| 1. |
- Azfar, Hossain Syed, et al.
(författare)
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Cardiovascular Disease and Mental Distress Among Ethnic Groups in Kyrgyzstan
- 2021
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Ingår i: Frontiers In Public Health. - : Frontiers Media S.A.. - 2296-2565. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to characterize different ethnic groups in Kyrgyzstan regarding cardiovascular disease (CVD) and mental distress, and to investigate the association between CVD and mental distress. The mental distress was measured in terms of sleep disturbance, burnout, and stress.Materials and Methods: A cross-sectional study was carried out among six ethnic groups in Kyrgyzstan, aged 18 years and above. The sample was stratified for age, education, family status, and income. We used the Karolinska Sleep Questionnaire to assess sleep disturbance, the physical and emotional subscale of the Shirom Melamed Burnout Questionnaire to assess burnout, and the 10-item Perceived Stress Scale to assess perceived stress.Results: The distribution of CVD differed significantly between the six ethnic groups, with higher prevalence among East Europeans, and Western Asians and lower among Other minorities and Central Asians. In all ethnic groups in Kyrgyzstan, individuals with CVD had increased odds of sleep disturbance and burnout. There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups.Conclusion: There was a significant difference in burnout and stress between persons with and without CVD in Kyrgyz and East European ethnic groups. In addition to CVD prevention, mitigating sleep disturbance and preventing burnout in the general population should be aimed at in public health measures.
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| 2. |
- Dahal, Usha, et al.
(författare)
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Green dreams, local realities: Complexities of the European Union's energy transition to ensure local health and well-being in a fossil fuel-based industrial region
- 2024
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Ingår i: Environmental impact assessment review. - : Elsevier. - 0195-9255 .- 1873-6432. ; 106
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Tidskriftsartikel (refereegranskat)abstract
- European Union's Green Deal is a legal obligation to EU countries to shift towards environment-friendly energy systems from fossil-fuel-based systems. This transition will bring significant global health benefits by combating climate change, but it is crucial to understand the so far understudied impacts on local communities' lives and, thus, on their health and well-being. The study proposes a novel conceptual framework based on socio-technical systems theory and the production of space theory to identify the interacting points between energy systems and health and well-being systems in the energy transition context. This framework is tested in Estonia's transitioning fossil fuel oil-shale-based energy system based on four focus group discussions, ten expert interviews, and document analysis. We innovatively pinpoint pathways, including feedback loops, through a causal loop diagram (CLD) impacting inhabitants' health and well-being from the interplay between energy and health and well-being systems. The analysis indicates that protecting and promoting health and well-being has been a challenge not only due to disruption created by the energy transition process but also due to the accumulated problems regarding socioeconomic conditions, environmental health impacts, and well-being at the local level. The compound effects of multiple existing and emerging issues, including the divergent interpretations of health and the lack of holistic support mechanisms for inhabitants to navigate the changes in sociocultural and economic space, can harm locals' health and well-being. The developed conceptual framework provides an important theoretical background to study the impacts on the mental and physical health, including social health and well-being, of the inhabitants living in the fossil-fuel-based industrial area. The CLD developed using this framework demonstrates the interacting points to avoid unintended consequences of energy transition.
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| 3. |
- Dahal, Usha, et al.
(författare)
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Perinatal Health Inequalities in the Industrial Region of Estonia: A Birth Registry-Based Study
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:18
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Tidskriftsartikel (refereegranskat)abstract
- Despite the increasing number of studies on industrially contaminated sites (ICS) and their health effects, there are very few studies on perinatal health outcomes in ICSs. In the present study, we examined the perinatal health inequalities by comparing adverse birth outcomes (ABOs) in the oil shale industry region of Ida-Viru County in Estonia with national-level figures and investigated the effects of maternal environmental and sociodemographic factors. Based on the 208,313 birth records from 2004–2018, Ida-Viru ICS has a birth weight 124.5 g lower than the average of 3544 g in Estonia. A higher prevalence of preterm birth (4.3%) and low birth weight (4.8%) in Ida-Viru ICS is found compared to 3.3% on both indicators at the national level. Multiple logistic regression analysis shows the statistically significant association of ABOs with fine particle (PM2.5) air pollution, mother’s ethnicity, and education throughout Estonia. However, in Ida-Viru ICS, the ABOs odds are remarkably higher in these characteristics except for the mother’s ethnicity. Furthermore, the ABOs are associated with the residential proximity to ICS. Thus, the Ida-Viru ICS has unequally higher odds of adverse perinatal health across the environmental and sociodemographic factors. In addition to reducing the air pollutants, policy actions on social disparities are vital to address the country’s unjustly higher perinatal health inequalities, especially in the Ida-Viru ICS.
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| 4. |
- Orru, Hans, et al.
(författare)
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Exposures, Symptoms and Risk Perception among Office Workers in Relation to Nanoparticles in the Work Environment
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:10
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Tidskriftsartikel (refereegranskat)abstract
- Submicroscopic nanoparticles (NPs) in air have received much attention due to their possible effects on health and wellbeing. Adverse health impacts of air pollution may not only be associated with level of exposure, but also mediated by the perception of the pollution and by beliefs of the exposure being hazardous. The aim of this study was to test a model that describes interrelations between NP pollution, perceived air quality, health risk perception, stress, and sick building syndrome. In the NanoOffice study, the level of NPs was measured and a survey on health risk perception was conducted among 260 employees in twelve office buildings in northern Sweden. Path analyses were performed to test the validity of the model. The data refute the model proposing that the NP exposure level significantly influences stress, chronic diseases, or SBS symptoms. Instead, the perceived exposure influences the perceived risk of NP, and the effect of perceived exposure on SBS and chronic disease is mediated by stress. There was little concern about nanoparticles, despite relatively high levels in some facilities. Perceived pollution and health risk perception may explain a large part of the environmentally induced symptoms and diseases, particularly in relatively low levels of pollution. The research results raise important questions on the physiologically or psychologically mediated health effects of air pollution.
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| 5. |
- Orru, Hans, et al.
(författare)
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Health impacts of particulate matter in five major Estonian towns : main sources of exposure and local differences
- 2011
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Ingår i: Air quality, atmosphere and health. - : Springer. - 1873-9318 .- 1873-9326. ; 4:3-4, s. 247-258
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Tidskriftsartikel (refereegranskat)abstract
- Particulate matter (PM) is the major air pollution problem with health impacts in Estonia. The prevailing sources of particles are traffic and local heating. In this study, we quantified the health effects of PM in neighbourhoods of five main cities with a health impact assessment (HIA) approach that uses information on exposure, baseline mortality/morbidity and exposure–response relationships from previous epidemiological studies. The exposure was defined as modelled PM2.5 annual levels and daily averages of PM10 (monitoring data in Tallinn and Kohtla-Järve and modelled levels in Tartu, Narva and Pärnu). The modelled results were validated with data from monitoring stations and additional measuring programmes. The annual average concentration of PM2.5 in the neighbourhoods studied varied from 7.6 to 23.6 μg m−3. The analysis indicated that the exposure above natural background corresponds to 462 [95% confidence interval (CI) 120–815] premature deaths, resulting in 6,034 (95% CI 1,583–10,309) years of life lost per year. The average decrease in life-expectancy at birth per resident of Tallinn was estimated to be 0.63 (95% CI 0.16–1.08) years. In the polluted city centres, this average decrease may reach >1 year and in Pärnu, it may reach 0.95 year. However, in the least polluted neighbourhood, the decrease of life expectancy was only 0.17 years. In addition, 231 (95% CI 145–306) respiratory and 338 (95% CI 205–454) cardiovascular hospitalisations per year could be expected. The majority of the external costs are related to the long-term effects on mortality and amount to €270 (95% CI 190–350) million annually. In comparison, the costs of hospitalisations contribute just €1.1 (95% CI 0.6–1.6) million. The main differences in health impacts were mostly driven by differences in the pollution sources, the magnitude of such sources and distribution patterns in the atmosphere. The smallest health effects, with the exception of the green residential areas, were observed in the industrial cities Kohtla-Järve and Narva (due to the small share contributed by local residential heating and relatively little car traffic). However, it is questionable whether the mass of fine particles is the best indicator of air pollution risk in such areas.
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| 6. |
- Orru, Hans, et al.
(författare)
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Residents' Self-Reported Health Effects and Annoyance in Relation to Air Pollution Exposure in an Industrial Area in Eastern-Estonia
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 15:2
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Tidskriftsartikel (refereegranskat)abstract
- Eastern Estonia has large oil shale mines and industrial facilities mainly focused on electricity generation from oil shale and shale oil extraction, which produce high air pollution emissions. The "Study of the health impact of the oil shale sector-SOHOS" was aimed at identifying the impacts on residents' health and annoyance due to the industrial processing. First, a population-wide survey about health effects and annoyance was carried out. Second, the total and oil shale sectors' emitted concentrations of benzene, phenol, and PM2.5 were modelled. Third, the differences between groups were tested and relationships between health effects and environmental pollution studied using multiple regression analysis. Compared to the control groups from non-industrial areas in Tartu or Laane-Viru, residents of Ida-Viru more frequently (p < 0.05) reported wheezing, chest tightness, shortness of breath, asthma attacks, a long-term cough, hypertension, heart diseases, myocardial infarction, stroke, and diabetes. All health effects except asthma were reported more frequently among non-Estonians. People living in regions with higher levels of PM2.5, had significantly higher odds (p < 0.05) of experiencing chest tightness (OR = 1.13, 95% CI 1.02-1.26), shortness of breath (1.16, 1.03-1.31) or an asthma attack (1.22, 1.04-1.42) during the previous year. People living in regions with higher levels of benzene had higher odds of experiencing myocardial infarction (1.98, 1.11-3.53) and with higher levels of phenol chest tightness (1.44, 1.03-2.00), long-term cough (1.48, 1.06-2.07) and myocardial infarction (2.17, 1.23-3.83). The prevalence of adverse health effects was also higher among those who had been working in the oil shale sector. Next to direct health effects, up to a quarter of the residents of Ida-Viru County were highly annoyed about air pollution. Perceived health risk from air pollution increased the odds of being annoyed. Annoyed people in Ida-Viru had significantly higher odds of experiencing respiratory symptoms during the last 12 months, e.g., wheezing (2.30, 1.31-4.04), chest tightness (2.88, 1.91-4.33 or attack of coughing (1.99, 1.34-2.95).
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| 7. |
- Orru, Kati, et al.
(författare)
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Making Administrative Systems Adaptive to Emerging Climate Change-Related Health Effects : Case of Estonia
- 2018
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Ingår i: Atmosphere. - : MDPI AG. - 2073-4433. ; 9:6
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Tidskriftsartikel (refereegranskat)abstract
- To facilitate resilience to a changing climate, it is necessary to go beyond quantitative studies and take an in-depth look at the functioning of health systems and the variety of drivers shaping its effectiveness. We clarify the factors determining the effectiveness of the Estonian health system in assessing and managing the health risks of climate change. Document analyses, expert interviews with key informants from health systems whose responsibilities are relevant to climate change, and analysis of a population-based survey conducted in 2015, indicate that the health effects of climate change have not been mainstreamed into policy. Therefore, many of the potential synergistic effects of combining information on health systems, environment, and vulnerable populations remain unexploited. The limited uptake of the issue of climate change-related health risks may be attributed to the lack of experience with managing extreme weather events; limited understanding of how to incorporate projections of longer-term health risks into policies and plans; unclear divisions of responsibility; and market liberal state approaches. Minority groups and urban dwellers are placing strong pressure on the health system to address climate change-related risks, likely due to their lower levels of perceived control over their physical wellbeing. The results have implications for national, community, and individual resilience in upper-middle income countries in Eastern Europe.
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| 8. |
- Orru, Kati, et al.
(författare)
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Perception of Risks from Wood Combustion and Traffic Induced Air Pollution : Evidence from Northern Europe
- 2022
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Ingår i: Sustainability. - : MDPI. - 2071-1050. ; 14:15
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Tidskriftsartikel (refereegranskat)abstract
- The health effects of particulate matter, increasing emissions from transportation and requisites for making use of biofuels brings up the need to understand how individuals interpret air-pollution-related risks from wood burning and traffic. We aim to clarify the extent to which perceived risks from road-traffic and wood-smoke can be explained by the individual psychological, social status-related and socio-institutional factors in the case of two Northern European countries, Finland and Estonia. This approach elucidates which of the closely intertwined factors shape the perception of risks from air pollution in different socio-institutional contexts and for different air pollution sources. The study uses data from cross-sectional population surveys conducted among 1112 Finnish and 1000 Estonian residents about environmental health risk perception and coping. Binary logistic regression analysis demonstrated that in both countries’ cases, the perceived personal and general risk from traffic exhaust and wood-smoke can be explained by the perception of exposure to pollution and, also, by the level of knowledge of, the worry about and the possible symptoms from environmental health factors. The perceived vulnerability due to poor health further sensitises individuals towards risks from air pollution. Higher trust towards state institutions in guaranteeing a healthy living environment and greater perceived openness about the risks may attenuate the feelings of vulnerability to air pollution risks in Finland compared to Estonia. The ingrained appeal for wood burning may explain the higher acceptance of exhausts from wood-burning compared to traffic. This may lead to scant support for measures to reduce emissions from wood combustion.
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| 9. |
- Orru, Kati, et al.
(författare)
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The role of perceived air pollution and health risk perception in health symptoms and disease : a population-based study combined with modelled levels of PM10
- 2018
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer. - 0340-0131 .- 1432-1246. ; 91:5, s. 581-589
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Adverse health impact of air pollution on health may not only be associated with the level of exposure, but rather mediated by perception of the pollution and by top-down processing (e.g. beliefs of the exposure being hazardous), especially in areas with relatively low levels of pollutants. The aim of this study was to test a model that describes interrelations between air pollution (particles < 10 μ m, PM10), perceived pollution, health risk perception, health symptoms and diseases.Methods: A population-based questionnaire study was conducted among 1000 Estonian residents (sample was stratified by age, sex, and geographical location) about health risk perception and coping. The PM10 levels were modelled in 1 × 1 km grids using a Eulerian air quality dispersion model. Respondents were ascribed their annual mean PM10 exposure according to their home address. Path analysis was performed to test the validity of the model.Results: The data refute the model proposing that exposure level significantly influences symptoms and disease. Instead, the perceived exposure influences symptoms and the effect of perceived exposure on disease is mediated by health risk perception. This relationship is more pronounced in large cities compared to smaller towns or rural areas.Conclusions: Perceived pollution and health risk perception, in particular in large cities, play important roles in understanding and predicting environmentally induced symptoms and diseases at relatively low levels of air pollution.
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| 10. |
- Orru, Kati, et al.
(författare)
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Well-being and environmental quality : Does pollution affect life satisfaction?
- 2016
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 25:3, s. 699-705
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We aimed to explore the effect of ambient air pollution on individual persons' levels of subjective well-being. Our research question was: to what extent is an individual's life satisfaction shaped by exposure to PM10?METHODS: We used regression models to analyse data on subjective well-being indicators from the last two waves of the European social survey (ESS) and detailed information on local levels of the air pollutant PM10.RESULTS: An increase in PM10 annual concentrations by 1 μg/m(3) was associated with a significant reduction in life satisfaction of .017 points on the ESS 10-point life satisfaction scale.CONCLUSIONS: Our findings suggest that even in cases of relatively low levels of PM10 air pollution (mean annual concentration of 8.3 ± 3.9 μg/m(3)), in addition to the effects on physical health, exposure negatively affects subjective assessments of well-being.
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| 11. |
- Reckien, Diana, et al.
(författare)
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How are cities planning to respond to climate change? : Assessment of local climate plans from 885 cities in the EU-28
- 2018
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Ingår i: Journal of Cleaner Production. - : Elsevier. - 0959-6526 .- 1879-1786. ; 191, s. 207-219
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Tidskriftsartikel (refereegranskat)abstract
- The Paris Agreement aims to limit global mean temperature rise this century well below 2 degrees Celsius above pre-industrial levels. This target has wide-ranging implications for Europe and its cities, which are the source of substantial proportions of greenhouse gas emissions. This paper reports the state of planning for climate change by collecting and analysing local climate mitigation and adaptation plans across 885 urban areas of the EU-28. A typology and analysis framework was developed that classifies local climate plans in terms of their spatial (alignment with local, national and international policy) and sectoral integration (alignment into existing local policy documents). We document local climate plans that we call type A1: non-compulsory by national law and not developed as part of international climate networks; A2: compulsory by national law and not developed as part of international networks; A3: plans developed as part of international networks. This most comprehensive analysis to date reveals that there is large diversity in the availability of local climate plans with most being available in Central and Northern European cities. Approximately 66% of EU cities have an A1, A2, or A3 mitigation plan, 26% an adaptation plan, 17% joint adaptation and mitigation plans, and about 30% lack any form of local climate plan (i.e. what we classify as A1, A2, A3 plans). Mitigation plans are more numerous than adaptation plans, but mitigation does not always precede adaptation. Our analysis reveals that city size, national legislation, and international networks can influence the development of local climate plans. We found that size does matter as about 70% of the cities above 1 million inhabitants have a comprehensive and stand-alone mitigation and/or an adaptation plan (A1 or A2). Countries with national climate legislation (A2), such as Denmark, France, Slovakia and the United Kingdom, are found to have nearly twice as many urban mitigation plans, and five times more likely to produce urban adaptation plans, than countries without such legislation. A1 and A2 mitigation plans are particularly numerous in Denmark, Poland, Germany, and Finland; while A1 and A2 adaptation plans are prevalent in Denmark, Finland, UK and France. The integration of adaptation and mitigation is country-specific and can mainly be observed in countries where local climate plans are compulsory, especially in France and the UK. Finally, local climate plans of international climate networks (A3) are mostly found in the many countries where autonomous, i.e. A1 plans are less common. The findings reported here are of international importance as they will inform and support decision-making and thinking of stakeholders with similar experiences or developments at all levels and sectors in other regions around the world.
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| 12. |
- Reckien, Diana, et al.
(författare)
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Quality of urban climate adaptation plans over time
- 2023
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Ingår i: npj Urban Sustainability. - : Springer Nature. - 2661-8001. ; 3:1
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Tidskriftsartikel (refereegranskat)abstract
- Defining and measuring progress in adaptation are important questions for climate adaptation science, policy, and practice. Here, we assess the progress of urban adaptation planning in 327 European cities between 2005 and 2020 using three ‘ADAptation plan Quality Assessment’ indices, called ADAQA-1/ 2/ 3, that combine six plan quality principles. Half of the cities have an adaptation plan and its quality significantly increased over time. However, generally, plan quality is still low in many cities. Participation and monitoring and evaluation are particularly weak aspects in urban adaptation policy, together with plan ‘consistency’. Consistency connects impacts and vulnerabilities with adaptation goals, planned measures, actions, monitoring and evaluation, and participation processes. Consistency is a key factor in the overall quality of plans. To help evaluate the quality of plans and policies and promote learning, we suggest incorporating our ADAptation plan Quality Assessment indices into the portfolio of adaptation progress assessments and tracking methodologies.
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| 13. |
- Salvia, Monica, et al.
(författare)
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Will climate mitigation ambitions lead to carbon neutrality? An analysis of the local-level plans of 327 cities in the EU
- 2021
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Ingår i: Renewable & sustainable energy reviews. - : Elsevier. - 1364-0321 .- 1879-0690. ; 135
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Tidskriftsartikel (refereegranskat)abstract
- Cities across the globe recognise their role in climate mitigation and are acting to reduce carbon emissions. Knowing whether cities set ambitious climate and energy targets is critical for determining their contribution towards the global 1.5 °C target, partly because it helps to identify areas where further action is necessary. This paper presents a comparative analysis of the mitigation targets of 327 European cities, as declared in their local climate plans. The sample encompasses over 25% of the EU population and includes cities of all sizes across all Member States, plus the UK. The study analyses whether the type of plan, city size, membership of climate networks, and its regional location are associated with different levels of mitigation ambition. Results reveal that 78% of the cities have a GHG emissions reduction target. However, with an average target of 47%, European cities are not on track to reach the Paris Agreement: they need to roughly double their ambitions and efforts. Some cities are ambitious, e.g. 25% of our sample (81) aim to reach carbon neutrality, with the earliest target date being 2020.90% of these cities are members of the Climate Alliance and 75% of the Covenant of Mayors. City size is the strongest predictor for carbon neutrality, whilst climate network(s) membership, combining adaptation and mitigation into a single strategy, and local motivation also play a role. The methods, data, results and analysis of this study can serve as a reference and baseline for tracking climate mitigation ambitions across European and global cities.
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| 14. |
- Veber, Triin, et al.
(författare)
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Industrial Air Pollution Leads to Adverse Birth Outcomes : A Systematized Review of Different Exposure Metrics and Health Effects in Newborns
- 2022
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Ingår i: Public Health Reviews. - : Frontiers Media S.A.. - 0301-0422 .- 2107-6952. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To review the evidence of associations between adverse birth outcomes (ABO) and industrial air pollution.Methods: Searches were conducted in PubMed, and Scopus databases, and additional articles were found from snowball search techniques. The included studies feature a study population of mothers with live-born babies exposed to industrial air pollutants, and they examine the effects of industrial pollutants on adverse birth outcomes-namely, low birth weight, term low birth weight, preterm birth, and small for gestational age.Results: Altogether, 45 studies were included in this review. Exposure to PM2.5, PAHs, benzene, cadmium, and mixtures of industrial air pollutants and living near an industrial area affect birth outcomes.Conclusion: This study concludes that industrial air pollution is an important risk factor for ABO, especially low birth weight and preterm birth. The strongest evidence is associations between ABO and air pollution from power plants and petrochemical industries. Understanding of specific chemicals that are critical to birth outcomes is still vague. However, the evidence is strongest for more specific air pollutants from the industry, such as PAH, benzene, BTEX, and cadmium.
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| 15. |
- Nahkur, Oliver, et al.
(författare)
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The engagement of informal volunteers in disaster management in Europe
- 2022
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Ingår i: International Journal of Disaster Risk Reduction. - : Elsevier BV. - 2212-4209. ; 83
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Tidskriftsartikel (refereegranskat)abstract
- Informal volunteering is increasingly important in disaster management, but authorities remain cautious about collaborating with informal volunteers. Relatively little is known about the extent to which informal volunteers are integrated into European disaster management systems. We try to remedy this gap by examining Germany, Italy, Belgium, Hungary, Sweden, Norway, Finland, and Estonia, focusing on (1) the policies and institutional arrangements for integrating informal volunteers, (2) the methods and tools used for their engagement, and (3) the presumed benefits and challenges of involving volunteers in disaster management. 95 expert interviews combined with desk research and four online table-top exercises in 2019–2020 involving analysis of 11 disaster cases show that disaster management systems in these countries are taking modest steps toward opening traditional command-and-control structures to informal volunteers. In Sweden and Norway, where volunteering is more common, the engagement of informal volunteers is somewhat regulated, providing an opportunity to formally insure them. In Belgium and Italy, the engagement of informal volunteers is not encouraged, but formal volunteering is encouraged. In Germany, Hungary, Finland, and Estonia, it is done on an ad hoc basis. In most of the countries studied, campaigns to raise volunteers’ awareness of support possibilities are backed up by practical training that focuses primarily on first aid. In all countries, except Germany, social media has been used by disaster management authorities to inform, guide, or register informal volunteers on an ad hoc basis. The studied cases indicate that disaster response is more efficient when procedures for informal volunteer engagement exist.
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| 16. |
- Nero, Kristi, et al.
(författare)
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Determinants of social care organisations’ abilities to provide help in times of COVID-19 pandemic
- 2021
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Konferensbidrag (refereegranskat)abstract
- The Covid-19 pandemic challenges the sustainability of the social care organisations (and those dependent on their services) when services are stopped or restricted to mitigate the spread of the virus. The aim of the study is to examine the outcomes for the social care organisations and their users in the early months (March to July 2020) of the pandemic, and the factors influencing the organisations’ abilities to successfully respond to the crisis. The study focuses on the experiences of social care organisations such as residential settings, day-centres and food banks that offer services to individuals in highly precarious situations or the homeless in nine countries: Germany, Italy, Hungary, The Netherlands, Norway, Czech Republic, Finland, Lithuania, Estonia. The study is based on 29 qualitative research interviews with managers and staff at social care organisations and document analysis. The analysis demonstrates that in the context of drastic surge in demand for services, diminishing funding, and lack of crisis plans, the dedication and creative solutions by organisations’ managers, organisational culture and intra -organisational cooperation were pivotal in maintaining the care provision. The study offers important insights in terms of potential strategies and the role of social service in health crises.
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| 17. |
- Orru, Hans, 1980-, et al.
(författare)
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Health impact assessment of particulate pollution in Tallinn using fine spatial resolution and modeling techniques
- 2009
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Ingår i: Environmental Health. - 1476-069X. ; 8, s. 7-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Health impact assessments (HIA) use information on exposure, baseline mortality/morbidity and exposure-response functions from epidemiological studies in order to quantify the health impacts of existing situations and/or alternative scenarios. The aim of this study was to improve HIA methods for air pollution studies in situations where exposures can be estimated using GIS with high spatial resolution and dispersion modeling approaches.METHODS: Tallinn was divided into 84 sections according to neighborhoods, with a total population of approx. 390,000 persons. Actual baseline rates for total mortality and hospitalization with cardiovascular and respiratory diagnosis were identified. The exposure to fine particles (PM2.5) from local emissions was defined as the modeled annual levels. The model validation and morbidity assessment were based on 2006 PM10 or PM2.5 levels at 3 monitoring stations. The exposure-response coefficients used were for total mortality 6.2% (95% CI 1.6-11%) per 10 microg/m3 increase of annual mean PM2.5 concentration and for the assessment of respiratory and cardiovascular hospitalizations 1.14% (95% CI 0.62-1.67%) and 0.73% (95% CI 0.47-0.93%) per 10 microg/m3 increase of PM10. The direct costs related to morbidity were calculated according to hospital treatment expenses in 2005 and the cost of premature deaths using the concept of Value of Life Year (VOLY).RESULTS: The annual population-weighted-modeled exposure to locally emitted PM2.5 in Tallinn was 11.6 microg/m3. Our analysis showed that it corresponds to 296 (95% CI 76528) premature deaths resulting in 3859 (95% CI 10236636) Years of Life Lost (YLL) per year. The average decrease in life-expectancy at birth per resident of Tallinn was estimated to be 0.64 (95% CI 0.17-1.10) years. While in the polluted city centre this may reach 1.17 years, in the least polluted neighborhoods it remains between 0.1 and 0.3 years. When dividing the YLL by the number of premature deaths, the decrease in life expectancy among the actual cases is around 13 years. As for the morbidity, the short-term effects of air pollution were estimated to result in an additional 71 (95% CI 43-104) respiratory and 204 (95% CI 131-260) cardiovascular hospitalizations per year. The biggest external costs are related to the long-term effects on mortality: this is on average euro 150 (95% CI 40-260) million annually. In comparison, the costs of short-term air-pollution driven hospitalizations are small euro 0.3 (95% CI 0.2-0.4) million.CONCLUSION: Sectioning the city for analysis and using GIS systems can help to improve the accuracy of air pollution health impact estimations, especially in study areas with poor air pollution monitoring data but available dispersion models.
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| 18. |
- Orru, Kati, et al.
(författare)
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Approaches to 'vulnerability' in eight European disaster management systems
- 2022
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Ingår i: Disasters. The Journal of Disaster Studies, Policy and Management. - : Wiley. - 0361-3666 .- 1467-7717. ; 46:3, s. 742-767
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Tidskriftsartikel (refereegranskat)abstract
- While social vulnerability in the face of disasters has received increasing academic attention, relatively little is known about the extent to which that knowledge is reflected in practice by institutions involved in disaster management. This study charts the practitioners’ approaches to disaster vulnerability in eight European countries: Belgium; Estonia; Finland; Germany; Hungary; Italy; Norway; and Sweden. It draws on a comparative document analysis and 95 interviews with disaster managers and reveals significant differences across countries in terms of the ontology of vulnerability, its sources, reduction strategies, and the allocation of related duties. To advance the debate and provide conceptual clarity, we put forward a heuristic model to facilitate different understandings of vulnerability along the dimensions of human agency and technological structures as well as social support through private relations and state actors. This could guide risk analysis of and planning for major hazards and could be adapted further to particular types of disasters.
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| 19. |
- Orru, Kati, et al.
(författare)
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Less is more? Why do we find less severe mental and material impact of COVID-19 among the most marginalised and homeless in countries with lower welfare spending?
- 2023
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Ingår i: International Journal of Disaster Risk Reduction. - : Elsevier. - 2212-4209. ; 97
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Tidskriftsartikel (refereegranskat)abstract
- The study examines how various policy approaches in countries may have influenced the material and mental well-being outcomes of the COVID-19 pandemic among marginalised groups and people experiencing homelessness in Europe. In a structured country comparison case study approach, we combine country-based indicators, e.g., the level of infection, unemployment, and restrictions, with individual data from a cross-sectional survey with 226 participants from 6 European countries. Contrary to expectations, our results suggest that vulnerable people living in countries with low welfare expenditure report lower negative mental and material impact of the COVID-19 pandemic than people living in countries with high welfare expenditure countries. This unexpected result could be explained by higher expectations of the level of support they should have received during extraordinary times such as the pandemic among respondents in the studied high welfare expenditure countries. Due to our cross-sectional design across only six countries, we cannot generalise the trend to Europe and only speculate on the causal mechanisms behind the observed association. We also discuss factors like the accessibility of care organisations' support and pre-existing welfare policies. We suggest possible additional factors that may shed light on our results, noting that these issues need to be examined further in future studies with a more extensive study sample.
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| 20. |
- Orru, Kati, et al.
(författare)
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Resilience in care organisations : challenges in maintaining support for vulnerable people in Europe during the Covid-19 pandemic
- 2021
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Ingår i: Disasters. The Journal of Disaster Studies, Policy and Management. - : John Wiley & Sons. - 0361-3666 .- 1467-7717. ; 45:S1, s. S48-S75
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Tidskriftsartikel (refereegranskat)abstract
- The Covid-19 pandemic has challenged the resilience of care organisations (and those dependent on them), especially when services are stopped or restricted. This study focuses on the experiences of care organisations that offer services to individuals in highly precarious situations in 10 European countries. It is based on 32 qualitative interviews and three workshops with managers and staff. The four key types of organisations reviewed largely had the same adaptation patterns in all countries. The most drastic changes were experienced by day centres, which had to suspend or digitise services, whereas night shelters and soup kitchens had to reorganise broadly their work; residential facilities were minimally affected. Given the drastic surge in demand for services, reliance on an overburdened (volunteer) workforce, and a lack of crisis plans, the care organisations with long-term trust networks with clients and intra-organisational cooperation adapted easier. The outcomes were worse for new clients, migrants, psychologically vulnerable people, and those with limited communicative abilities.
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| 21. |
- Orru, Kati, et al.
(författare)
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Satisfaction with virtual nature tour : the roles of the need for emotional arousal and pro-ecological motivations
- 2019
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Ingår i: Journal of Ecotourism. - : Routledge. - 1472-4049 .- 1747-7638. ; 18:3, s. 221-242
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Tidskriftsartikel (refereegranskat)abstract
- Interactive multimedia enables a mediated nature experience in ecologically vulnerable areas. The aim of this study is to clarify the social and individual motivational factors governing satisfaction with virtual nature tours. After visiting the Piusa Caves Nature Reserve in Estonia, and participating in its virtual tourism (VT), 299 tourists responded to a questionnaire regarding their natural and VT experiences. We use a general linear model to explore the effectiveness of predicting satisfaction with VT based on values, beliefs about treating nature, pro-ecological norms, and need for emotional arousal from virtual experiences. Compared to people with a high need for arousal, people with a low need are more easily satisfied with VT, regardless of its weak emotional triggers, e.g. lack of lively impressions, feeling of place change, and connection to real nature. Pro-ecological beliefs augment satisfaction with VT in people with a high need for arousal. Mediated nature experiences offer ways of engaging with nature more conveniently to hedonistic travellers and would likely be rejected by people who seek social interaction and physical challenges when travelling. As VT is better received among women, lower educated people, and 50–70-year-olds, these may be ideal target groups for promotion of mediated nature experiences.
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| 22. |
- Orru, Kati, et al.
(författare)
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Socio-structural and psychological factors behind car use : Comparing Northern and Eastern Europe
- 2019
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Ingår i: Transportation Research Part A. - : Elsevier. - 0965-8564 .- 1879-2375. ; 119, s. 313-325
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Tidskriftsartikel (refereegranskat)abstract
- This study explores cross-cultural differences in car travel behaviour in a northern and an eastern European country, namely Sweden and Estonia. We assess the role of country-specific socio-structural circumstances, and the influence of individual motivations, including social values, perceived seriousness of environmental problems associated with car use, and car use reduction intentions, in shaping the frequency of car use for different purposes. The results show that compared to Swedish people, people in Estonia are more dependent on cars in their everyday travel. Our study shows that higher social position is associated with higher frequency of car trips in more stratified Estonian society, but not necessarily where socio-economic differences are less pronounced, as in Sweden. Regarding the relative significance of values and intentions next to socio-economic determinants, values and intentions have a greater explanatory power of car use frequency in Estonia, compared to Sweden. That values and preferences play a smaller role in car travel frequency in the socio-economically more secure Sweden, indicates that car travel is a basic habit, which is not easily discernible through individual values and attitudes in more affluent societies. Differences in car travel frequencies between the respondents from different settlement types in Estonian but no differences between settlement types in Sweden, shows that a country's broader approach to managing the economic and social viability of its regions, may shape car travel needs and opportunities. The results of this study may have implications in terms of ways of curbing emissions from transportation in different parts of Europe.
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| 23. |
- Torpan, Sten, et al.
(författare)
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European emergency managers on social media : institutional arrangements and guidelines
- 2023
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Ingår i: International Journal of Emergency Services. - 2047-0894 .- 2047-0908.
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Tidskriftsartikel (refereegranskat)abstract
- Purpose - This paper offers an empirical overview of European emergency managers' institutional arrangements and guidelines for using social media in risk and crisis communication.Design/methodology/approach - The authors collected and analysed material including publicly accessible relevant legal acts, policy documents, official guidelines, and press reports in eight European countries – Germany, Italy, Belgium, Sweden, Hungary, Finland, Norway, and Estonia. Additionally, the authors carried out 95 interviews with emergency managers in the eight countries between September 2019 and February 2020.Findings - The authors found that emergency management institutions' social media usage is rarely centrally controlled and social media crisis communication was regulated with the same guidelines as crisis communication on traditional media. Considering this study's findings against the backdrop of existing research and practice, the authors find support for a “mixed arrangement” model by which centralised policies work in tandem with decentralised practices on an ad hoc basis.Practical implications - Comparative insights about institutional arrangements and procedural guidelines on social media crisis communication in the studied countries could inform the future policies concerning social media use in other emergency management systems.Originality/value - This study includes novel, cross-national comparative data on the institutional arrangements and guidelines for using social media in emergency management in the context of Europe.
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| 24. |
- Torpan, Sten, et al.
(författare)
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Handling false information in emergency management : A cross-national comparative study of European practices
- 2021
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Ingår i: International Journal of Disaster Risk Reduction. - : Elsevier BV. - 2212-4209. ; 57
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Tidskriftsartikel (refereegranskat)abstract
- During emergencies, exposure to false information can increase individual vulnerability. More research is needed on how emergency management institutions understand the effects of false information and what are the various approaches to handling it. Our document analysis and 95 expert interviews in eight European countries ? Germany, Italy, Belgium, Sweden, Hungary, Norway, Finland, and Estonia ? show that approaches vary considerably: some have instituted central management of identifying and tackling false information while others prioritise the spreading of accurate information. A review of national practices and an analysis of recent crisis cases show that both approaches may be necessary. The diffusion of false information is strongly affected by the lack of timely and verifiable information from governments. We also find that in several countries, the emergence of false information is often associated with malicious foreign influence activities. Our study contributes to a better understanding of how the effects of false information are mitigated by the emergency management systems in Europe.
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| 25. |
- Torpan, Sten, et al.
(författare)
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Mitigating vulnerabilities with social media : A cross-national study of European disaster managers' practices
- 2024
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Ingår i: Risk, Hazards & Crisis in Public Policy. - 1944-4079.
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Tidskriftsartikel (refereegranskat)abstract
- In this article, we provide an overview of the ways in which disaster managers in eight European countries use social media to mitigate people's vulnerability to hazards. Our document analysis and 95 expert interviews in Germany, Italy, Belgium, Sweden, Hungary, Finland, Norway, and Estonia revealed six distinct institutional social media practices that may reduce disaster vulnerability: sharing educational guidelines, informing and warning the public, identifying citizens' concerns, identifying missing persons, sharing guidelines during disaster, and organizing volunteers. We discuss how these practices could affect people's ability to access, understand, and react adequately to information about risks and hazards. Our findings can be used to improve guidelines for official crisis communication on social media and demonstrate the value of using social media in disaster risk reduction.
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