Integration of Health and Environment

8/13/2019 Integration of Health and Environment

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Concept of Integration and Sustainability

•Integration- Fostering a sense

of oneness. An approach thatcombines all aspects that are

relevant to tackle the

problems in the environment.

• Sustainability- “The

development that meets the

needs of the present without

compromising the ability offuture generations to meet

their own needs”.





Relationship of the Panch Tatva with the Environment

The surroundings of an organism living in its natural habitat is termed as

environment. These surroundings include physical, mental and spiritualconditions.

Physical or Abiotic environment- It consists of the combination of “Earth,

Water, Fire, Space and Air” the five basic elements (Panch Tatva) which

influence life.

Living or Biotic environment- It consists of plants, animals ,human beings andmicro-organisms.

All the environmental factors directly or indirectly affect the life of an organism.

These biotic and abiotic components are in a dynamic state i.e. they constantly

depend and affect each other and cannot be dealt in isolation.

The un-thoughtful use of a resource, pollutes the other environmental factor,which in turn affects the polluting one, as all of them are interrelated and

interdependent. This is the fundamental of environmental pollution.



How significant is the impact of environment on health?

Globally, an estimated 24% of the disease burden (healthy lifeyears lost) and an estimated 23% of all deaths (premature

mortality) can be attributed to environmental factors.

Among children 0-14 years of age, the proportion of deathsattributed to the environment was as high as 36%.

Disease with the largest absolute burden attributable to

modifiable environmental factors included: Diarrhoea, lowerrespiratory infections, other unintentional injuries, and vector

borne diseases like malaria.



Regions of the world where health is most affected

by environmental factors

•Developing regions carry a disproportionately heavy

burden for communicable diseases and injuries.

•The total number of healthy life years lost per capita as a

result of environmental burden was 15 times higher indeveloping countries than in developed countries.

•The environmental burden per capita of diarrheal

diseases and lower respiratory infections was 120 to 150

times greater in certain WHO developing country sub-

regions as compared to developed country sub-regions.

•These differences arise from variations in exposure to

environmental risks and in access to health care.



Water and Health •About 21% communicable diseases are

water borne.•50 million suffer from intestinal diseases

eg; diarrhea, cholera, dysentery,

typhoid etc.

•5 million people die, of which 1.5 millionare children below 5.

INDIA

•Total WSH-related diseases 782, 000

•% of total deaths 7.5%

•Total WSH-related DALYs 28. 2 million

• % of total DALYs 9.4%



Water Safety and Quality

Diarrhoea: An estimated 94% of

the diarrheal burden of disease is

attributable to environment, with

risk factors such as unsafedrinking water and poor

sanitation and hygiene.

Issues

• About 25% of water sources are

polluted due to bacteriological andchemical contamination

• 66 mill. at risk due to excess fluoride inDW

• 14 mill. at risk due to excess arsenic indrinking water.

• Intensive use of fertilizer in agriculturecontaminates GW with nitrate.

• Excess use of pesticides is contaminatesGW/ SW. Some are carcinogenic.



Air and Health

•Issues

•Ambient Air Quality1.Transportation and Industries are the

major contributors.

2.SPM is reported to be very high and

mostly in critical condition.

•Indoor air Quality

1.Around 6 lakh Indians die due to indoor

air pollution.

2.Poor Women, children and elderly are

more vulnerable due to overcrowdingand lack of ventilation.

3.Incomplete combustion of biomass used

in poor homes have very high CO, HC

and SPM

Lower respiratory infections:

Associated with indoor air pollution

due to household solid fuel use and

possibly to second-hand tobacco

smoke, as well as to outdoor air pollution. In developed countries,

an estimated 20% of such infections

are attributable to environmental

cause, in developing countries it is

42%.



JMP report 2012:

In World total 1053.7 million people are practicing open defecation. Out of them 60

percent are living in India only.

Census 2011: India

49.8% of total 122.9 million households practice open defecation. In rural India 67.3% i.e.

113 million households practice open defecation.

According to survey done by Sulabh Academy, around 50% of houses lack sewerage

facilities in Delhi slums. Most of the people around 41% uses community toilet and 9%

practice open defecation.

The World Bank – Water and Sanitation Programme study “The Economic Impacts of

Inadequate Sanitation in India (2010)” showed that inadequate sanitation (viz. inadequate

household access as well as associated poor hygienic behavior and lack of safeconfinement and disposal of fecal matter) caused India considerable economic losses,

equivalent to 6.4 per cent of India‟s GDP in 2006 at US$53.8 billion (Rs.5.4 trillion). The

poorest 20% of households living in urban areas bore the highest per capita economic

impacts of inadequate sanitation.

Open Defecation



Sanitation & Health

Fecal oral infections• Open defecation –

major cause of thisinfection

•Contaminated

fingers, food,

domestic flies, soil,contaminated drinking

water help in

transmission

•

Faecal oral infectioncause diarrheal

diseases

•Around 7 lakhs

deaths take place due

to diarrheal diseases





Sanitation and Health

•Studies conducted by Dr. Feachem indicated relative importance

of alternative preventive strategies concerning water supply,

sanitation and health education revealed that health impact of

supplying clean water alone is limited. However carefully

designed programmes which combine water quality with

improvements in water availability, safe disposal of human wasteand hygiene education have the potential to be successful.

•The All India Institute of Hygiene and Public Health, Kolkata,

observed that the mortality and morbidity rates were higher in

villages with only tube well water supply facility than at placeswhere only pour-flush water seal toilets had been provided. The

best results were found where both the facilities were available.

The worst was where none existed.



Health risks of Solid waste•Solid waste can come into direct or indirect contact with

human beings at several stages in the waste cycle- high

health risk.•Uncollected organic domestic wastes ferment, creating

conditions favorable to the survival and growth of

microbial pathogens.

•Organic wastes also provide feeding stock and natural

environment for insects, rodents and other animals.

•Uncollected solid waste can also obstruct storm water

run off, resulting in flooding or creation of stagnant

water bodies which become habitats and breeding

places for water borne vectors of tropical diseases.

•Direct dumping of untreated solid wastes in river, result

in chemical and microbial contamination of water.

•Landfills are a source of fires, dust, smoke, noise and

disease vectors.

•Incinerators cause air pollution toxic chemicals and

heavy metals.





Projected Rise in Global Average Temperature

(Source: www.epa.gov)



Rising Impacts of Global Warming

Extinction of more than 40% of known species ; Global economic losses

of up to 5% GDP ; Partial melting of Green land and W. Antarctica Icesheets ; Eventually raising sea-level 1.3-2 feet.

Major changes in natural systems cause predominantly negative

consequences for biodiversity, water and food supplies.

Widespread coral mortality.Millions more people face flooding risk every year .

Increased risk of extinction for 20-30% of known species.

Most corals bleached.

Increasing mortality from heat waves, floods and droughts

Decreasing water availability ; Increasing drought in many regions ;

Increasing wildfire risk ; Increased flood and storm damage ;Increasing burden from malnutrition, diarrheal, cardio-respiratory and

infectious diseases

2080s

2050s

2020s

+50c

+40c

+30c

+20c

+10c

2007Current

Warming

Over 1980-1999

Temperature levels

Substantial burden on health services; Global food production

decreases; About 30% of global coastal wetlands lost.







Main Objectives

To reduce the disease burden

Help the weaker sections of the society

Introduce community participation and promote self-help

Bring awareness on cleanliness and environmental hygiene

Link preventive healthcare and city planning

Promote ecological balance and sustainable development

Integrate sectoral planning and management at the local area level

Reorient medical services and health systems away from hospitalcare towards primary healthcare

Promote physical, mental and environmental well-being of the urbandwellers



Qualities of a Healthy City

A clean and safe physical

environment

A stable ecosystem that issustainable

A strong mutually supportive and

non-exploitative community

A high degree of participation andcontrol by the public

A diverse, vital and innovative city

economy

Retention of ethnicity and heritage

High health Status



"Treat the earth well: it was not given to you by your parents, it was

loaned to you by your children.

We do not inherit the Earth from our Ancestors, we borrow it from

our Children."

Ancient Indian Proverb

Documents

Integration of Health and Environment