(Chapter 1) Introduction:  The Environment at Risk
Healthy People 2010 Goals
“Promote health for all through a healthy environment”

Objectives:
–indoor and outdoor air quality
–healthy homes and healthy communities
–toxics and wastes
–water quality
–infrastructure and surveillance
–global environmental health

Environmental Health Threats
–beach closings
–air pollution
–toxic chemicals
–destruction of wildlife habitat
Principle determinants of health worldwide
pollution, population, poverty
Population
over population in developing nations is leading to exceeding carrying capacity of planet

urban crowding

H1N1 (Avian Influenza)

Poverty
–linked to overpopulation and is a determinant of adverse health outcomes
Scope of Environmental Health Problems
–environmental factors are thought to contribute significantly to many forms of chronic disease such as various forms of cancer (cervical, prostate, breast)

–large proportion of the burden of disease associated with environmental sources

–prevalence and mortality from asthma in U.S. have increased since 1980 by 78%, respectively

–high percentage of U.S. children with elevated blood lead levels

–degrading air quality worldwide

Environmental Risk Transition
–characterizes changes in environmental risks that happen as a consequence of economic development in the less developed regions of the world

–before transition occurs: poor food, air, and water quality

Causes of population growth
–increases in fertility and decreases in mortality

–increased sanitation and health care
–increased education and employment opportunities for women
–later age at parturition
–availability of family planning and contraception

Demographic transition
–alterations over time in a population’s fertility, mortality, and make-up
3 stages of demographic transition
1. population mostly young with high fertility and mortality rates. overall population remains small.

2. mortality rates drop and fertility rates remain high. rapid increase in population size, particluarly among younger age groups.

3. fertility rates drop and cause a more even distribution of the population according to age and sex.

epidemiologic transition
–describes a shift in the pattern of morbidity and mortality from causes related primarily to infectious and communicable diseases to causes associated with chronic, degenerative diseases (such as cardiovascular diseases, cancer, neuro-psychiatric conditions, injuries)
consequences of population increases
–urbanization
–carrying capacity exceeded
–food insecurity
–loss of biodiversity
Hazards of the urban environment
1. biologic pathogens or pollutants, including pathogenic agents and their vectors (and reservoirs)

2. chemical pollutants, including those added to the environment by human activities (industrial wastes) and chemical agents present in the environment independent of human activities

3. reduced availability , increased cost, and lowered quality of natural resources on which human health depends (water, food, fuel)

4. physical hazards (high risk of flooding in houses and settlements built on floodplains, mudslides or landslides for houses on slopes)

5. built environment can affect physical or psycho-social health (overcrowding, inadequate noise protection, inadequate provision of infrastructure, etc)

6. natural resource degradation (soil and water quality)

7. national/global environmental degradation with more indirect but long-term influences on human health

carrying capacity
–the population that an area will support without undergoing environmental deterioration

–tends to limit population size

–food availability, reproductive behavior, and infectious diseases tend to keep animal populations in check

population crashes
–animal populations experience “population crashes” when population growth exceeds carrying capacity

–loss of biodiversity

Environment
–refers to the “complex of physical, chemical, and biotic factors (as climate, soil, and living things) that act upon an organism or an ecological community and ultimately determine its form and survival. (physical environment)

–encompasses influences upon the individual that arise from societal and cultural factors (social environment)

Ecological model
a model that describes aspects of health. proposes that the determinants of health (environmental, biological, and behavioral) interact and are interlinked over the life course of individuals
ecological system (ecosystem)
dynamic complex of plant, animal, and microorganism communities and the nonliving environment acting as a functional unit
environmental health
“…comprises those aspects of human health, including quality of life, that are determined by physical, chemical, biological, social, and psychosocial factors in the environment.”
Hippocrates
–greek philosopher (~460 – 370 BC)
–“father of medicine”
–emphasized the role of the environment as an influence on people’s health and health status
–proposed that environmental and climatic factors (weather, seasons, prevailing winds, quality of air, water, food, and geographic location) were influential in causing changes in human health
Bernardino Ramazzini
–“founder of the field of occupational medicine”
–highlighted risks posed by hazardous chemicals, dusts, and metals used in the workplace
current hot topics
–environmental justice
–global climatic change
–nuclear power
–pesticides and herbicides
–war and terrorism
careers in environmental health
1. industrial hygienist
2. toxicologist
3. environmental health inspector
4. occupational health physician/occupational health nurse
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