Week 11 Flashcards
Communities and health
Our communities may affect health in several ways:
- access to education, employment
- access to green space, recreation
- access to foods
- access to healthcare
- social connections
- transportation options are implicit in several of the above
- transportation can affect health and well-being:
The good: access to health care, education, jobs, exercise
The bad: traffic accidents, air pollution, noise, sedentary behaviour
Urban planning and public health share common origins
- both fields emerged largely in response to rapid industrialisation, urbanisation, and crowding in the late 1800s
- housing conditions, inadequate sanitation, poor working conditions associated with disease outbreaks
paradigm shifts in the early to mid 1900s
- public health began to focus more on laboratory investigations of infectious agents
- urban planning focused more on efficiency, suburban economic development
–> zoning intended to separate land uses
–> made possible with widespread use of automobiles
Principles of healthy community design
- mixed land use
- transportation alternatives
- density
- walking/biking infrastructure
- affordable housing
- community centers
- access to green space and parks
- access to nutritious foods
Negative aspects of car dependent communities
Effects on communities:
- traffic-related air pollution
–> direct health effects (PM 2.5, CO, etc)
–> climate change (CO2)
- traffic-related noise
–> irritation, stress, impacts on sleep
–> cardiovascular health effects, pregnancy effects
Effects on road users:
- accidents
- negative impacts on physical activity
–> may discourage “active transport” (walking, cycling)
Traffic related air pollution
High or moderate-to-high confidence:
- asthma onset (adults & children)
- ALRIs (children)
- all-cause mortality
- circulatory mortality
- ischemic heart disease mortality
- lung cancer mortality
Moderate confidence:
- term low birth weight
- small for gestational age
- asthma ever
- active asthma
- ischemic heart disease events
- diabetes
- respiratory mortality
Traffic related noise
- hypertension
- CVD
- diabetes
- mortality
road traffic injuries
- over 1.2 million people die each year on the world’s roads (aged 15-29 years old)
Nature and health
the public health field views the natural environment with ambivalence. Infectious agents, extreme weather, and geological events regularly sicken, injure, and kill people, often en masse. Yet people cannot remain healthy w/out clean air, clean water, food, and other resources provided as “ecosystem services”
Pathways between nature and positive health outcomes
- reduction in hazards (air pollution, noise, heat)
- increased physical activity (utilitarian and recreational walking)
- psychosocial influences (increased social connections0
- psychological influences (reduced stress, attention restoration)
Green spaces and health
increased residential greenness was associated with beneficial birth outcomes in this population-based cohort
- adjusting for noise and air pollution didn’t change the estimated effect of green space
green spaces decrease:
- salivary cortisol
- heart rate
- diastolic blood pressure
- preterm birth
- small size for gestational age
- type 2 diabetes
- all cause mortality
- CVD mortality
Environmental justice
is the fair treatment and meaningful involvement of all people regardless of race, colour, national origin, or income, w respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. This goal will be achieved when everyone enjoys:
- the same degree of protection from environmental and health hazards, and
- equal access to the decision-making process to have a healthy environment in which to live, learn and work
Environmental justice considerations
- distribution of environmental goods and bads
- distribution of the effects of environmental goods and bads
- access to the policy making process
- administration and enforcement of environmental protection programs
PCBs
Uses:
- coolants or lubricants in electrical equipment
- food insulators, flame resistant
Persistent pollutants, lipid soluble
Health effects:
- skin condition (acne, rashes)
- liver damage
- some evidence of carcinogenicity
- endocrine disruptors
Canada, US banned production and importation in the late 1970s
Birth of the modern EJ movement
- large amount of contaminated soil needed to be disposed of
–> choose poorest county in the state (I think) - all waste designated for the site was ultimately dumped there
The earliest EJ research
- research into the siting of waste facilities was conducted following the events in North Carolina
- results were controversial and methods were critizied, and EJ research methods continue to receive criticism
Criticisms of environmental justice research
Proximity vs exposure vs impacts:
- easier to demonstrate differences in proximity than differences in exposure
- easier to demonstrate differences in exposure than differences in impact (health)
Chicken or the egg
- did the residents come to the nuisance or was the nuisance imposed on them?
- a particular problem in cross-sectional studies
- does it matter?
Environmental (In)justice in Canada - drinking water in First Nations Communities
- October 2005, high levels of E. coli were detected in drinking waters of the Kashechewan First Nation community in northern ontario
- state of emergency declared in late October
- approximately 1,000 of the community’s 1900 residents were evacuated
- drew significant media attention to the (environmental) condition in Indigenous Canadian communities)
