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This article seeks to review the key concepts and issues central to environmental health in relation to the protection of public health. It will focus on the holistic framework in which environmental health operates and the major threats faced. The key issue to be addressed is the need for collaboration at the professional and organisational level as a central prerequisite for a healthy nation.
Peru's expanding population and rapid urbanization--a result of migration to its largest cities--have stressed the country's public services infrastructure and the provision of public health and environmental health services. In response, the Ministry of Health established the General Directorate of Environmental Health (DIGESA), the branch charged with assuring adequate environmental health services to populations in rural and urban areas. The magnitude of the environmental health problems in peri-urban settlements, however, has exceeded the capacity of DIGESA to respond. The Urban Environmental Health Project is an effort to develop the ability of local communities to address these problems
A significant part of the work of an environmental health professional is the communication of information to clients, customers, and the public in the context of safety and health promotion or as an adjunct to enforcement activities. While a wide range of communication methods are available today, printed material still forms an important aspect of the communications methodology of environmental health departments. This paper raises a number of questions about the effectiveness of environmental health promotion brochures in common use in the United Kingdom and the problems that could arise from simply assuming that the brochures are conveying the intended message to the target audience. Through a series of case studies conducted in environmental health departments, evaluative data on a range of brochures were gathered in two interlinked stages: a readability test and a target-audience questionnaire survey. The sources of the brochures included the central government, charities, trade unions, and commercial enterprises; some brochures were produced "in house." Results indicated a common mismatch between the estimated reading age of the target audience and the reading age determined by the readability test; concern about the efficacy of using commercially sourced brochures carrying advertising that may conflict with advice on other environmental health issues; "in-house" brochures that appeared to optimize self-promotion rather than the conveyance of topic information; ineffective brochures used as an adjunct to enforcement activity; and the possibility that the latter could be introduced as defense evidence in related legal proceedings. Overall, the study showed that a well-structured method for brochure choice and ongoing evaluation are essential tools for environmental health departments seeking to maximize their resources and effectiveness.
A political ecology approach to the study of environmental health problems can provide a comprehensive analytical framework with which to understand geographical and social disparities in health status. To date, however, political ecology has remained limited in its application to health problems, and where health has been addressed, biomedical models have prevailed, with little attention to differing explanatory models of health and disease. By integrating political ecology with an interpretive critical medical anthropology, one can better understand the ways in which health and environment intersect, and the differing social responses to environmental practices that affect human health. In this paper I summarize these theoretical issues and then discuss how this theory can be applied toward an analysis of air quality and health in Houston, Texas. This research suggests that local understandings of respiratory health often contradict public health concepts of environmental health and, in turn, differentially shape people's interactions with the environment.
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Environmental health professionals are often confronted with difficult conflicts involving multiple stakeholders. A problem-based-learning approach was used to engage students in a mock conflict resolution exercise involving the heavily publicized dispute over industrial contamination of an aquifer supplying drinking water to neighborhoods in Woburn, Massachusetts. This dispute provided the basis for the bestselling novel A Civil Action, by Jonathan Harr, as well as a major motion picture bearing the same name. Students were assigned to one of three stakeholder groups: the affected families, an industry consortium, or state and federal regulatory authorities. These stakeholder groups were then directed to participate in alternative-dispute-resolution mock negotiations, with the course instructor serving as a neutral facilitator. The "problem" the students were assigned was to reach a consent agreement that was acceptable to all three stakeholder groups. Two groups of undergraduate students (from different semesters) successfully completed all five phases of this endeavor, with nearly unanimous agreement that the approach was more rapid and potentially less expensive than the civil-litigation process portrayed in the book and movie. The alternative-dispute-resolution approach also provided a less adversarial environment, thereby allowing the industry and community groups to work together to forge a more creative, long-term agreement than that which resulted from the actual civil litigation.
As population health programs, environmental health services differ fundamentally from other forms of health service delivery. At a time when the health sector is striving for integration, the incorporation of these unique services into the delivery system presents a unique challenge to policy makers and administrators across the country. The University of Alberta recently completed a comprehensive review and redesign of locally governed and delivered environmental health protection services in Alberta. This paper outlines the key issues and unique features surrounding the delivery of environmental health services and presents the study team's suggested approach to addressing these issues.
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Environmental threats to children's health are complex and multifaceted; consequently, children's environmental health research strives to identify areas of elevated exposure, determine whether particular demographic groups are inequitably exposed, and link exposures to incidence of disease. Many environmental health researchers use geographic information systems (GIS) to ex post display the results of their data collection and analysis. This methodological paper shows some ways by which the ex ante integration of GIS into environmental exposure and epidemiological research can significantly enhance: research design; sampling, recruitment, and retention strategies; data management and analysis; and community translation.
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Events affecting environmental health and food safety policy, programs and organization and emerging or identified foodborne diseases are reviewed by decade. The review starts with the impact of the 1940s war years on environmental sanitation, as it was called, and disease control. It continues with the intensifying disease surveillance and improvements in sanitation of the 1950s and the improvements in foodborne-disease surveillance and the reorganization of environmental programs of the 1960s. Many previously unknown foodborne pathogens were identified, and more changes in environmental policy came about in the 1970s. Evaluation of foodborne-disease control measures were initiated. In the 1980s, evaluation of major foodborne-disease problems came to the forefront. In the 1990s, the media and consumer groups became aware of foodborne-disease problems and concerned with the environment. The first decade of the 21st century will be faced with continuing dilemmas posed by emerging diseases and will need to provide solutions through the balancing of science, education, and politics.
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