1. Vulnerability and Adaptation to Dengue Fever: A Socioeconomic Scenario Charmaine Heslop-Thomas and Wilma-Bailey*

2. AIM  To develop socioeconomic scenarios to analyse the vulnerability of communities in Jamaica to possible increase in the transmission of dengue and to propose actions that can mitigate the effects

3. RESEARCH QUESTIONS  What areas of the country are vulnerable?  What are the characteristics of the individuals and households that are vulnerable?  What are the factors that are associated with vulnerability?  How will climate change impact on transmission?  What modifications can effect change?  How can community based interventions be encouraged and supported?

4. SCENARIO DEVELOPMENT Proceed from macro to micro scale:  Identify key sectors and current conditions  Identify data for dimensions of current and future vulnerability

5. Macro highlights  More than three decades of economic difficulties with few sectors showing growth trends.  Market problems for traditional exports. Inability of domestic agriculture to compete with imported products.  Manufacturing sector buffeted by high interest rate policy and inability to retool.  Social environment and international developments present challenges to tourism. Large numbers but discounted rooms.  High levels of unemployment is the most significant and persistent labour market trends (between 15 and 16 percent).

6. Macro Cont’d  High levels of inflation with devaluation and these have their greatest impact on the poor.  Poor performance of the economy reflected in movements in the GDP.  High percentage of GDP (42 percent) goes toward debt repayment.

8. FOOD SECURITY AND POVERTY  There is a very sensitive and immediate relationship between economic shocks and food security (Table 1)

9. Table 1. Clinical Undernutrition (0 to 35 months) and Minimum Wage Year Min. Wage as % of Basket of Food Admission for undernutrition 1978110140 198098168 198262170 1984*38230 1986*36380 1988*50145 199048190 1992**20310 *removal of food subsidies **devaluation

10. Despite unfavourable economic trends the level of poverty is decliningDespite unfavourable economic trends the level of poverty is declining

11. Table 2 – Percentage below the poverty line - Jamaica  Absolute poverty focuses on the ability of households to purchase the basket of food.  The role of welfare provisions and remittances. Area20002001 Jamaica18.716.8 Rural25.124.1 KMA7.69.9 Other Towns 13.316.6

13. Vulnerability Data : -occupation -lack of skills -livelihoods at risk -welfare/remittances -consumption patterns (food and non- food) -agricultural practices -marketing arrangements

14. Housing  Unemployment and low wage affect access to a range of basic services- housing for example.  The discrepancy between the growth in the number of new households in the period 1991 to 2000 (79, 700) and the growth in the housing stock (30, 308).  The cost of basic housing units puts them outside of the reach of the poor (Table 3)

15. Table 3-NHT Income Bands-Jamaica 1999 (J$) Nearly 82% earn less than J$3,000 per week Weekly income <1, 100 1, 1001 to 2,000 2,001 to 3, 000 3001 to 4,000 4001 to 5000 5001 to 6,000 >6000 Employed257,907228,215121,78054,81231,75315,60225,117 %34.630.616.37.44.32.14.7

16. Cost Profile of NHT Studio Unit (January 2001) NHT/Building Society Mortgage (J$) Purchase Price1, 100,000 Less Down-Payment 110,000 NHT Pari Passu 990,000 Building Society Loan 150, 000 Monthly Repayment NHT Loan (2% per annum) 3, 560.38 Building Society Loan (14%) per annum 1, 805.65 Building Insurance 363.97 Total 5, 730.00 Required Income 19, 100.00 per month

17. Cont’d  The growth of informal housing and associated unacceptable practices.  Fifty percent of households in the island have access to flush toilets  Seventy –one percent have access to piped water (urban and rural disparities) but in many cases, water is piped into a common yard necessitating storage

18. Vulnerability data -measure: access to piped water -types of storage -sewage disposal facilities -household waste -overcrowding

19. SETTING THE BOUNDARIES OF THE AREA TO BE STUDIED  Inadequacy of data – numerical and spatial.  Mapping of outbreaks to identify spatial patterns.  Selection of the parish of St. James with 88 out of a reported 224 cases in 1998.  Setting the boundaries

29.  END