integration of health and environment
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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”.
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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.
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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.
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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.
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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%
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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.
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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%.
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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
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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
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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.
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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.
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Projected Rise in Global Average Temperature
(Source: www.epa.gov)
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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.
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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
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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
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"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