triple jeopardy environmental and health inequalities a clearer future 18 19 sept 2008 l.
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  1. Triple jeopardy: environmental and health inequalitiesA Clearer Future: 18/19 Sept 2008 Dr Jeremy Wight Joint Director of Public Health NHS Sheffield/Sheffield City Council

  2. Biophysical and ecological systems of the natural environment are fundamental to human health • Mounting pressures on the environment are disrupting and depleting these systems • Resulting health risks will particularly affect vulnerable and poorly resourced populations

  3. Globally & Locally

  4. Who you are • Age, gender, ethnicity, income • are known to be main predictors of health and health related behaviour • BUT….

  5. Where you live also matters • Shown for: • Total and CHD mortality • CHD prevalence + risk factors • Morbidity • Depression • Diet, physical activity , smoking, alcohol consumption

  6. Living: • Down wind • Down hill • Down stream • Most deprived are more likely to live near industrial pollution, derelict land, flood hazards & in areas of heavy traffic, noise and poor air quality

  7. Outdoor environment and health INDIRECT HEALTH IMPACTS Safety and incivilitiesGeneral healthObesityPhysical activity Social contact Natural spacesPhysical activity Social contact Psychological well-being DIRECT HEALTH IMPACTS Natural spaces General healthMental healthBlood pressureCholesterolStress & anxiety Recovery rates Air pollution Cardiovascular disease Mortality Cancer Male fertility INDIVIDUAL/ COMMUNITY Floods Respiratory illnessStomach upsetsBlood pressurePsychological well-being Noise Heart diseaseHearing impairmentMental healthReading abilities in children Mixed land useObesitySocial contactPhysical activity Street designPhysical activityObesity Road Traffic Accidents Deaths AccessibilityObesitySocial contact

  8. Direct impacts • People living in most deprived areas are exposed to poorer air quality than people living in more affluent areas

  9. Population sample in ‘high pollution’ areas by decile England

  10. Short term impacts air pollution • Particles, NO2, SO2, ozone, CO • Exacerbation respiratory symptoms • Hospital admissions • Cardiovascular mortality • Days of restricted activity/off work

  11. Long term impacts air pollution • Particles: especially PM 2.5 • Mortality: from all causes, lung cancer & cardio pulmonary mortality: 8 months decrease in life expectancy • In utero/childhood exposure leading to hypertension, type 2 diabetes, heart disease in later life • Low birth weight • Poor lung function development in children • Recent study evidence of impact on IQ • No threshold

  12. Environmental inequality with respect to air pollution is widening

  13. Future trends in England – 2003 vs. 2010

  14. Children & young people are most affected as more children and young people live in deprived areas

  15. Age-based analysis (3)

  16. Triple jeopardy • Socio economic deprivation + • Poorer air quality + • Greater susceptibility to poor air quality

  17. Triple jeopardy • Greater susceptibility due to: • Increased exposure to other pollutants and allergens - incl environmental tobacco smoke • Existing chronic disease • Unhealthy behaviours – diet alcohol • Chronic stress – (raised inflammatory disease markers)

  18. Tackle the root causes • Recognise the connections between environmental • and health inequalities • Which increase risk of diabetes, heart and lung disease, risks which are increased by poor air quality caused by cars, traffic transport, development & planning policies & decisions …. • Air quality is a symptom of cars, traffic, transport, development • & planning policies and decisions • Which reduce social interaction, green space, & opportunities for physical activity • Which in turn lead to chronic stress & obesity,

  19. Climate change • Air pollution is one symptom of a high carbon economy • No longer sustainable for health or environment • Local Area Agreement: national indicator on carbon emissions • Sheffield has target to reduce carbon emissions by 10% by 2011 – will require a reduction of 414K tonnes CO2 over next 3 years

  20. Our challenge

  21. Our challenge • Ecological footprint action research in Sheffield • Locally, as globally, those most affected by environmental and health inequalities tend to have smaller ecological (and carbon) footprints

  22. Our challenge • To reduce carbon and reduce inequality • Housing: affordable warmth programme • Transport: low emissions strategy • Planning & urban design to encourage less car dependence/modal shift • A clearer & fairer future