TEXT Flashcards
Environmental Health Science?
Environmental health science is essentially about two things: hazards in the environment, their effects on health, and the variations in sensitivity to exposures within populations; and the development of effective means to protect against hazards in the environment
Gaia hypothesis
James Lovelock, a British atmospheric scientist, advanced the hypothesis that the earth and all its components (including the geosphere and the water, gas, nutrients, energy cycles, and all living organisms) constitute a global homeostatic mechanism that ensures constancy of the environment
“Health” as defined by the WHO
“a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO,1948).
Last defined “Environment” as
Last (1995) defined environment as “[All] that which is external to the individual human host. [It] can be divided into physical, biological, social, cultural, any or all of which can influence health status in populations.”
Health for All policy of the World Health Organization (WHO)
established at a conference in Alma Ata in 1978. The final declaration stated that a goal of governments, international organizations, and the world community should be “the attainment by all people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life.”
“Health is only possible where resources are available to meet human needs and where the living and working environment is protected from life-threatening and health-threatening pollutants, pathogens and physical hazards
Health has 3 main factors that can be influenced by, or influence it.
- The scale and nature of human activities
- Biological Environment
- Type and distribution of pathogens, and vectors, as well as their habitats - Physical and Chemical environment
Environmental Health as defined by UN
“Environmental health comprises those aspects of human health, including quality of life, that are determined by physical, biological, social, and psychosocial factors in the environment. It also refers to the theory and practice of assessing, correcting, controlling, and preventing those factors in the environment that can potentially affect adversely the health of present and future generations” (WHO, 1993a).
Supportive Environments
- the role of local environmental factors in the healthy development of the community
- an approach that enables and promotes health, as well as protects from environmental hazards
- creation of equity in health within a community
- the importance of sustainable development as a health issue
- people’s understanding of environment in a broad sense
- people’s sense of involvement and personal interest in restoring or creating a healthy environment.
First Environmental Crisis
First public Health law ___(year)
The first wave of sustained and broad-based environmental concern appeared in Europe in the nineteenth century in response to serious public health problems associated with adulterated food and water contamination.
The Public Health Act concentrated on environmental problems of a different type, namely clean water and health hazards related to infectious diseases.
1848
The Second wave of environmental concern
The second wave of public environmental concern, which came in the mid- to late twentieth century, was dominated by two broad movements that came together into what was called the environmental or ecology movement. In the first movement, which had its roots in the nineteenth century, conservation of natural resources and preservation of special sites of natural or historic significance were important priorities. Until the mid-twentieth century its major achievement was the designation in various countries of certain areas as parks, wilderness areas, and other protected lands. The second movement focused on substances that could be toxic to humans or damaging to the environment. It grew in part out of concerns at the turn of the century with food and drug adulteration; its greatest achievement was food and drug safety laws, mostly in the early twentieth century.
____ _____ came out with “silent spring” in _____
Rachel Carson
1962
“Our Common Future” by the ____ commission came out in _____
Brundtland
1987
called for sustainable development
Third Wave of Environmental concern
In the 1980s and into the 1990s, the accelerated rate of economic development, combined with a substantial increase in world population, introduced a critical new factor into the environmental equation. Until the 1980s the levels of production in the developing world were relatively low compared to those in the developed countries. As a consequence, industrial pollution in developing countries tended to be confined to local areas, as it had been in Europe and America in earlier times. Recently, however, production levels in these countries have increased very rapidly along with the demand for goods and the capacity for direct (p.14) trading among countries because of the globalization of trade. Much of the production in this new sector is relatively undercapitalized and therefore it is often based on expedient, cheaper technologies. There are usually few controls over effluents and emissions, and the result is increases in industrial pollution.
Resulted in “Our Common Future”
as much as __% of all sickness and disease in some developing countries has been attributed to the lack of safe water and appropriate means to dispose of excrement (WHO,1992a)
Nearly ____ the world’s population suffers from diseases associated with insufficient or contaminated water, which affect mostly the poor in virtually all developing countries
80
half
Insect vectors breeding in water transmit other life-threatening diseases such as malaria
____ million infected
267
exposure assessment
The measurement and/or estimation of levels of exposure to an environmental pollutant or hazard
a health effect
A health effect is the specific damage to health that an environmental hazard can cause in an individual person
epidemiology
“the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems” (Last,1995)
This definition highlights the fact that epidemiologists are concerned not only with death and disease but also with more positive health states and with the means to improve health.
incidence versus prevalence
incidence: measures of new cases (incidence)
- can only be measured within a defined time period (for acute infectious disease, incidence is often measured in days or weeks, whereas for chronic diseases it is often measured in years
prevalence: measures of existing cases (prevalence)
- Prevalence can only be measured at a specific point in time or over a relatively short defined period (called period prevalence).
qualityadjusted life years(QALYs) ordisability-adjusted life years (DALYs
express the burden of disease in a single number, namely the overall life-years-lost equivalent.
For example, improved rehabilitation, technologies for mobility, and access policies have made physical disabilities much less of a handicap in some countries than they used to be. To assume that a particular type of disability is equivalent to a particular number of life-years-lost in every country at any time may seriously bias the interpretation of what these calculations mean.
The Global Burden of Disease
The sum of disease across all ages, conditions, and regions is referred to as the global burden of disease
Despite successes in tackling vaccine-preventable diseases, each year ___ million children die from them and a further ___ million suffer ill health as a result of these diseases (WHO,1993b
2.8
3
Of the 1.3 billion people living in poverty, __% are women (UNDP,1995).
70
The World Bank has shown that for every year of schooling a woman receives, her fertility rate is reduced by __% and for every 1–3 years of schooling, child mortality rates are reduced by __% (World Bank,1993
10
15
Johnson PDF
Thus, we propose five recommendations for action to elucidate and address health disparities.
First, a national population health framework to set the stage and lead the way.
Second, a coordinated and integrated population health-information infrastructure that includes culturally appropriate, community-relevant indicators.
Third, a plan to assess population health initiatives and relay the information to policy makers.
Fourth, a life-course perspective on health disparity issues and setting priorities.
Last, education, research, training, and professional opportunities that build capacity for innovation and implementation of the interdisciplinary, interprofessional, and multi-jurisdictional strategies for societal action on the determinants of health.
-A National Population Health Framework Needed in Canada
-Identification of intermediate and process targets that meet short-term mandates can maintain momentum towards long-term goals.
-The Saskatchewan Population
Health and Evaluation Research Unit has been a leader
in the development of culturally appropriate, locally
relevant frameworks and indicators, working on one
project with several Aboriginal and northern
communities 20 and on another with provincial government to evaluate population-level interventions to promote child health.
- Canadian examples can be found
in Aboriginal communities and organisations in which
investments have been made in cultural determinants of
health,26 or in cross-jurisdictional and intersectoral
partnerships in the creation of an integrated community
model of primary health-care delivery
