Indicators for environmental health are those that identify a state of environmental degradation that people and communities are exposed to, such as air, water, or food contamination. Life today, and above all well-being, is subject to making decisions that require timely, accurate, and trustworthy information about health and the environment. Indicators have the potential to build important tools for technical and scientific communication; transforming information into action and for that matter, into scientific literacy.
Given the characteristics and functions of environmental health indicators we consider the information relevant in identifying the principal environmental problems and subsequently of communicating them to the citizens, and of guiding problems in scientific literacy. In this regard, and since the scientific literacy of Vision II, environmental indicators contribute to the acquisition of scientific knowledge being used in socially relevant contexts, and therefore should help to resolve environmental problems.
In other words, they contribute to scientific literacy, both formally and informally, addressing in an effective manner the current problems in the field of environmental health. Within this framework in the environmental health indicators we undertake an exercise to identify the main environmental quandaries that are present in the second most populated city in Mexico: Once identified, we pose one of the best strategies to deal with it through scientific literacy of its citizens.
We have three main references: The information provided by the residents on the environmental conditions of the community in which they live is of the utmost importance given the fact that they are affected by their surroundings. One of the most complete studies on the problems identified by the residents of the city of Guadalajara was the Ecology Forum organized by the Guadalajara City Council with the purpose of structuring a Municipal Development Plan. In it were presented environmental matters that were deemed relevant; thus the participants could assess them in order of their importance.
The call was open and issued by means of daily newspapers and radio spots. The results are presented in the following table:.
Services on Demand
In the preceding chart we can observe that air pollution is found within the three main problems mentioned by the different participants in the social sector. Studies carried out in recent years confirm the problem of air pollution. It is increasingly serious, principally in the city of Guadalajara. In the UNEP Year Book , the United Nations Environment Program studied for the second consecutive year the topic of air pollution and human health in cities as an emerging topic for the global environment. Both in and urban air pollution on a global level has been presented as a relevant indicator, including three contaminating criteria: On the American continent, the three countries with the biggest problem in particulate matter are Argentina, Chile, and Mexico.
The countries most contaminated with nitrogen dioxide are Brazil, Mexico, and Venezuela; and in the case of sulfur dioxide: Mexico, Argentina, and Brazil. Main environmental problems identified by different social sectors. In , Bell et al.
The study is very interesting and presents a contribution to environmental health as well as scientific literacy, if we take the information and look at it for example on the level of average pollution by particulate matter less than ten microns. We find that the order of the cities studied according to conditions from good to poor is the following:. But through the environmental health indicator related to the order of cities with regard to exposure of the population under five years old which is the most vulnerable , particulate matter pollution levels that affect health would be in the following order:.
Several studies report that children under five are most vulnerable to damage their health to acute and chronic exposure to air pollutants levels. Their physiological immaturity is because of their organs, tissues and systems are under development. Consequently they are more susceptible to damage by pollutants. Proportionally children breathe more air than adults, are more exposed to pollutants and enter more noxious compounds to their body Makri and Stilianakis, ; WHO ; Salvi The previous information would be a result of changing the state indicator average levels of pollution to one of exposure.
In other words, there is a need for scientific literacy in order to know how not to be exposed to dangerous levels of pollution. Such a need to protect one's health is greater in Guadalajara and Mexico City. When the proportion of numbers of vehicles to inhabitants is analyzed we see that it is greater in the city of Guadalajara than in Mexico City, the latter considered as the metropolis with the greatest population in the country. Likewise, we recognize that a strategy to deal with it is increasing the social capacities in the fields of scientific literacy for its citizens.
Air pollution is an environmental health problem with a tendency to increase in recent years; thus measures are being taken to resolve the structural causes that provoke it. Furthermore, it is a problem before which we are exposed, and its solution not only depends on the individual, but rather on the collective interest and the political will. We must take into account that the analysis of environmental health indicators is a source of valuable information to guide scientific literacy processes. That is to say, a scientifically literate population is capable of stopping and reversing the risks that atmospheric pollution represents to health.
According to information from the WHO , it is estimated that air pollution causes approximately two million premature deaths per year in the world, a situation that is possible to change as long as citizens make appropriate decisions regarding their health and the health of their ecosystems. Air quality is our main link to the environment. Each time we breathe we are connected to and at the same time exposed to its degradation and quality. The study and understanding of how different kinds of practices harm its state constitute fundamental aspects for the development of sustainable societies.
Moreover, air quality is an indicator that in turn allows us to evaluate practices of human civilization like consumption, production, mobility and industrialization. As a consequence, it is accepted that air quality is an indicator of the level of scientific literacy in a community and its relationship with the planet. Generally, residents with low educational illiterate or elementary school had a higher number of deaths from air pollution-related effects than those with high educational attainment middle school or above. The effect estimates of pollutants were times larger among the low-education group compared with the high-education group Kan et al, In many countries, road traffic is the major source of ambient air pollution in urban areas, where most people live.
In , in Denver, Colorado, showed elevated risks of cancer among children living near streets with high traffic density. These results indicate an association between traffic density near the home occupied at the time of diagnosis and childhood cancer age years , Evidence of increasing risk with increasing traffic density was found for the total number of cancers and leukemias Savitz, Childhood obesity has emerged as a major public health problem in the United States and elsewhere.
Recently, researchers examined the role of traffic density around the homes of children. Other research indicates that air pollution exposure, with traffic as a major source in many cities, may operate through inflammatory pathways to initiate metabolic processes contributing to diabetes formation Brook et al, Accordingly, and given the situation that exists in the city of Guadalajara, we urge that curriculum design for both compulsory education as well as for non-formal education be flexible; with an ability to address problems that are causing the most damage to human health and its surroundings.
A greater effort will be necessary for the application of literacy strategies that assist the population that are not a formal education process. The situation that currently exists in Guadalajara is an indication that its citizens do not have literacy which affords them a quality of life; and therefore they are incapable of reducing the sources of pollution vehicles or exposure to pollution. From this brief sketch about air pollution problems in cities and their implications for the health of inhabitants, it is crucial to highlight the importance of focusing efforts on citizen scientific literacy and topics or situations that accomplish criteria suggested by Aikenhead , educational soundness and relevancy rather than political expediency.
Considering these criteria, environmental topics should hold a privileged spot in science curricula and should promote an educated citizenry able to critically examine issues of local importance and global significance in ways they currently do not Dillon, a. Attention to problems in the environmental health field: An opportunity to improve scientific literacy for citizens. Scientific literacy is necessary to address environmental problems and thus requires an interdisciplinary collaboration between natural and social sciences.
Regarding this approach Chapin, et al. This type of environmental literacy has as its main purpose in providing scientific, economic, and social information which would allow the building of a foundation that would guide their actions in both reducing the uncertainties as well as improving their well-being. When we discuss citizen literacy regarding environmental health we would like to emphasize that the concept is not limited to individual actions aimed at mitigating environmental impact problems by the prevailing development systems, but rather we consider the transformation capacity derived from the social awareness that leads to a better cultural relationship with the environment; leads individuals and communities to take the environmental issues as a matter of interest, and responsibility and collective action.
Scientific literacy should recognize the need to make science education more culturally and socially relevant Roth and Barton, Touching upon the air pollution problem once again in the Metropolitan Area of Guadalajara, concurrently we consider that the current situation demonstrates the quality practices of its inhabitants. Although actions have been taken to resolve this situation, it has not yielded the desired effects.
However, what we deem important is that it represents an opportunity to undertake community practices which create a permanent scientific literacy process that may lead to a better understanding of the decision making population and its well-being. We recognize that environmental health is a condition for a sustainable development to which we aspire; not only as a technical and specialized issue, but rather a human one as well.
Primarily the most important challenge is to generate a better understanding of environmental and health problems and provide tools that enable citizens to become more participative in committed action, i. In consequence, "focusing on issues of health and the environment might motivate more students to appreciate the value of science and to consider studying it for longer either at school or elsewhere. Towards a cultural view of quality science teaching. Gunstone Eds , The professional knowledge base of science teaching International Handbook of Science Education.
Environmental health indicators and a case study of air pollution in Latin American cities. The relationship between diabetes mellitus and traffic-related air pollution. J Occup Env Med, Scientific Literacy and Discursive Identity: Journal of Environmental Studies and Sciences, 1: Chartered Institute of Environmental Health, London. Decision-making in Environmenal Health: Limitantes al desarrollo sustentable en Jalisco. Marco para una agenda educativa participativa. Another look at its historical and contemporary meanings and its relationship to science education reform.
Journal of Research in Science Teaching, 37, 6, Towards a renewed pedagogy for science education. Clay's Handbook of Environmental Health. Salud ambiental, campo de la complejidad ambiental. Revista Ideas Ambientales 2: New minds for a changing world. Science Education, 82, School science, citizenship and the public understanding of science. Institute of Medicine US. Rebuilding the Unity of Health and the Environment: National Academies Press US ; Advances in the field of environmental health have taught us much about human health hazards; for example, air pollution can cause respiratory disease, heavy metals can cause neurotoxicity, global climate change is likely to fuel the spread of infectious diseases.
Domestically, the response has been to clean up the environment, a laudable goal, said Rafe Pomerance of Sky Trust. Environmental health issues traditionally have been addressed at the international level within the context of such issues as ozone depletion, climate change, and biodiversity.
Countries have tried to address these issues through the multilateral process, such as multilateral agreements and commissions, bilateral assistance and cooperation, private sector investment, trade, the work of nongovernmental organizations, education, and training. These efforts can be profoundly effective, asserted Pomerance; witness the reductions in the emissions of chlorofluorocarbons achieved through legislation and transnational agreements in the s.
However, efforts have not been so successful in maintaining biodiversity, said Pomerance, as the world continues to lose species on a daily basis. Challenges also remain in assuring a safe and healthful food supply. The natural environment, broadly conceived, can also enhance health, for example, many pharmaceuticals are derived from plants and animals, providing a compelling argument for preserving biodiversity.
In addition, contact with the natural world may be directly beneficial to health. If so, then the field of environmental health needs to extend beyond mere considerations of toxicity. According to the speakers, research and policy must be directed toward understanding the interactions of human health and the natural environment, from the most personal level—that is, how individuals interact with the world around them—to the global scale—that is, how nations agree to reduce pollution, pursue sound agricultural and land use practices, and feed their citizens.
Each of these issues is explored below. A theoretical basis for the notion that contact with nature is beneficial comes from E. Wilson, who introduced the term Biophilia almost 20 years ago, defined as the innately emotional affiliation of human beings to other living organisms. From an evolutionary perspective, a deep-seated connection with the natural world should be no surprise. Humans have been evolving for more than 2 million years, yet have lived relatively insulated from nature for only the last 10, years.
This is not a new idea, claimed Howard Frumkin of Emory University. The human connection to nature and the idea that this might be a component of good health have a long and fascinating history in philosophy, art, and popular culture. There is ample evidence—from animals, plants, landscapes, and wilderness experiences—that we can build on this affiliation to enhance our health. Animals have always played a prominent part in human life. Today, more people go to zoos each year than to all professional sporting events.
More than half of all U. A considerable body of evidence links contact with animals to human health.
Chemicals, man and the environment: a historic perspective of pollution and related topics.
According to Frumkin, preserving the bond between people and their animals, like encouraging good nutrition and exercise, appears to be in the best interests of those concerned with public health. Exposure to plants and flowers also nourishes a sense of our well-being. In a National Gardening Survey of more than 2, randomly selected households, half of the respondents agreed with the statement that flowers and plants at theme parks, historic sites, golf courses, and restaurants are important to enjoyment of these locations, and 40 percent agreed with the statement that being around plants makes them feel calmer and more relaxed.
Office employees report similar feelings, stating that an office with plants is a more desirable place to work. Psychologist Michael Perlman has written of the psychological power of trees, as evidenced by mythology, dreams, and self-reported emotional responses. Indeed, the concept that plants have a role in mental health is fairly well established, said Frumkin. Of note, hospitals have traditionally had gardens as an adjunct to recuperation and healing. Perhaps this time-honored practice reflects a recognition that proximity to plants, like proximity to animals, may in some circumstances enhance health see Figure 3.
The addition of gardens has been shown to be essential for mental health and helps individuals recuperate after illness. However, that impact is undeniable. Over a billion people in developing countries, for example, have inadequate access to water, and 2.
The World Health Organization estimates that environmental factors were responsible for However, as these data suggest, there is also a fundamental equity dimension to the distribution of both the cause and distribution of environmental stressors, the susceptibility to exposure, and the adverse effects of those exposures. Poor indoor air quality is associated with unfit or inadequate housing standards, conditions that overwhelmingly affect the deprived The Marmot Review Team, There is evidence that deprived communities are not only more exposed to environmental hazards but are also more susceptible to the effects of those exposures Goodman et al.
This effect is also seen in social and physical environments. An adequate and nutritious diet is essential to a healthy, productive, and fulfilling life, and it is a fundamental right predicated by a range of factors including personal knowledge, choice, convenience, availability, quality, cost, and social norms. The proportion of adults considered overweight or obese in in the 19 EU member states for which data were available ranged between 37 and 57 percent for women and between 51 and 69 percent for men EUROSTAT.
English children from deprived areas are almost twice as likely to be obese than those in affluent areas, and adult obesity is also associated with deprivation, particularly in women Public Health England, ; National Obesity Observatory, The poor in developed countries are adept at sourcing cheap calories and are exposed to a large numbers of local outlets selling cheap, calorie-dense takeaway food Saunders et al.
These meals are often super-sized and contain high levels of fats, sugar, and salt. At the same time, many of these areas provide limited access to healthy food options, creating a highly compromised public health environment Saunders et al. In addition, environmental stressors seem to have a cumulative impact, exacerbating this inequality. It is evident that poorer people have multiple health, social, and environmental stressors.
It is entirely plausible that these stressors modify the effect of exposure to pollutants, as is reflected in the increased vulnerability of obese people to the effects of exposure to air pollutants, including increased risk of diseases such as cardiovascular events and respiratory symptoms WHO, ; Jung et al. Long-term exposure to airborne pollutants has also been reported to increase the risk of obesity, and being overweight or obese is associated with an increased susceptibility to indoor air pollution in urban children with asthma Lu et al.
The responsibility for, and relative benefits and costs of, environmental contamination are also important components of inequality. Environmental contamination may be tolerated by communities living in the vicinity of dirty industrial processes if they perceive a benefit in terms of local employment, although that trade-off has largely broken down in developed countries as those industries have declined in the 20th and 21st centuries.
This is a gross injustice. This poisonous cocktail of waste oil and contaminants was the result of the trading in, and processing of, hydrocarbon fuels by multinational commodity and shipping companies, criminal levels of cost cutting, and local political corruption, which led to 17 deaths and over 30, injuries in one of the poorest communities in the world Bohand et al. Inuit mothers in northern Canada have elevated levels of chemicals such as PCBs—generated many hundreds, if not thousands, of miles away—in their breast milk Johansen, The redistribution of the environmental injustices historically endured by the poor also perversely appears to be affecting more affluent communities in the West.
During a period when environmental catalysts for distress migrations are becoming more frequent Thomas-Hope, , there is a moral as well as a professional duty for the Environmental Health community to tackle these inequalities, which otherwise are likely to both widen and deepen. While human communities have long valued access to natural resources such as green spaces, the industrialization of the 19th and early 20th centuries saw millions of people deprived of this access.
This era did witness some far-sighted philanthropic gifting of areas of open recreational space for the working classes driven by a moral rather than evidence-based imperative. Though welcome, the distribution of, and access to, such resources was limited, inconsistent, unplanned, and vulnerable to the insecurities of voluntary funding. Subsequent local municipal development of parks and other open spaces increased access, and a greater understanding of the benefits of such access blossomed during the late 20th century as research demonstrated and quantified the public health dividends.
Access to good-quality green spaces not only makes the places in which we live, work, and play more attractive, but also has a demonstrable effect on improving health and well-being. Green space is linked to lower levels of several diseases and conditions, including lower rates of mortality Villeneuve et al. Plausible mechanisms for these benefits include the provision of a venue for physical activity, promotion of social contact, and the direct impacts of green spaces on psychological and physical health.
Natural spaces also promote greater community cohesion and reduce social isolation, providing a platform for community activities, social interaction, physical activity, and recreation Public Health England, Research from the United States has identified powerful associations between green space and major reductions in aggressive behavior, domestic abuse, and other crime in deprived urban areas Kuo et al.
And yet, there remain great inequalities in the distribution, use, and quality of this empowering resource. People living in the most deprived areas are less likely to live in the greenest areas and therefore have less opportunity to gain the health benefits of green space compared with people living in the least deprived areas Public Health England, Accessibility, however, is not the same as availability or utility, nor is it simply a function of proximity. It is strongly impacted by the cost of access, whether it is actually physically available, opening times, and the ease of being able to get to it, for example, walking and good public transport.
Deprived communities in particular appreciate the value of such spaces, but they tend to underuse them due to concerns about the safety and quality of the spaces CABE, Experience has shown that quality of the green space is just as important, if not more so, than its size.
Environment in Health and Well-Being - Oxford Research Encyclopedia of Environmental Science
Post-World War II urban developments in many countries have included large grassy areas, and substantially derelict former industrial sites have often been entirely grassed over. The sterility and sheer size of these sites, the cost of maintenance, and the lack of facilities have often led to misuse and subsequent abandonment by both communities and local municipalities. The provision, maintenance, and promotion of good-quality and safe , publicly available spaces is not a subsidy; it is an investment delivering economic, health, and regeneration benefits.
Research on Philadelphia estimated that maintaining city parks could achieve huge annual savings in health care costs, stormwater management, air pollution mitigation, and social cohesion benefits The Trust for Public Land, The improved social cohesion associated with natural spaces also has economic benefits. It is clear from the evidence that increasing the use of good-quality green space for all social groups is likely to improve health outcomes and reduce health inequalities. Among the developments that, for Western societies, consigned environment to the periphery of medical and public health interest in the post—World War II era, we highlighted the epidemiological transition in the midth century.
Indeed, for a period in the s and s it seemed that infectious disease in the developed world had effectively been conquered Fauci, It was even tempting to suggest that the developing world might eventually follow suit. Yet, within a relatively few years, the twin threats of emerging infectious disease and antibiotic resistance would shatter the earlier confidence and reestablish infection as a live threat to individuals, communities, and populations and one that presented, increasingly, on a global scale. Although the return of infection was not necessarily anticipated by a confident global community, many predisposing factors were clearly present.
Changes in land use, growth and movement of populations, contacts between people and animals, international trade and travel, and, often, an absence of a public health infrastructure all played a part. Where such influences coincided, as in sub-Saharan Africa or parts of Asia, hotspots were created that were conducive to the emergence of infectious disease. Several hundred new infectious diseases appeared across the globe in the period between and , with the greatest number emerging in the s Jones et al.
By , AIDS alone would result in approximately 78 million cases worldwide. More recently still, the distressing incidence of microcephaly in South America putatively linked to the Zika virus simply emphasizes the abiding challenge posed by infection for public health and global economics European Centre for Disease Control, Antibiotic resistance has been a developing public health horror story over, perhaps, 50 years.
The therapeutic use of antimicrobials and especially antibiotics was a key factor in slashing the burden of illness from infection in Western countries in the latter half of the 20th century. Yet all classes of organisms—fungi, protozoa, viruses, and bacteria—can develop antimicrobial resistance. Through their genetic processes, bacteria have derived multiple resistance mechanisms to antibiotics used in medicine and agriculture. The threat renders humankind vulnerable to a host of infections, notably in hospital settings where treatment options for many infections are now severely limited.
The challenges of EIDs and antimicrobial resistance are, unquestionably, game changers for medicine and public health in the 21st century. Importantly, they are among the factors that have revealed the true limitations of the biomedical model of health and disease in the 20th century and rekindled interest in the socioeconomic and environmental determinants of disease.
Although it is believed to have origins in nonhuman primates in West Africa, it is not an environmental disease in the sense that there is a specific environmental reservoir. Medical sciences and epidemiology have shown transmission of the virus via unprotected sex, contaminated blood transfusions, hypodermic needles, and mother to child transmission during pregnancy, delivery, and breastfeeding. HIV the infection and AIDS the disease have shown the capacity to extend beyond the initially identified high-risk groups, potentially placing whole populations at risk.
In some areas of sub-Saharan Africa where the infection is widespread, it impacts negatively on almost every aspect of society and the economy. Over 30 years after it first emerged and despite concerted efforts, there is still no cure. In addition to banishing complacency, the infection and the disease call for a much wider perspective than that which took root in the postwar era of scientific positivism and medical paternalism.
The failure to manage the threat stems in part from an incapacity to understand where to intervene to change behaviors and to see the disease in its social and environmental context. Earlier in this article, we identified five issues that helped reestablish awareness of the environment as a key component in the production of human health and well-being in the late 20th century.
These issues, and our understanding of them, continue to evolve to challenge the public health community and wider society in the 21st century. In the most general terms, progress seems most likely where issues and challenges are framed with reference to a much wider range of pertinent factors by developing new approaches to evidence and its synthesis; by aligning institutional, physical, and educational infrastructures to the task; and by building governance structures in which all players are accountable and yet are encouraged to unite in common cause.
However, society must now embrace an additional and potentially more devastating threat to health and well-being. Human activity, including economic activity, is now directly and indirectly driving changes to the ecosystems and planetary processes on which we rely for health, well-being, and existence. For too long, human beings have lived, moved, consumed, and pursued health and well-being as if humankind is distinct and separate from nature rather than integral to it.
The consequences of this disconnect for the natural world were graphically expressed by Rachel Carson in the s and many others in the ensuing years e. However, developments in science and technology now reveal the true extent of the crisis, its accelerating nature, and its consequences both now and in the medium and longer term. The relationship of the environment and human health and well-being must be understood and addressed on vastly extended temporal and spatial scales.
The notion that the planet is a finite resource on which human activity can place intolerable pressure and that the consequences of doing so are potentially catastrophic has been around for some time e.
A contemporary evolution of this thinking is expressed by Rockstrom and colleagues. Where applicable, it proposes thresholds beyond which nonlinear, abrupt, and potentially catastrophic changes in these systems might be expected. Also included are systems of a rather different sort. These are the slow variables that buffer and regulate planetary resilience. These slow variables comprise interference with the nitrogen and phosphorus cycles; land-use change; rate of biodiversity loss; and freshwater use.
Two parameters, air pollution and chemical pollution, are especially difficult to quantify, meaning that thresholds cannot yet be defined. It is emphasized that, while for understandable reasons, the nine systems are often discussed independently, they are interrelated in ways meaning that changes in one system have profound implications for the others.
Rockstrom and colleagues observe that in the preindustrial era, all nine parameters were within the safe operating boundaries, and yet by the s, change was underway, most evidently in the nitrogen cycle. By , according to their analysis, three planetary boundaries had been transgressed: An implicit challenge in limiting global ecosystem damage and its multiple implications is how to achieve recognition among the public and policymakers that the choices they make either directly or indirectly cause ecosystem damage and related environmental change Morris et al. Climate change is simply the most striking example, but comparable challenges over communication exist in relation to other planetary process and systems.
It also demands a much fuller appreciation of the global connectivity of social, economic, and ecological systems Morris et al. When initiating our discussion of the role of environment in health, we observed that the modern public health era was built on an environmental conceptualization of public health. It is now inconceivable that health, well-being, health care, and equity in any of these domains can be delivered without rediscovering an environmental conceptualization of public health for the 21st century.
The extent to which we embrace ecological principles will be evidenced in policies that address how we live for example, the energy efficiency of our homes , how we move particularly our reluctance to substitute travel in fossil-fueled cars with more active forms of travel ; how we consume notably how we source and produce food and, of course how we obtain and conserve energy. Despite being necessarily selective, this article has sought to illustrate how perspectives on the role of the environment in human health and well-being have evolved over the course of the modern public health era.
Perspectives can be seen to shift owing to changes in the nature of environmental hazards and risks that are themselves products of the evolution of how societies live, move around, consume, source their energy, and so on. Our understanding of the health relevance of the built and natural environments is also shaped by advances in scientific understanding and technology and a much wider economic, social, cultural, and even political context.
These eras are differentiated according to the dominant paradigm of the time concerning the causes of disease, each underpinned by analytical approaches to understand and prioritize risk. The importance accorded to the environment as a mainstream public health issue arguably reached its lowest point in the decades following World War II when the tendency to regard health and disease as characteristics of individuals, rather than communities or populations, gained prominence. This approach diverted attention from social and environmental factors, divorcing health from place. Notions that humans are self-contained and impervious to context have now been largely swept away, not least because denial of a socioecological perspective hugely undermined attempts to address the most serious contemporary health challenges.
Also instrumental in challenging the notion of the self-contained body has been an environmentalist movement with a particular interest in pesticide and other chemical contamination of the biosphere. The toxic effects of chemical contamination reinforce the reality of a body that is permeable and invariably in a state of intimate exchange with its surroundings.
We would simply add that humans exhibit comparable porosity and vulnerability to the social and economic context in which they exist. We recognize that our account contains only limited reference to the regulatory context that has been so central to controlling the environment for public health. We consider it appropriate to sound a warning in this regard.
The processes through which environment is monitored and regulated to protect human health and well-being are sometimes taken for granted. Pressure to loosen or even abandon aspects of environmental regulation has weakened formal controls, leaving society vulnerable to corporate excess and irresponsibility, with often serious impacts on public health Oldenkamp et al. This is not to argue that regulation should be static. Rather, it should adapt to changing technological, social, and economic circumstances and should be appropriately funded whether it relates to the quality of the air we breathe, the water we drink, the buildings we live, learn, and work in, or the nutritional aspects of the food we eat.
Neither do we deny the potential to exploit citizen science and the power of new technology to supplement conventional regulation e. Mainly anthropogenic damage to planetary resources and ecosystems demands that, wherever we are in the world, public health agencies must understand not just the proximal threats to health and well-being that have been the targets of public health intervention throughout the modern public health era.
They must also understand and move to prevent, counteract, and contain more distal threats to health and well-being. The distal threats derive from changes to environments that appear remote in space or time or involve a complex interaction of social, environmental, and economic influences. These are no longer abstract considerations. The unprecedented global connectivity of economic and social systems and the growing understanding of ecosystem interdependencies demand that the implications of human activity for health and well-being be recognized, understood, and addressed on a vastly extended temporal and spatial scale.
Only by build health and well-being on ecological principles Ecological Public Health will society effectively address the more distal threats to health and well-being from global ecosystem damage; the socioecological complexity of the proximal environment and the interconnections between these. In this necessarily brief and artificially linear account, our intention has been to reinforce the enduring importance of the environment for health and well-being.
Along the way, we have identified three factors that have marginalized the environment as a component of health and disease. We suggest that they continue to represent clear and present threats, undermining public health and, in the case of the latter, an existential threat to humankind. This tendency to think of disease almost exclusively in terms of pathogenic agents and organic dysfunction marginalizes any influence outside the crucible of the laboratory. This trend was most evident in the decades following World War II but remains an ever-present threat.
Closely related to medical reductionism is the tendency to downplay the importance of local context for life. Such perspectives are divisive. Science now permits humans to understand the true extent to which their activities are plundering natural resources and harming the planetary systems and processes on which they depend. The pace of change is such that health, well-being, heath care, or anything approaching equity in these things will not be sustained in the medium to longer term without radically rethinking society, the environment, and the economy.
The global connectivity of social, economic, and environmental systems means, ultimately, that no one is insulated from the threat whether by distance or socioeconomic circumstance. It demands recognition of the dynamic interconnections between people and their environment. Manifestly, we depend on the environment we inhabit, and we powerfully affect it. Among the clearest impediments to delivering ecological public health and preserving a viable environment for future generations are the belief that we can manipulate and conquer the natural environment without consequence, and the irresponsible capitalist imperative that subverts regulatory standards and damages and exploits the environment for profit.
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