A healthy environment is vital to “ensure healthy lives and promote well-being for all at all ages”(1). As the intersection of environment and public health, in the framework of this Strategy, environmental public health addresses global, regional, national, and local environmental factors that influence human health, including physical, chemical, and biological factors external to a person, and all related behaviors. Collectively, these conditions are referred to as environmental determinants of health (EDHs). Threats to any one of the EDHs can have an adverse impact on health and well-being at the population level. (1) These environmental threats can occur naturally or because of social conditions and ways people live. Addressing EDHs improves directly the health of populations. Indirectly, it also improves productivity and increases the enjoyment of consumption of goods and services unrelated to health.
(1) Sustainable Development Goal 3: Ensure healthy lives and promote well-being for all at all ages. The 2030 Agenda for Sustainable Development.
- Approximately 83 million people still do not have adequate sanitation systems of which 15.6 million people still practice open defecation and 28 million do not have access to improve sources of safe drinking water, resulting in about 30 thousand preventable deaths each year;
- Hazardous chemical risks, such as exposure to toxic pesticides, lead, and mercury tend to disproportionally impact children and pregnant women;
- Exposure to toxic chemicals can lead to chronic and often irreversible health conditions such as neurodevelopment problems, and congenital defects and diseases associated with endocrine disruption;
- Environmental changes such as climate change increasingly have an impact on people’s health and well-being in the Region by disrupting physical, biological, and ecological systems globally. Extreme weather events have exacerbated food insecurity, air pollution, access to clean water, population migration and transmission patterns of vector-borne illnesses. The health effects of these disruptions may include increased respiratory, cardiovascular, and infectious disease; injuries; heat stress and mental health problems;
- Groups in situations of vulnerability to climate-related hazards, such as those living on small islands, are subject to a disproportionate risk due to the greater frequency and severity of extreme weather events and the elevation of sea level or communities living in mountains are subject to a disproportionate risk due to changes in river flows, alterations in flora and fauna, and the increased risk of rock landslides, avalanches, and floods due to melting glaciers and decreasing the layer of snow;
- The emergence of new environmental hazards, for example, electronic waste, nanoparticles, microplastics, chemicals that alter the endocrine system and water scarcity;
- Complex management challenges posed by interregional pollution (for example, cross-border air pollution and shared polluted basins).
Five key Sustainable Development Goals (SDGs) of the 2030 Agenda address the environmental determinants of health and contribute directly and indirectly to SDG 3 focused on “health” - ensuring healthy lives and promoting well-being for all at all ages. These SDGs address the issues of water, sanitation and hygiene, air quality, chemical safety, and climate action.
To achieve these objectives, environmental public health programs must evaluate possible health problems attributable to environmental factors; develop inclusive and equitable public policies to protect all people from environmental hazards; and ensure compliance with these policies. This is achieved through inter programmatic, intersectoral, multisectoral, subnational, national and supranational approaches. It is important that environmental public health programs foster an environmentally responsible and resilient health sector and environmentally healthy and resilient communities.
In order to reduce the burden of disease and inequity in health attributable to environmental determinants of health in the Region of the Americas, PAHO provides technical cooperation to the countries of the region of the Americas to increase the capacity of health actors in the Region to address the environmental determinants of health; emphasizing air quality, chemical safety, factors associated with climate, and water, sanitation and hygiene prioritizing populations living in vulnerable situations.
Specifically, PAHO works with the countries of the Region of the Americas through:
- Improving the performance of environmental public health programs
- Strengthening environmental public health surveillance
- Fostering an environmentally responsible and resilient health sector
- Promoting environmentally healthy and resilient communities.
The essential function of PAHO is to harness the power of alliances and knowledge to convene, coordinate and guide processes that have a direct impact on the countries of the Region of the Americas. These processes are implemented by the countries with the support of PAHO and the technical support of the WHO Collaborating Centers and other national reference institutions.