Vulnerability synthetic indices: a literature integrative
                    review

Schumann, Lívia Rejane Miguel Amaral; Moura, Leides Baroso Azevedo

doi:10.1590/1413-81232015207.10742014

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Review • Ciênc. saúde coletiva 20 (7) • July 2015 • https://doi.org/10.1590/1413-81232015207.10742014 copy

Vulnerability synthetic indices: a literature integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

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

Databases	Articles found	Excluded articles			Articles analyzed
Databases	Articles found	Repetition	Failure to submit a vulnerability index	Incompatibility of filter selection for articles	Articles analyzed
Biomed	23	0	16	2	5
Bireme	41	12	10	0	19
PubMed	50	25	23	2	0
Redalyc	37	3	16	1	17
Scielo	24	14	6	0	4
Web of Science	37	23	9	3	2
Total	212	77	80	8	47

Thematic category	Name of the Synthetic-index	Authors/institutions	Component Dimensions/indicators	reference Date
Vulnerability synthetic indices under the perspective of the Social Determinants of Health	Social Vulnerability Index (SVI)	Huang and London⁶6 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.	% of the area occupied by the blocks that are 1 mile distant of the health services; % of the population in poverty; % of people over 25 years without a high school diploma; % of families considered linguistically isolated (situation which occurs when the family does not have a member over 14 years of age who speaks fluent English); % of colored people (except non-Hispanic whites); % of the population under 5 years or over 60 of age.	2012
	Health Vulnerability Index (HVS)	Municipal Secretariat of Health of Belo Horizonte³⁵35 Ferreira MP. Índice Paulista de Vulnerabilidade Social. São Paulo: Fundação SEADE; 2013.–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 Horizonte. In: Hogan DJ, Baeninger R, Cunha JMP, Carmo RL, organizadores. Migração e Ambiente nas Aglomerações Urbanas. Campinas: Unicamp; 2001. p. 461-487.	> Sanitation: % of permanent households with inadequate or no water supply; % of permanent households with inadequate or no sanitation; % of permanent households with inappropriate or no waste destination. > Socioeconomic: Ratio of residents per household; % of illiterate persons; % of private households with per capita income up to ½ minimum wage; Average nominal monthly income of responsible individuals; % of people of mixed race / color, black or indigenous.	1998

Thematic category	Name of the Synthetic-Index	Authors/Institutions	Component Dimensions/Indicators	Reference Date
Vulnerability of synthetic indices under the socioenvironmental perspective and climatic conditions	Environmental Vulnerability Index (EVI)	Zanella et al.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.	> Synthetic Index of Social Vulnerability: Education: Women who are responsible and illiterate; Women who are responsible and uneducated or with up to three years of study; Literate men who are responsible for permanent private households; Men who are responsible for permanent private households with no education or with up to 3 years of study. Income: Women who are responsible without an income or with monthly income of up to 2 minimum wages; Men who are responsible for permanent private households with no income and nominal monthly income of up to 2 minimum wages. Housing quality: Permanent private housing units that do not have mains water supply, wells or springs on the property and plumbing in at least one room; Private households that do not have bathrooms or toilets connected to sewer or septic tank; Permanent households where there is no garbage collection by the cleaning services or bucket and no destination for garbage disposal. > Environmental Vulnerability Index: Geology Geomorphology Pedology Vegetation Cover Quality of urban infrastructure	2013
	Municipal Vulnerability Index (MVI)	Fiocruz⁷7 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.	General Vulnerability Index: > Health Vulnerability Index: Morbidity: Dengue, Leptospirosis and American Cutaneous Leishmaniasis Mortality from diarrhea in children under 5 years > Social Vulnerability Index of the Family: Family Structure Access to Knowledge Access to Work Availability of resources (income) Children and Youth Development Housing Conditions > Environmental Vulnerability Index: Native vegetation cover and regeneration Biodiversity Conservation Occurrence of extreme hydrometeorological events and victims Coastal Area	2011
Vulnerability of synthetic indices under the socioenvironmental perspective and climatic conditions	Social and Environmental Vulnerability Index (SEVI)	Almeida¹⁰10 Almeida LQ. Por uma ciência dos riscos e vulnerabilidades na geografia. Mercator - Rev Geografia da UFC 2011; 10(23):83-99.	> Social Vulnerability Index: Education; Infrastructure and housing; Presence of the elderly; and Presence of young people. > Physical-Spatial Vulnerability Index to Floods: Frequency of flooding events.	2010
	Heat Vulnerability Index (HVI)	Reid et al.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.	% of the population below the poverty line; % of the population that has not completed high school; % of the population of different color other than white; % of the population living alone; % of the population 65 years of age or older; % of the population aged 65 and over who live alone; % of the census tract area not covered by vegetation; % of the population diagnosed with diabetes; % of the family without air conditioning; % of family with no air conditioning.	2009
	General Vulnerability Index (GVI)	Ministry of Science and Technology (MCT)/Fiocruz²⁰20 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.	Socioeconomic vulnerability index (SVI): Demographics: population density (inhabitants/ km²) and level of urbanization (%); Income: households with more than 2 persons per room (%) and population with per capita income up to ½ the minimum wage (%); Education: population aged 15 years and over with schooling below 4 years of education (%) Sanitation: water supply (% of households), sewage (% of households) and garbage disposal (% of households); Health: Infant mortality rate (%), life expectancy at birth (years) and health plans (% of total population with coverage). Epidemiological vulnerability index (EVI): Incidence rate; Ratio between the number of hospitalizations in the city and number of hospitalizations in the micro region; Ratio between the number of deaths in the city and the number of deaths in the micro region; Ratio between the total cost of hospitalization (R$) in the city and the total cost of hospitalization (R$) in the micro region. Climate Vulnerability Index (CVI): Percentage of months of extreme precipitation, higher or lower than average.	2007

Thematic category	Name of the Synthetic-index	Authors/institutions	Component Dimensions/indicators	reference Date
Synthetic indices of vulnerability from the perspective of the family and the life course	Vulnerability Index of Paraná Families (VIPRF)	State Secretariat for the Family and Social Development of Paraná (SEDS) / Paraná Institute for Economic and Social Development (IPARDES)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.	> Household Suitability: Type of dwelling; Density per bedroom; Household building materials; City water; and Sanitation. > Profile and Family Composition: Responsibility for the family; Ratio of children and adolescents, and adults; Presence of child labor in the family; Presence of children and adolescents hospitalized; Presence of elderly patients; Presence of disabled people in the family; Elderly in aggregated condition; and Illiteracy of the household head. > Access to employment and income in the family: Labor of the adult individuals and monthly household income per capita. > Schooling condition: Children and adolescents out of school; discrepancy between age and grade; and Youth and adults without basic education.	2012
	Families Vulnerability Index regarding Disability and Dependency (IVF-ID)	Amendola et al.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.	Lack of vulnerability; Access to knowledge; Access to work; Availability of resources; Child development; Housing Conditions; Social relations; and Health Conditions	2011
	Youth Vulnerability Index regarding Violence (IVJ-Violence)	Brazilian Forum on Public Safety/ SEADE Foundation¹⁴14 Brasil. Ministério da Justiça (MJ). Projeto Juventude e Prevenção da Violência – Primeiros resultados. Brasília: MJ; 2009.,¹⁵15 Pereira NA. Ministério da Justiça. Fórum Brasileiro de Segurança Pública. Metodologia de Construção do Índice de Vulnerabilidade Juvenil à Violência Ano Base 2010. Brasília: MJ; 2013.	Violence among young people; Frequency in school and employment situation among young people; and Poverty and inequalities in the county.	2009
Synthetic indices of vulnerability from the perspective of the family and the life course	Family Social Vulnerability Index (FSVI)	Curitiba City Hall / Institute for Urban Research and Planning of Curitiba (IURPC) / Social Action Foundation (FAZ)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.	Household situation; Type of property; Number of rooms; Number of people per household; Number of disabilities; Documentation; Education Degree; Professional Qualification / Occupation; Number of children 0-1 year and 11 months old; Number of children 2-6 years and 11 months old; Number of children 0-6 year old who are left alone; Number of children 0-3 year old who do not attend daycare; Number of children 4-6 year old who do not attend daycare; Number of children and adolescents 7-14 who do not attend school; Senior Quantity at home; Receiving social federal program wages; and Family average income per capita.	2008
	Social Vulnerability Index (SVI)	Andrew et al.¹⁶16 Andrew MK, Mitnitski AB, Rockwood K. Social Vulnerability, Frailty and Mortality in Elderly People. Plos One 2008; 3(5):e2232.	Ability to communicate in the community; Company at home; Social Support; Socially oriented activities; Leisure activities; Reflection on the relationships with family, friends and other matters that affect the individual's daily life; and Socioeconomic status.	2008
	Family Development Index (FDI)	Barros et al./IPEA²¹21 Barros RP, Carvalho M, Franco S. Índice de desenvolvimento da família (IDF). Rio de Janeiro: IPEA; 2003. Texto para discussão Nº 986.	Lack of vulnerability; Access to knowledge; Access to work; Availability of resources; Child development; and Housing Conditions.	2003
Synthetic indices of vulnerability from the perspective of the family and the life course	Social Vulnerability Index of Children and Adolescents of the Greater Porto Alegre (SVI - IJ)	City Hall of Porto Alegre²²22 Prefeitura Municipal de Porto Alegre. Índice de Vulnerabilidade Social Infanto-Juvenil da Grande Porto Alegre. Porto Alegre: Prefeitura de Porto Alegre; 2003.	> Environmental dimension: Percentage of inadequate water supply; Inadequate sanitation percentage; and Percentage of inadequate garbage collection. > Cultural dimension: Illiterate rate; and age-grade discrepancy rate. > Economic Dimension: Indication of greater or lesser likelihood of families with insufficient monetary resources in the region or municipality. > Survival Security Dimension: Infant Mortality rate and incidence of AIDS cases in children and adolescents; Percentage of illiterate teenage mothers and female heads of family; Homicide rate up to 18 years; and Rate of children and adolescents living on the streets.	2003
	Youth Development Index (YDI)	Unesco²³23 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.	> Education: Relationship between the number of illiterates in the range of 15 to 24 years of age and the population of this age group in a given state; Percentage of young people aged 15 to 24 who attend school or Medium Higher Education in relation to the population of this range in a given state; and standardized average of proficiency scales of the 8th grade of elementary school and the 3rd year of high school in the areas of Portuguese language and mathematics as measured by the SAEB. > Health: Number of deaths due to internal causes in 100 thousand young people aged 15 to 24 years; and Number of deaths from homicides, suicides and for traffic accidents among 100 thousand young people; > Income: Family income per capita	2003
	Youth Vulnerability Index (YVI)	Seade Foundation/SP²⁹29 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.	Annual rate of population growth in the intercensal period 1991-2000; Involvement of young people between 15 and 19 years in the population of the district; Mortality rate for murder of the male population between 15 and 19 years; Participation of adolescent mothers aged 14 to 17, the total number of live births; Average nominal monthly income of the household head; Percentage of young people between 15 and 17 who do not attend school.	2002

Thematic category	Name of the Synthetic-index	Authors/institutions	Component Dimensions/indicators	reference Date
Vulnerability synthetic indices from the perspective of a territory and specific geographic areas	Social Vulnerability Index (SVI) - Amazônia	Ministry of Environment / German Technical Cooperation (GTZ)¹¹11 Szlafsztein C, Marques O, Maia H, Prette M, Fischenich P, Altieri F. Referências Metodológicas para mapeamento de Riscos Naturais na Amazônia: Mapeando as vulnerabilidades. Brasília: MMA, GTZ; 2010.	Proportion of the total state population corresponding to county population. Proportion of the total county population corresponding to childrens between 0 and 4 years of age. Proportion of the total county population corresponding to people over 60yearsofage; Share of total city population that has less than 4 years of study; and Proportion of the total county population corresponding to household heads with income lower than 2 minimum wages.	2010
	Social Vulnerability Index (SVI)	Fekete¹⁷17 Fekete A. Validation of a social vulnerability index in context to river-floods in Germany. Nat. Hazards Earth Syst. Sci. 2009; 9:393-403.	Fragility; Socioeconomic conditions; and Region.	2008
	Social Vulnerability Index (SoVI)	Cutter et al.²⁵25 Cutter SL, Boruff BJ, Shirley WL. Social Vulnerability to Environmental Hazards. Social Science Quarterly 2003; 84(2):242-261.,²⁶26 Armas I, Gavris A. Social vulnerability assessment using spatial multi-criteria analysis (SEVI model) and the Social Vulnerability Index (SoVI model) – a case study for Bucharest, Romania. Nat. Hazards Earth Syst. Sci. 2013; 13:1481-1499.	Per capita income; [translate] Median age; No. Commercial establishments/mi2; % employed in extractive industries; % housing units that are mobile homes; % African American; % Hispanic; % Native American; % Asian; % employed in service occupations; % employed in transportation, communication and public utilities.	2003
	Paulista Social Vulnerability Index (PSVI)	Seade Foundation/SP²⁹29 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.	% of literate people who are household heads; % of persons responsible from 10 to 29 years; Average age of the persons responsible; % of children from 0 to 5 years of age; % of women responsible from 10 to 29 years; Average nominal income of the head of household; % of responsible individuals under 3 minimum wages; Household income per capita; Average income of women who are the head of household; % of households with per capita household income up to 1/2 the minimum wage; % of households with per capita household income of up to 1/4 of the minimum wage; % of persons responsible with incomplete primary education; and Average years of schooling;	2000
Vulnerability synthetic indices from the perspective of a territory and specific geographic areas	Amazon Social Vulnerability Index (SVI-AM)	State Secretariat for the Planning and Economic Development of Amazonas¹¹11 Szlafsztein C, Marques O, Maia H, Prette M, Fischenich P, Altieri F. Referências Metodológicas para mapeamento de Riscos Naturais na Amazônia: Mapeando as vulnerabilidades. Brasília: MMA, GTZ; 2010.	> Income: Average nominal income of the head of household; % of family heads earning up to one minimum wage or no income, resulting in the total number of family leaders for the census tract; > Education: % of illiterate residents; % of illiterate household heads; % of household heads with eight years of schooling or less; Average years of schooling of the the head of household; > Cycle of Family Life: Dependency ratio; Average number of persons per household; % Of households without water supply; % Of households without garbage collection; % Of households without sanitation - general system or septic tank.	2000
	Social Vulnerability Index (SVI)	City Hall of Belo horizonte /PUC Minas³⁷37 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 Horizonte. In: Hogan DJ, Baeninger R, Cunha JMP, Carmo RL, organizadores. Migração e Ambiente nas Aglomerações Urbanas. Campinas: Unicamp; 2001. p. 461-487.–⁴⁵45 Serra-Negra JM. Relationship between Tasks Performed, Personality Traits, and Sleep Bruxism in Brazilian School Children – A Population-Based Cross-Sectional Study. Plos One 2013; 8(11):e80075.	> Environmental: Access to housing; and access to urban infrastructure services; > Cultural: Access to education; > Economic: Access to work; and access to income; > Legal: Access to legal assistance; > Safety and Survival: Access to health services; Food safety assurance; and Access to Social Security.	1999
	Chronic Vulnerability Index (CVI)	Early Warning Working Group⁴⁶46 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.	> Coping: Basic Agricultural production per capita; Prevalence of cash crops; Number of cattle per capita; Quality and quantity of pasture and accessibility of the road; and percentage with access to potable water. > Risk: Average price of maize and sorghum; Drought risk; Drought or extreme rain likelihood; Need of help for food in recent years; Variability of basic agricultural production; Malaria risk; Drought risk; Percentage of households headed by women; Drought or extreme rain likelihood; and Population density.	1999

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[1] Collaborations

LRMA Schumann worked in the design, analysis and interpretation of data, as well as the design of the article and LBA Moura worked in the interpretation of data, critical review and approval of the final version to be published.