PubMed, Reldalyc, SciELO e Web of Science, com utilização de descritores controlados nos idiomas inglês e português, para todos os intervalos temporais disponíveis, com seleção e análise de 47 estudos que apresentaram resultados de 23 índices sintéticos de vulnerabilidade. Os resultados apontaram que os índices sintéticos de vulnerabilidade abordam 4 categorias temáticas: determinantes sociais de saúde; socioambiental e condições climáticas; família e curso da vida; territórios e espaços geográficos específicos. Concluiuse que a delimitação dos componentes e indicadores, bem como das metodologias adotadas para a construção dos índices sintéticos precisam ser avaliados mediante as limitações e vantagens em retratar a vulnerabilidade por meio de medidas resumo na formulação de políticas e nas tomadas de decisão visando ao desenvolvimento humano.
Palavras-chave
Análise de Vulnerabilidade; Risco
Introduction
In recent decades, the term vulnerability has been used in studies expressing the multidimensionality of a concept under construction that is employed in several fields of knowledge and can highlight areas such as natural and social life sciences, especially in the area of geography, demography, economy, health and bioethics. The diversity of disciplinary approaches and the polysemy definition provide a wide use of the term vulnerability, which acquires specific boundaries depending on the area in which it is used, but risks losing meaning by its indiscriminate use in a broad spectrum of approaches without a theoretical and conceptual delimitation.
Concerning the different forms of usage of the term vulnerability, Gallopín11 Gallopín GC. Linkages between vulnerability, resilience, and adaptive capacity. Global Environmental Change 2006; 16(3):293-303. states that this plurality of definitions possibly occurs due to the different needs of disciplinary fields and it may be a reflection of the different intellectual traditions, which ultimately does not produce implementation and communication interfaces in all disciplines.
Synthetic indicators are measures-syntheses used to understand a particular social reality or dimensions of the social world and can be applied in relation to population development dynamics, spaces and environments. According to Neto et al.22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas], these measures came to have greater expression in Brazil during the 90s, a time when several indicators have emerged in the country in order to understand the social reality through a single measure, achieved by the combination of multiple quantifiable analytical measurements of their dimensions. Increasingly, indicators of social welfare, such as the Human Development Index (HDI) developed by the United Nations Development Program, are now used by researchers and public administrators. Jannuzzi33 Jannuzzi PM. Indicadores para Diagnóstico, Monitoramento e Avaliação de Programas Sociais no Brasil. Rev Serviço Público 2005; 56(2):137-159. lists a group of synthetic indicators, not necessarily involved with the issue of vulnerability, but which were developed in Brazil by researchers from universities, government agencies and research centers; they are: i) Municipal Human Development Index (HDI) and Municipal Life Conditions Index (LCI), of the João Pinheiro Foundation, MG; ii) Municipal Quality Index - green, Municipal Quality Index - needs, Municipal Quality Index - housing needs and Municipal Quality Index - fiscal sustainability, of the CIDE/RJ Foundation; iii) Paulista Social Responsibility Index (PSRI), Youth Vulnerability Index (YVI) and Paulista Social Vulnerability Index (PSVI), of the SEADE/SP Foundation; iv) Expanded Municipal Social Index (EMSI), of the Economics and Statistics Foundation, RS; v) Social Development Index (SDI) and Economic Development Index (EDI), of the Superintendence of Economic and Social Studies of Bahia (SEI/BA); vi) Urban Life Quality Index (ULQI) and Social Vulnerability Index (SVI), of the Municipality of Belo Horizonte/PUC Minas/MG; and vii) Municipal Indicator of Educational Development (MIED) of INEP, Cedeplar and NEPO.
These instruments are presented as facilitators to meet the information demands for policy-making, for decision-making in public spheres, for dissemination of the synthetic results by the media, as well as the dissemination of the culture of indicators’ use in the agreements of the agendas of national and global public policies.
Considering the boost given to the construction of synthetic indicators, the question posted by Neto et al.22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas] expresses the possibility of extending the use of these tools: if the HDI, synthesizing only three dimensions of social reality, seems to be an indisputable measure to monitor the social progress of countries in the eyes of great part of the media and managers - or rather, human development in the countries - and work as an instrument to mark the distribution of international aid resources, why not develop a composite indicator of a larger set of proxies of the social world and enhance its use as a broader assessment tool of public action and as a global allocation criterion of the public spending in the country?22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas]
However, despite the increased use of synthetic indicators, some researchers have doubts in terms of the potential of these quantitative measurement instruments and situations and moments of decision-making within the cycle of public policies in which they should be applied. While some researchers consider it easier to make a decision using a measurement-synthesis than considering a wide range of indicators that may not point priorities22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas], there are those who believe that a system of synthetic indicators would be more useful for establishing diagnoses and intervention plans22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas].
This study aims to describe, in national and international literature, the proposed synthetic indicators involved with the issue of vulnerability.
Methodology
The integrative review was guided by the question “What are the indicators of vulnerability related to social issues presented in scientific studies and how they are built?” Using the keywords “vulnerability indicator”, “Vulnerability Index” and “Vulnerability Analysis”, on April 1, 2014, the articles available in international and national literature indexed in the following databases were consulted: BioMed, Bireme, PubMed, Redalyc, SciELO and Web of Science.
Each database has its access capabilities. Therefore, it was necessary to adopt a strategic search for the articles according to the specificity of each database. For inclusion criteria only access free articles written in Portuguese and English were considered.
When selecting data 212 articles were found. This number was reduced to 47 after deleting 77 repeated articles, excluding 80 articles that did not mention or only briefly mentioned a synthetic indicator of vulnerability without describing it as well as 8 articles that did not meet the inclusion criteria. The details of the selection process of the articles are shown in Table 1 according to each database.
Results
A total of 47 articles were selected and 23 synthetic indices were identified;
they are: i) Environmental Vulnerability Index (EVI)44 Zanella ME, Olímpio JL, Costa MCL, Dantas EWC. Vulnerabilidade
Socioambiental do Baixo Curso da Bacia Hidrográfica do Rio Cocó,
Fortaleza-CE. Sociedade & Natureza 2013; 25(2):
317-331. - Zanella et al., 2013; ii) Vulnerability Index
of Families from Paraná (IFPR)55 Instituto Paranaense de Desenvolvimento Econômico e Social
(IPARDES). Índice de Vulnerabilidade das Famílias Paranaenses:
Mensuração a partir do Cadastro Único para Programas Sociais
– CadÚnico. Curitiba: IPARDES; 2012. Nota
técnica. - Secretariat of State for Family and Social Development of
Paraná (SEDS)/Paraná Institute for Economic and Social Development
(IPARDES), 2012; iii) Social Vulnerability Index (SVI)66 Huang G, London JK. Cumulative Environmental Vulnerability and
Environmental Justice in California's San Joaquin Valley. Int J
Environ Res Public Health 2012; 9(5):1593-1608. - Huang and London, 2012; iv) Municipal
Vulnerability Index (MVI)77 Freitas MIC, Cunha L. Cartografia da vulnerabilidade socioambiental:
convergências e divergências a partir de algumas experiências em
Portugal e no Brasil. Rev Brasileira de Gestão Urbana
2013; 5(1):15-31. -
Fiocruz, 2011; v) Family Vulnerability Index to Disability and Dependency
(IVF-ID)88 Amendola F, Alvarenga MRM, Gaspar JC, Yamashita CH, Oliveira MAC,
Validade aparente de um índice de vulnerabilidade das famílias a
incapacidade e dependência. Rev Esc Enferm USP 2011;
45(Esp. 2):1736-1742.,99 Amendola F, Alvarenga MRM, Latorre MRDO, Oliveira MAC.
Desenvolvimento e validação do índice de vulnerabilidade de
famílias a incapacidades e dependência (IVF-ID). Rev Esc
Enferm USP 2014; 48(1):82-90. -Amendola et al., 2011; vi)
Social and Environmental Vulnerability Index (SEVI)77 Freitas MIC, Cunha L. Cartografia da vulnerabilidade socioambiental:
convergências e divergências a partir de algumas experiências em
Portugal e no Brasil. Rev Brasileira de Gestão Urbana
2013; 5(1):15-31.,1010 Almeida LQ. Por uma ciência dos riscos e vulnerabilidades na
geografia. Mercator - Rev Geografia da UFC 2011;
10(23):83-99.
-Almeida, 2010; vii) Social Vulnerability Index (SVI)1111 Szlafsztein C, Marques O, Maia H, Prette M, Fischenich P, Altieri F.
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Naturais na Amazônia: Mapeando as vulnerabilidades.
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Environment/German Technical Cooperation (GTZ), 2010; viii) Heat Vulnerability
Index (HIV)1212 Reid CE, O’Neill MS, Gronlund CJ, Brines SJ, Brown DG,
Diez-Roux AV, Schwartz J. Mapping Community Determinants of Heat Vulnerability.
Environ Health Perspect 2009;
17(11):1730-1736.,1313 Reid CE, Mann JK, Alfasso R, English PB, King GC, Lincoln RA,
Margolis HG, Rubado DJ, Sabato JE, West NL, Woods B, Navarro KM, Balmes JR.
Evaluation of a Heat Vulnerability Index on Abnormally Hot Days: An
Environmental Public Health Tracking Study. Environ Health
Perspect 2012; 120(5):715-720. - Reid et al, 2009;. xix) Youth Vulnerability
Index to Violence (YVI-Violence)1414 Brasil. Ministério da Justiça (MJ). Projeto
Juventude e Prevenção da Violência – Primeiros
resultados. Brasília: MJ; 2009.,1515 Pereira NA. Ministério da Justiça. Fórum Brasileiro
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(SVI)1616 Andrew MK, Mitnitski AB, Rockwood K. Social Vulnerability, Frailty
and Mortality in Elderly People. Plos One 2008;
3(5):e2232. -Andrew et
al., 2008; xi) Social Vulnerability Index (SVI)1717 Fekete A. Validation of a social vulnerability index in context to
river-floods in Germany. Nat. Hazards Earth Syst. Sci. 2009;
9:393-403. - Fekete, 2008; xii) Family Social
Vulnerability Index (FSVI)1818 Leite LO. Índice de Vulnerabilidade Social Familiar e os
Sistemas de Informações para sua Gestão: Estudo de Caso na
Prefeitura Municipal de Curitiba. In: XIII SEMEAD Seminários em
Administração; 2010; São Paulo.,1919 Neri MC. Parecer sobre o Índice de Vulnerabilidade
Social das Famílias Curitibanas. São Paulo:
Fundação Getúlio Vargas; 2011. - Municipal Government of
Curitiba/Institute of Urban Research and Planning of Curitiba (IPPUC)/Social
Action Foundation (FAZ), 2008; xiii) General Vulnerability Index (GVI)2020 Tibúrcio LH, Corrêa MP. Análise da vulnerabilidade da
Microrregião de Itajubá por meio do IVG com vistas à
mitigação dos impactos causados pelas mudanças climáticas.
Ambiente & Sociedade 2012;
15(3):123-139. - Ministry of Science and
Technology (MCT)/Fiocruz, 2007; xiv) Family Development Index (FDI)2121 Barros RP, Carvalho M, Franco S. Índice de
desenvolvimento da família (IDF). Rio de Janeiro: IPEA; 2003.
Texto para discussão Nº 986. - Barros et al./IPEA, 2003;
xv) Social Vulnerability Index of Children and Adolescents of the Greater Porto
Alegre (SVI -IJ)2222 Prefeitura Municipal de Porto Alegre. Índice de
Vulnerabilidade Social Infanto-Juvenil da Grande Porto Alegre.
Porto Alegre: Prefeitura de Porto Alegre; 2003. - Municipal
Government of Porto Alegre, 2003; xvi) Youth Development Index (YDI)2323 Waiselfisz JJ. Relatório de desenvolvimento juvenil
2003. Brasília: Unesco; 2004.,2424 Waiselfisz JJ. Relatório de desenvolvimento juvenil
2007. Brasília: Rede de Informação Tecnológica
Latino-Americana (RITLA), Instituto Sangari, Ministério da Ciência e
Tecnologia (MCT); 2007. -Unesco, 2003; xvii) Social Vulnerability Index (SoVI)
7,25,26 - Cutter et al., 2003; xviii) Youth Vulnerability Index (YVI)2727 Ceschini FL, Florindo AA, Benício MHDA. Nível de atividade
física em adolescentes de uma região de elevado índice de
vulnerabilidade juvenil. Rev Brasileira de Ciência e
Movimento 2007; 15(4):67-78.,2828 Borelli E. Vulnerabilidades sociais e juvenil nos mananciais da zona
sul da cidade de São Paulo. Rev Katálysis 2012;
15(1):62-69. - Seade Foundation, SP, 2002; xix) Social Vulnerability
Index of São Paulo (SVI-SP)77 Freitas MIC, Cunha L. Cartografia da vulnerabilidade socioambiental:
convergências e divergências a partir de algumas experiências em
Portugal e no Brasil. Rev Brasileira de Gestão Urbana
2013; 5(1):15-31.,1010 Almeida LQ. Por uma ciência dos riscos e vulnerabilidades na
geografia. Mercator - Rev Geografia da UFC 2011;
10(23):83-99.,2929 Ferreira MP, Dini NP, Ferreira SP. Espaços e Dimensões da
Pobreza nos Municípios do Estado de São Paulo. Índice Paulista de
Vulnerabilidade Social – IPVS. São Paulo em
Perspectiva 2006; 20(1):5-17.–3535 Ferreira MP. Índice Paulista de Vulnerabilidade
Social. São Paulo: Fundação SEADE;
2013. - Seade Foundation, SP, 2000; xx) Social
Vulnerability Index of Amazonas (SVI-AM)3636 Amazonas. Secretaria de Estado de Planejamento e Desenvolvimento
Econômico do. Índice de Vulnerabilidade Social do
Amazonas.[acessado 2014 jun 17]. Disponível em:
http://www.ivs.am.gov.br/oivsam.php
http://www.ivs.am.gov.br/oivsam.php...
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Development, 2000; xxi) Social Vulnerability Index (SVI)3737 Nahas MIP. Metodologia de construção de índices e
indicadores sociais, como instrumentos balizadores da gestão municipal da
qualidade de vida urbana: uma síntese da experiência de Belo
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Traits, and Sleep Bruxism in Brazilian School Children – A
Population-Based Cross-Sectional Study. Plos One 2013;
8(11):e80075. - Municipal Government of Belo Horizonte/PUC
Minas, 1999; xii) Chronic Vulnerability Index (CVI)4646 Burg J. Measuring populations’ vulnerabilities for famine and
food security interventions: the case of Ethiopia's Chronic Vulnerability
Index. Disasters 2008; 32(4):609-630. - Early Warning Working Group, 1999; and
xxiii) Health Vulnerability Index (HVI)4747 Pessanha JEM, Caiaffa WT, Kroon EG, Proietti FA. Dengue em três
distritos sanitários de Belo Horizonte, Brasil: inquérito
soroepidemiológico de base populacional, 2006 a 2007. Rev Panam
Salud Publica 2010; 27(4):252-258.–5252 Pitchon A. Índice de Vulnerabilidade da Saúde
2012. Belo Horizonte: Prefeitura de Belo Horizonte;
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Municipal Health Department of Belo Horizonte, 1998.
Predominantly, the articles presented a quantitative approach through the use of statistical techniques. The studies examined both the primary data collected through field research, and secondary data from bases such as IBGE, SIM, Sinasc and municipal governments.
Regarding the origin of publications, most of the studies were published in Brazilian magazines and presented analyzes obtained in the Brazilian territory. However, we have also identified Brazilian articles in international journals and researches on the vulnerability of processes found in other countries such as Canada, USA, Ethiopia, Germany and Romania.
Charts 1 to 4 show the total number of selected indexes classified into four thematic categories depending on their prevailing approach: synthetic indices of vulnerability from the perspective of social determinants of health; social and environmental and climatic conditions; family and the life course; and a territory and specific geographic areas.
Vulnerability synthetic indices under a socioenvironmental perspective and climatic conditions.
Vulnerability synthetic indices from the perspective of a territory and specific geographic areas.
Discussion
In relation to the thematic categorization of synthetic indices described in the literature, as proposed in this article, it is important to mention that some of the areas present a certain level of overlap. All identified indexes treated, to some extent, the factors related to quality of life, the social determinants of life and interaction with the environment. The thematic division presented was based on the specific focus adopted, but it is not intended to limit the potential application for the other areas and it is recognized that the population, space, territory and territoriality are inseparable dimensions.
The vulnerability from the perspective of social determinants of health was represented by two indices, the HVI and the SVI. The HVI aimed to describe the sensitivity of the community to the challenges of health and resources to mitigate the negative health impacts caused by environmental risks. Among the variables discussed in this index we observed: location of health facilities, poverty rate, education, linguistic isolation, race/ethnicity and age. As a data source, researchers used the Cal-Atlas website to get the information from places with facilities for health care. And, for the calculation of the indicators, we considered the data of persons in a radius of one mile of the health unit.
The SVI is a composite indicator that analyzes the characteristics of population groups living in census tracts through socioeconomic and sanitation variables. Based on the Census data, the index evaluated the percentage of permanent households with water supply, sewage and destination of inadequate or absent garbage; the ratio of household members; the percentage of illiterate persons; the percentage of private households with per capita income up to ½ a minimum wage; the average monthly nominal income of the persons responsible; and the percentage of people of different races or mixed skin color, black or indigenous.
The HVI was used in many studies as a tool for the identification of people who are in vulnerable processes. We analyzed various population groups, such as people who contracted dengue4747 Pessanha JEM, Caiaffa WT, Kroon EG, Proietti FA. Dengue em três distritos sanitários de Belo Horizonte, Brasil: inquérito soroepidemiológico de base populacional, 2006 a 2007. Rev Panam Salud Publica 2010; 27(4):252-258., elderly4848 Braga LS, Macinko J, Proietti FA, César CC, Costa MFL. Diferenciais intra-urbanos de vulnerabilidade da população idosa. Cad Saude Publica 2010; 26(12):2307-2315., people with functional limitations4949 Frichel AAL, César CC, Caiaffa WT. Fatores associados à limitação funcional em Belo Horizonte, MG. Rev Med Minas Gerais 2011; 21(4):396-403., people who are overweight or have obesity problems5050 Mendes LL, Nogueira H, Padez C, Ferrao M, Velasquez-Melendez G. Individual and environmental factors associated for overweight in urban population of Brazil. BMC PublicHealth 2013; 13:988., and cases of perinatal mortality5151 Martins EF, Rezende EM, Almeida MCM, Lana FCF. Mortalidade perinatal e desigualdades socioespaciais. Rev. Latino-Am. Enfermagem 2013; 21(5):1070-1070..
The vulnerability under the social and environmental approach and climatic conditions was composed of five indices. The SVI, SEVI and HVI indexes emphasize the social and environmental conditions. After the construction of SEVI and SVI the spatial distribution of the values found was made to form the social and environmental maps. The crossing of these two maps and the values of each index through a matrix allowed a better understanding of the situation of a particular locality.
In relation to climate conditions we present the MVI and the GVI. The MVI is the result of the aggregation of two other indices: the CCI and the GVI. The CCI addresses the projected climate anomalies and the GVI, which differs from the second index of this dimension, is made up of health, environmental, social and family components. However the GVI, of the Ministry of Science and Technology (MST) and Oswaldo Cruz Foundation (Fiocruz), aggregates by means of arithmetical average the results of three other indices: socioeconomic (SEVI), epidemiological (EVI) and the climatological (CVI). Thus, we understand that the GVI is a composite index that combines different variables and assigns to each place a comparative measure regarding its vulnerability to climate changes anticipated in the coming decades2020 Tibúrcio LH, Corrêa MP. Análise da vulnerabilidade da Microrregião de Itajubá por meio do IVG com vistas à mitigação dos impactos causados pelas mudanças climáticas. Ambiente & Sociedade 2012; 15(3):123-139..
The vulnerability under the family perspective and course of life was represented by nine indices, IVFPR, FVI-ID, YVI-Violence, FSVI, HVI, FDI, HVI - IJ, YDI and YVI.
Analyzing the four measures directed to the family, the concern of researchers in terms of not to limiting the vulnerability assessment to income analysis is noticeable. The FVI-PR is represented by 19 component indicators, divided into four dimensions: adequacy of the home; profile and composition of the family; access to work and income; and schooling conditions. The FDI was built based on six aspects: e) lack of vulnerability; ii) access to knowledge; iii) access to work; iv) availability of resources; v) child development; and vi) housing conditions. The FDIID, which is an adaptation of the FDI, has added two other dimensions: social relationships and health condition. And FSVI portrays the characteristics of the home, education, occupation, income per capita and the number of children, adolescents and elderly.
The other indices of this theme category are directed to two specific population groups; four check the children's vulnerability condition; and one analyzes the situation of the elderly. For the first group we may highlight the YVI-Violence, the HVI - IJ, the YDI and YVI. For the group of elderly we have the HVI.
Among the main indicators associated with the children's group we have the homicide mortality rate of the male population between 15 and 19 years; death rate from accidents; participation of adolescent mothers aged 14 to 17 in the total number of live births; percentage of young people between 15 and 17 who do not attend school; percentage of young people aged 18 to 24 who do not study or work; and percentage of people with less than half the minimum wage per capita in terms of family income.
In the index associated with the elderly, however, the vulnerability is operationalized according to the deficit accumulation approach, comparing it to fragility. In this sense, the variables assessed in this index address different dimensions compared to other selected indices, such as the existence of a social support, participation in socially oriented activities and the realization of leisure activities.
The last theme category showed vulnerability from the perspective of a territory and was represented by seven synthetic indices. The most common variables in this category were related to schooling, occupation, income, demographic characteristics and sanitation.
The use of these summary measures requires an analysis of its strengths and limitations. According to Guimarães and Jannuzzi5353 Guimarães JRS, Jannuzzi PM. IDH, indicadores sintéticos e suas aplicações em políticas públicas. Rev Brasileira de Estudos Urbanos e Regionais (ANPUR) 2005; 7(1):73-90., it must be admitted that “the culture of using social indicators was certainly strengthened in Brazil, granting legitimacy to various kinds to Synthetic Indicators”. The motivation for the implementation of these measures is based on the opportunity to summarize multidimensional and complex issues, the possibility of interpreting compared results with the trend analysis of a social reality and the checking of the developments and of the reference unit chosen as dimensions for the monitoring of an individual's life course, living conditions in the households and living arrangements, as well as the social indicators of territories and environmental conditions.
Among the limitations22 Neto WJS, Jannuzzi PM, Silva PLNE. Sistemas de indicadores ou indicadores sintéticos: do que precisam os gestores de programas sociais. In: Anais do XVI Encontro Nacional de Estudos Populacionais; 2008; Caxambu. [informar as páginas],33 Jannuzzi PM. Indicadores para Diagnóstico, Monitoramento e Avaliação de Programas Sociais no Brasil. Rev Serviço Público 2005; 56(2):137-159.,5353 Guimarães JRS, Jannuzzi PM. IDH, indicadores sintéticos e suas aplicações em políticas públicas. Rev Brasileira de Estudos Urbanos e Regionais (ANPUR) 2005; 7(1):73-90.,5454 Araújo EM, Rocha EMP. Trajetória da sociedade da informação no Brasil: proposta de mensuração por meio de um indicador sintético. Ciência da Informação 2009; 38(3):9-20. pointed out to the use of synthetic indicators, however, we may include: i) the difficulty in gathering variables of various types and with different measurement scales in the construction of a model never before formalized; ii) the possibility of prioritizing erroneous decisions based on a mistaken and incorrectly designed model that favors bias of interpretation, or that is built without a theoretical framework. It is noteworthy that the results presented by these misguided models can provide simplistic and unidirectional understandings that hide important inequalities; iii) methodological clarity shortage of the steps required to build a synthetic indicator; and, iv) risk of replacement of the concept to be measured by the “reification” of the synthetic indicator.
Final Considerations
The literature review on indicators and methodologies adopted for the construction of synthetic indices evidences the existence of limitations to theoretically portray vulnerability.
An initial obstacle faced in the construction of these instruments is the difficulty of representing dynamic processes through quantitative and specific measures. It is essential that the index under development is based on a theoretical and conceptual basis, so that there is an adequate definition of what is to be measured and which evidences were used to support the choices in terms of dimensions and their components and indicators. In the case of vulnerability, in the face of its multiple approaches and process characteristics and not product characteristics, this is a complex task.
Another barrier in the index construction process is the unavailability of necessary information. Many studies end up working with alternative variables due to lack of reliable information that achieves the desired level of detail. There are situations where data does not exist or cannot be accessed, and there are also cases where it is the difficult to perform geoprocessing and disaggregation in municipal units, despite the availability of data. Given the choice of using primary data, there is also the difficulty regarding operational and budgetary cost of research, which can prevent a detailed search. In addition, researchers use their own data collection instruments that make it difficult to compare the results in other regions.
These limitations do not preclude the use of indices; however, they signal caution that researchers should have to propose a measure that is capable of assisting vulnerability assessment processes in a particular region or group of people. Among the advantages of using vulnerability indices are the systemic analysis capabilities. When it is possible to use data that characterize the census tracts, for example, researches benefit from promoting the analysis of the most disaggregated level of population and socioeconomic data already collected in a standardized, systematic and regular manner, and they have national coverage. This is a reality found between the IBGE data, such as the Census and the National Household Sample Survey (PNAD). In addition, this level of detail allows the analysis of data at different levels of aggregation, according to the research plan and it makes the implementation of specific actions for certain population groups easier.
The possibility of using statistical techniques for the selection of variables that make up the synthetic index also constitutes a favorable point in this process. However, it should be noted that the empirical knowledge of the researcher and the other people involved with the research in terms of the reality being portrayed should not be ruled out in this procedure. Rather it must be added to the evidence at the time of choice of the factors that make up the index, which will ensure greater credibility to the instrument.
The elaboration of maps, based on the results estimated by the index, is also a plus, since mapping favors the visualization of important aspects of vulnerability. Thus, it emphasizes the priority areas of intersectoral coordination of policies and facilitates the longitudinal monitoring and cycle monitoring of specific policies in the development of territoriality.
Finally, synthetic indices can be important tools in the active management of territories and public health. They facilitate the evaluation of public policies implemented, especially if its periodic update is possible. They also enable the proposition and the most appropriate orienting measures and programs aimed at populations who are in vulnerability processes and have their response capacities reduced in terms of the promotion, protection and maintenance of health. the most appropriate orienting measures and programs aimed at populations who are in vulnerability processes and have their response capacities reduced in terms of the promotion, protection and maintenance of health.
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Erratum
Ciência & Saúde Coletiva volume 20 número 7 – 2015p. 2105onde se lê/which reads:Lívia Amaral Schumannleia-se/reads up:Lívia Rejane Miguel Amaral Schumannp. 2016, 2108, 2110, 2112, 2114, 2116, 2118, 2120onde se lê/which reads:Schumann LAleia-se/ reads up:Schumann LRMAp. 2118onde se lê/which reads:LA Schumann>leia-se/reads up:LRMA Schumann
Publication Dates
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Publication in this collection
July 2015
History
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Received
28 July 2014 -
Reviewed
11 Sept 2014 -
Accepted
13 Sept 2014