Table 3.

Vulnerable groups and associated vulnerability factors by priority health area. Source: References [16,21].

Vector-Borne Diseases
Vulnerable Groups	Vulnerability Factors
Individuals of low socioeconomic status	Increased reliance on rainwater and/or public standpipes Dominica Water and Sewerage Company Limited (DOWASCO) water disconnections occur more frequently in poorer communities More likely to incorrectly store water in containers Reduced ability to adapt due to financial constraints
Kalinago community	Higher poverty rate than general population, increasing exposure risk Highly dependent on climate-sensitive agriculture and fisheries for food security
Squatters living in “Shanty Towns”	Poor housing conditions leading to increased exposure to vectors
Individuals with poor nutritional status and suffering from micronutrient deficiencies	At higher risk of developing more severe dengue infection
Older persons	Chikungunya can increase mortality in older persons
Infants	Rate of mortality associated with dengue higher in infants
Homebound individuals	Aedes aegypti mosquito known to bite indoors
Farmers	Commonly store water in containers (incorrectly) around farm property, increasing exposure risk
Urban area residents	Higher population density increases exposure risk
Migrants	Increased exposure risk to vectors due to poor housing conditions Reduced access to social and health services
Visitors/tourists	Particularly susceptible to vector-borne diseases
Food and Water-Related Diseases
Vulnerable Groups	Vulnerability Factors
Those without access to reticulated drinking water	Stored water more likely to become contaminated during heavy rainfall
Individuals without access to improved sanitation	Lack of improved sanitation known to increase risk of transmission
Those living in areas vulnerable to landslides and flooding	Higher risk of water contamination during these events
Those living near agricultural lands	More vulnerable to chemical contamination of water
Migrants living in “Shanty Towns”	Poor housing quality and water management increase exposure risk; reduced adaptive capacity
Recreational water users	Recreational water quality testing indicates sources often do not meet standards
Farmers and fisher folk	Increased exposure risk
Certain occupational groups (e.g., abattoir workers and veterinarians)	Increased exposure risk for abattoir workers, meat handlers, and veterinarians
Infants and children aged <5 years old	This age group is disproportionately affected by gastroenteritis Increased sensitivity
Malnourished children	More sensitive to gastroenteritis, and infection can worsen state of malnourishment
Older persons	Sensitivities related to medications they may be taking, immune response, and physiology
Individuals of low socioeconomic status	May be less educated about safe food and water practices Lack of access to safe drinking water and improved sanitation Limited adaptive capacity
Females	Increased exposure risk (e.g., food preparation) and possible biological factors
Pregnant women and their newborn children	Infection may lead to low birth weight
Immunocompromised individuals	More sensitive to gastroenteritis as infection can become debilitating and life threatening
Persons who eat out regularly	Higher risk of being exposed to parasitic organisms
Visitors/tourists	Unaccustomed to being vigilant when purchasing food and water
Food Insecurity
Vulnerable Groups	Vulnerability Factors
Individuals of low socioeconomic status and their dependents	Limited purchasing power and more vulnerable to food price increases
Kalinago community	High poverty levels and already established low food security levels Younger generation largely uninterested in farming and fishing
Small-scale farmers and fishers	Depend on agricultural productivity and fisheries catches for stable sources of food and their livelihoods