Humans interact with the environment constantly. These interactions affect quality of life, years of healthy life lived, and health disparities. The World Health Organization (WHO) defines environment, as it relates to health, as “all the physical, chemical, and biological factors external to a person, and all the related behaviors.” Environmental health consists of preventing or controlling disease, injury, and disability related to the interactions between people and their environment.
The Healthy People 2020 Environmental Health objectives focus on 6 themes, each of which highlights an element of environmental health:
Outdoor air quality
Surface and ground water quality
Toxic substances and hazardous wastes
Homes and communities
Infrastructure and surveillance
Global environmental health
Creating health-promoting environments is complex and relies on continuing research to understand more fully the effects of exposure to environmental hazards on people’s health.
Why is environmental health important?
Maintaining a healthy environment is central to increasing quality of life and years of healthy life. Globally, nearly 25 percent of all deaths and the total disease burden can be attributed to environmental factors. Environmental factors are diverse and far reaching. They include:
Exposure to hazardous substances in the air, water, soil, and food
Natural and technological disasters
Physical hazards
Nutritional deficiencies
The built environment
Poor environmental quality has its greatest impact on people whose health status is already at risk. Therefore, environmental health must address the societal and environmental factors that increase the likelihood of exposure and disease.
Understanding environmental health
The 6 themes of the Environmental Health topic area draw attention to elements of the environment and their linkages to health.
Outdoor Air Quality
Poor air quality is linked to premature death, cancer, and long-term damage to respiratory and cardiovascular systems. Progress has been made to reduce unhealthy air emissions, but, in 2008, approximately 127 million people lived in U.S. counties that exceeded national air quality standards. Decreasing air pollution is an important step in creating a healthy environment.
Surface and Ground Water
Surface and ground water quality applies to both drinking water and recreational waters. Contamination by infectious agents or chemicals can cause mild to severe illness. Protecting water sources and minimizing exposure to contaminated water sources are important parts of environmental health.
Toxic Substances and Hazardous Wastes
The health effects of toxic substances and hazardous wastes are not yet fully understood. Research to better understand how these exposures may impact health is ongoing. Meanwhile, efforts to reduce exposures continue. Reducing exposure to toxic substances and hazardous wastes is fundamental to environmental health.
Homes and Communities
People spend most of their time at home, work, or school. Some of these environments may expose people to:
Indoor air pollution
Inadequate heating and sanitation
Structural problems
Electrical and fire hazards
Lead-based paint hazards
These hazards can impact health and safety. Maintaining healthy homes and communities is essential to environmental health.
Infrastructure and Surveillance
Prevention of exposure to environmental hazards relies on many partners, including State and local health departments. Personnel, surveillance systems, and education are important resources for investigating and responding to disease, monitoring for hazards, and educating the public. Additional methods and greater capacity to measure and respond to environmental hazards are needed.
Global Environmental Health
Water quality is an important global challenge. Diseases can be reduced by improving water quality and sanitation and increasing access to adequate water and sanitation facilities.
Emerging issues in environmental health
Environmental health is a dynamic and evolving field. While not all complex environmental issues can be predicted, some known emerging issues in the field include:
Climate Change
Climate change is projected to impact sea level, patterns of infectious disease, air quality, and the severity of natural disasters such as floods, droughts, and storms.
Disaster Preparedness
Preparedness for the environmental impact of natural disasters as well as disasters of human origin includes planning for human health needs and the impact on public infrastructure, such as water and roadways.
Nanotechnology
The potential impact of nanotechnology is significant and offers possible improvements to:
Disease prevention, detection, and treatment
Electronics
Clean energy
Manufacturing
Environmental risk assessment
However, nanotechnology may also present unintended health risks or changes to the environment.
The Built Environment
Features of the built environment appear to impact human health-influencing behaviors, physical activity patterns, social networks, and access to resources.
Exposure to Unknown Hazards
Finally, every year, hundreds of new chemicals are introduced to the U.S. market. It is presumed that some of these chemicals may present new, unexpected challenges to human health, and, therefore, their safety should be evaluated prior to release.
These cross-cutting issues are not yet understood well enough to inform the development of systems for measuring and tracking their impact. Further exploration is warranted. The environmental health landscape will continue to evolve and may present opportunities for additional research, analysis, and monitoring.
Blood Lead Levels
The number of children with elevated blood lead levels in the U.S. is steadily decreasing. As a result, determining stable national prevalence estimates and changes in estimated prevalence over time using NHANES is increasingly difficult.
Eliminating elevated blood lead levels in children remains a goal of utmost importance to public health. The sample sizes available with the currently structured NHANES are too small to produce statistically reliable estimates and preclude the ability to have a viable target for HP2020. Efforts must and will continue to reduce blood lead levels and to monitor the prevalence of children with elevated blood lead levels.