Developing an Early Childhood Environmental Health Vulnerability Index to Assess Cumulative Health Impacts Across Contiguous US.
4 affiliations
- 1Department of Geography and Environmental Sustainability College of Atmospheric and Geographic Sciences University of Oklahoma Norman OK USA.
- 2Early Childhood Education Institute University of Oklahoma-Tulsa Tulsa OK USA.
- 3Department of Occupational and Environmental Health Hudson College of Public Health University of Oklahoma Health Campus Oklahoma City OK USA.
- 4Children's Environmental Health Center in U.S. Southern Great Plains Hudson College of Public Health University of Oklahoma Health Campus Oklahoma City OK USA.
Abstract
Young children (birth to age five) are uniquely vulnerable to environmental hazards due to their higher exposure relative to body weight, rapid physiological and neurological development, and strong reliance on caregivers for protection and care. Such risks are often amplified in marginalized communities with socioeconomic disadvantage and limited access to resources. However, widely used indices, such as the Social Vulnerability Index (SVI), the Climate Vulnerability Index (CVI), and the Child Opportunity Index (COI), were not specifically developed for young children and may not capture the combined environmental and socioeconomic risks faced by this age group. To address this critical gap, we developed a county-level Early Childhood Environmental Health Vulnerability Index (EC-EHVI) for the contiguous US using multidimensional indicators within an Exposure-Sensitivity-Adaptive Capacity framework and informed by Bronfenbrenner's bioecological model. We identified the underlying drivers and the spatial patterns of the EC-EHVI. Our results showed that the EC-EHVI exhibited the strongest association with county-level mortality among young children and explained a larger proportion of spatial heterogeneity compared with the SVI, CVI, and COI. Elevated vulnerability clustered in the Great Plains and Southeastern US, where over half of high-vulnerability counties were exposure-driven, and 411 high-high hotspots were identified. The EC-EHVI offers a valuable spatial decision-support tool for designing targeted, place-based interventions and advancing environmental health equity for young children.
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BibTeX
@article{liu2026developing,
title = {{Developing an Early Childhood Environmental Health Vulnerability Index to Assess Cumulative Health Impacts Across Contiguous US.}},
author = {Siyu Liu and Anni Yang and Diane Horm and Mingze Zhu and Changjie Cai},
journal = {GeoHealth},
year = {2026},
month = oct,
doi = {10.1029/2026gh001874},
url = {https://europepmc.org/article/MED/42948754},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Developing an Early Childhood Environmental Health Vulnerability Index to Assess Cumulative Health Impacts Across Contiguous US.
AU - Siyu Liu
AU - Anni Yang
AU - Diane Horm
AU - Mingze Zhu
AU - Changjie Cai
PY - 2026
DA - 2026/10/27
JO - GeoHealth
DO - 10.1029/2026gh001874
UR - https://europepmc.org/article/MED/42948754
AB - Young children (birth to age five) are uniquely vulnerable to environmental hazards due to their higher exposure relative to body weight, rapid physiological and neurological development, and strong reliance on caregivers for protection and care. Such risks are often amplified in marginalized communities with socioeconomic disadvantage and limited access to resources. However, widely used indices, such as the Social Vulnerability Index (SVI), the Climate Vulnerability Index (CVI), and the Child Opportunity Index (COI), were not specifically developed for young children and may not capture the combined environmental and socioeconomic risks faced by this age group. To address this critical gap, we developed a county-level Early Childhood Environmental Health Vulnerability Index (EC-EHVI) for the contiguous US using multidimensional indicators within an Exposure-Sensitivity-Adaptive Capacity framework and informed by Bronfenbrenner's bioecological model. We identified the underlying drivers and the spatial patterns of the EC-EHVI. Our results showed that the EC-EHVI exhibited the strongest association with county-level mortality among young children and explained a larger proportion of spatial heterogeneity compared with the SVI, CVI, and COI. Elevated vulnerability clustered in the Great Plains and Southeastern US, where over half of high-vulnerability counties were exposure-driven, and 411 high-high hotspots were identified. The EC-EHVI offers a valuable spatial decision-support tool for designing targeted, place-based interventions and advancing environmental health equity for young children.
SN - 2471-1403
ER -