The major global environmental problems (climate change, air pollution, waste, water contamination, etc.) and their adverse impact on human health, lead to an estimated 23-24% of the causes of disease in industrialised countries being attributed to environmental factors. (WHO, 2006)
According to the WHO the priority health risks to the environment relate to:
- Control of vector-borne diseases
- The urban environment
- Indoor and indoor air pollution
- Water, health and ecosystems
- Climate Change
- Production of toxic substances
By linking socio-economic developments with environmental protection and health and well-being, Agenda 2030 offers general support to address health determinants as relevant policies are defined or important choices are made, in a preventive and sustainable way, rather than repeatedly dealing with adverse impacts and inequalities. The commitment to tackle overuse of natural resources, large-scale waste generation, undue influence and private interests at the expense of public interests should enable more sustainable economic activities and the creation of global public goods for health.
The responsibility for environmental determinants of health and the tools to address these determinants are beyond the direct control of individuals or the health sector alone. Substantial transitions in large systems, such as energy and transport, are underway, which can result in profound impacts, both negative and positive, on the health of the population. Therefore, a broader, more holistic, population-based approach to social and intersectoral health is needed. Examples of good practice are available, but such integrated approaches are not universally applied, and rarely address upstream environmental and social determinants of health.
Main contexts to serve as a venue for interventions
The following key contexts present opportunities to address environmental health risks and reduce health inequalities while responding to demographic, social, economic, technological and lifestyle changes.
- Homes. Ensure shelter that: is structurally sound; has adequate indoor temperatures; provides clean water, sanitation, lighting and sufficient space; is equipped with clean, affordable and reliable energy for cooking, heating, lighting and ventilation; and protects against indoor pollutants, the risk of injury, mould and pests.
- Schools. Ensure a safe environment for education; use schools as centres to raise awareness of the links between health and the environment and facilitate the inclusion of best practice in the wider community.
- Workplaces. Ensure coverage of occupational health services that address the full range of physical, chemical, biological, psychosocial and ergonomic risks in the workplace, contribute to the prevention and control of modifiable risk factors, especially those linked to non-communicable diseases, and are adapted to new forms of work, migration and workplace organisation.
- Health units. Ensure the delivery of essential environmental health services, such as access to clean and reliable energy and clean water, sanitation and hygiene; resilience to extreme weather events and climate change; and the protection of health workers and the wider community through chemical safety, infection control and waste management.
- Cities. Addressing the specific challenges of cities as a concentration of exposure to environmental hazards such as air pollution, poor sanitation, waste or occupational hazards, while taking advantage of the opportunity presented by having a single authority in the form of the mayor who has the power to make intersectoral decisions, for example, on urban planning, energy supply, water and sanitation, and waste management.
Platforms for Sustainable Development Objectives
Agenda 2030 has led to the formation of high-level policy forums that are strengthening the means to implement and monitor commitments. Many of the Goals fully support actions to be taken to create healthy environments and are aligned with them. Therefore, these forums are essential platforms to trigger progress and thus act on upstream environmental causes of disease and promote equity in health.
The main objectives for health, environment and climate change, in addition to Goal 3 on good health and well-being, are Goal 6 (clean water and sanitation), Goal 7 (clean and accessible energy), Goal 8 (decent work and economic growth), Goal 11 (sustainable cities and communities), Goal 12 (responsible production and consumption) and Goal 13 (climate actions).
WHO's role and leadership in global health
Promoting healthier populations. Conditions for healthier populations include: healthier cities; sustainable water supply, sanitation and hygiene; healthy transport solutions; clean energy policies; sustainable food and sustainable agriculture.
While the core functions of WHO remain the basis of its work, important changes need to be made to respond to changing requirements. The main focus of work in the area of health, environment and climate change is on promoting healthier populations.