MIDLANDS STATE UNIVERSITY

DEPARTMENT OF GEOGRAPHY AND ENVIRONMENTAL STUDIES

NAME REG. NO. PROGRAMME : : : TARIRO MANGENA R0432737 POST-GRADUATE DIPLOMA IN ENVIRONMENTAL HEALTH AND SAFETY COURSE ASGMT : : DGES 504-POPULATION HEALTH AND THE ENVIRONMENT Justify the Assertion that Health is an indicator of the

quality of the Population- Environmental Relationships. DUE DATE LECTURER : : 8 SEPTEMBER 2011 MRS MADEWE

Justify the Assertion that Health is an indicator of the quality of the PopulationEnvironmental Relationships One of the major conclusions of the 2005 United Nations Millennium Ecosystem Assessment was that during the past half century, humans have changed our planets ecosystems more rapidly and extensively than any comparable period in history. Deteriorating environmental conditions associated with expanding agriculture or deforestation can pose threats to human health, especially for women, and infants less than five years of age (Conservation international,2006). Population health has been defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group. [1] It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health inequities among population groups. Population health seeks to step beyond the individual-level focus of mainstream medicine and public health by addressing a broad range of factors that impact health on a populationlevel, such as environment, social structure, resource distribution, etc. An important theme in population health is importance of social determinants of health and the relatively minor impact that medicine and healthcare have on improving health overall. From a population health perspective, health has been defined not simply as a state free from disease but as "the capacity of people to adapt to, respond to, or control life's challenges and changes".[2] Environmental Burden of Disease is one methodology for quantitatively assessing environmental health impacts at the population level in terms of deaths, disability adjusted life years (DALYs), or occasionally, number of cases. Other indirect measures can be used to estimate health impacts, for example the number of hospital admissions. The objective is To provide a quantitative estimate of the number of people within a defined population with a health impact that is attributable to an environmental exposure (World Health Organization (WHO), 2002). Quantitative assessments of health impacts are based on combining exposure data with exposure-response information. Such assessments require (i) the compilation of exposure data, (ii) a systematic review of evidence from epidemiology and other scientific disciplines concerning the association between environmental factors and human health, and (iii) the combination of exposure and exposure -response. Quantitative assessments include the following steps:

Specify the health risk to be addressed in the impact assessment. Specify the measure of exposure and the range of exposure to be considered.

Estimate the population exposure distribution. Select appropriate health outcome(s). Select exposure-response relationship in the population of interest, from the scientific literature or available guidance. Combine exposure and exposure-response relationship data for each population group under consideration. (e.g. by age and gender). Calculate the attributable fraction of disease(s) multiplied by the health statistics associated with the disease(s) under study. Quantify uncertainty of the estimate (range of potential effect).

WHO has undertaken an assessment of the amount of disease caused by 26 risk factors in 14 WHO-defined epidemiological regions of the world, by age and gender group. As an example, the results for the number of deaths from six selected environmental risk factors for the group of countries Indonesia, Sri Lanka, Thailand are presented in the graph below.

WORLD HEALTH ORGANIZATION (2002)

These assessments provide a means of estimating the number of people who can be expected to become ill as a consequence of an environmental exposure within a

population. Together with associated cost -effectiveness analysis strategies, this method offers quantifiable evidence to the decision-maker seeking to define priorities within a socio-economic and political context. Such an assessment also provides the basis for other economic evaluations. Roughly one-sixth of the worlds population approaching 1.1 billion people lives in ecological hotspots. These are the planets land areas that are richest in biodiversity and most threatened by human activity. While these hotspots comprise just 12 percent of the planets land surface, they hold nearly 20 percent of its human population, with little access to basic government services like health and education. And that hotspotbased population is growing nearly 40 percent faster than that of the world as a whole (www.environmentalhealth.com,2006).

SOURCE: Population Action International Dramatic changes in forest cover and land use have implications for human wellbeing because there are direct linkages between ecosystems and the essential services they provide, including provisioning services (e.g., food, fresh water, fuel); regulating services (e.g., climate regulation, flood regulation, disease regulation); and cultural services (e.g., spiritual, recreational, educational). These changes have historically led to irreversible loss of biodiversity. Ninety percent of the waste water in the developing world is released into local watersheds, and more than three million people per year,

mostly children, are killed by preventable waterborne diseases such as cholera, typhoid, diarrhea and gastroenteritis. Diarrhoea is still a leading cause of infant mortality . In Madagascar, for example, the Population Reference Bureau (PRB) reports that, in 2002, 30 percent of population was using inadequate sanitation(Conservation international, 2006. Humans and the environment are inextricably linked. Population size and age, fertility, mobility, settlement patterns, and resource availability and consumption all influence the impact we have on the environment. Solving the complex challenges we face today demands a better understanding of how these aspects of population impact the environment, how environmental change impacts our health and well-being, and what can be done to address these issues (Population Reference Bureau,2011). When family planning is widely available and accessible, for example, couples are better able to achieve their desired family size. This not only impacts families health and wellbeing, but contributes to better management and conservation of natural resources and eases population pressures on local ecosystems. Offering basic health services can dramatically reduce community morbidity and mortality and reduce dependence on natural resources for livelihood. Social and environmental conditions shape patterns of population health across the world. While diseases are influenced by a number of specific risk factors and agents, socioeconomically disadvantaged men and women and those who are socially excluded from full participation in their societies are almost without exception at increased risk for whatever diseases are prevalent in their society. Thus, while specific disease agents and risk factors come and go, the social and physical environment shapes both the distribution of risks as well as susceptibility and resilience to risk. Identification of these environmental conditions in both industrialized and developing countries and understanding the ways in which they become biologically embedded is core. Poverty, economic inequality, social isolation and exclusion and job stress along with environmental conditions related to pollution, unsanitary living conditions and poor nutrition shape health in ways that the health care system will be hard pressed to fix (Harvard Center for Population and Development Studies, 2011). Environmental contaminants from air, water, and land can influence the overall health of a nation. However, many factors other than the environment influence the health of a population, such as socio-demographic attributes, behavioral and genetic risk factors, level of preventive care, and quality of and access to health care (USA Environmental Protection Agency, 2011).For human sustainability, priority must be accorded to protection of the urban environment. The creation of employment opportunities is essential in areas with high poverty and unemployment. Poverty also affects the

demographic characteristics of the population and hinders the transition to slower population growth. Unless significant measures are taken to incorporate environmental concerns into development, urban planning, technological innovations, industrial growth, and resource management, the situation is likely to worsen in the future. Efforts to protect the environment requires a range of actions, including conservation of resources, introducing new technology, and taking economic and legal measures to prevent and clean up pollution. In addition, the slowing population growth can reduce the stress on the environment (.Agrawal, Anil, Suita Narain and Shrabani Sen (eds.), (1999). Health therefore is an outcome of the interaction between the population and the environment. Capacity and ability to modify the environment to make them safe is required to curb the burden of disease and reduction of life expectancy. In developed countries harsh weather conditions, for example very low temperatures are survivable because of the availability of central heating systems within most houses. In developing countries, whilst technology to treat disease may be available, the problem is the environment because treated persons return back to the environment where they were infected. Old or aging populations can face negative impacts from their environment e.g. heat waves because of a decline in immunity with time. The characteristics of a population can help determine the possible impact of health problems and the trends and patterns of disease over space and time. Characteristics of a population include:

sex, age, race and ethnicity, and socio-economic factors, such as poverty.

These characteristics may be related to the number of new and existing cases of a particular disease. For example, the number of new cases of different types of cancer among racial groups varies greatly. White women have the highest number of new breast cancer, leukemia, and non-Hodgkins lymphoma cases; Black women have the highest number of new colon and pancreas cancer cases; Hispanic women have the highest number of new cervical cancer cases; and Asian/Pacific Islanders have the highest number of new stomach cancer cases (Centers for Disease Control and Prevention,2010) Socioeconomic factors are conditions that may affect the social standing of a person or group. These factors include education, occupation, and income. They are related to whether a person or group is poor and has health insurance. Studies show that education, occupation, and income are associated with health problems such as heart

disease, asthma, and lung cancer. These kinds of associations are important to consider when deciding whether connections exist between the environment and health outcomes. The association between population characteristics and the environment is difficult to measure. But some research shows that these factors do affect a persons exposure to environmental hazards. Racial minorities and low-income populations may have a greater chance for exposure to several environmental conditions that can threaten their health because they are more likely to live near hazardous waste sites and in areas with high air pollution and poor housing conditions. For example, low-income populations, minorities, and children living in inner cities have more emergency department visits, hospitalizations, and deaths resulting from asthma than the general population. In New York, people living within a half mile of toxic land sites were 66% more likely to be hospitalized for asthma, 30% more likely to be poor, and 13% more likely to be a member of a minority group than people outside the half mile radius (Centers for Disease Control and Prevention,2010). Children exposed to secondhand tobacco smoke are at a higher risk for acute lower respiratory infections, asthma, and middle ear infections. Children living below or near the poverty level are more likely to have high blood-cotinine levels than children living in higher income families. Blood-cotinine levels are a way of telling whether someone has been exposed to secondhand smoke. Some studies suggest that crowded housing and lower parental education levels may be contributing factors( Centers for Disease Control and Prevention,2010) The state of human health globally serves as a key indicator for the conditions of the natural environment and the success of sustainable development. Sound development is not possible without a healthy population. Many development activities affect the environment in a way that typically causes or exacerbates health problems. At the same time, a lack of development adversely affects the health of many people. Environmental pollution is one of the serious problems faced by the people in the country. Rapid population growth, industrialization and urbanization accompanied by growing number of vehicles in countries such as India are adversely affecting the environment. Though the relationship is complex, population size and growth tend to expand and accelerate these human impacts on the environment. All these in turn lead to an increase in the pollution levels. However, environmental pollution not only leads to deteriorating environmental conditions but also have adverse effects on the health of people. leading to deaths and serious health hazards. There is urgent need to control population and environmental pollution for better quality of life and health of present and future generation .(Agrawal et.al1999 ). REFERENCES

1. Agrawal, Anil, Suita Narain and Shrabani Sen (eds.), (1999), "State of India's Environment: The Citizen's Fifth Report, Centre for Science and Environment, New Delhi 2. Centers for Disease Control and Prevention (www.cdc.gov) 3. Harvard Center for Population and Development Studies Social and Environmental Determinants of Population Health 4. The Impact of Inequality: How to Make Sick Societies Healthier. New York: The New Press, 2005. UK: Routledge 5. WHO, World Health Report 2002: Reducing Risks, Promoting Healthy life, WHO, Geneva, 2002, (http://www.who.int/whr/). 6. www.conservationinternational.org 7. www.environmentalhealth.com . 8. www.populationreferencebureau.org 9. www.wikipedia.com