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Introduction: Key Concepts (Moeller Chapter 1)

Geography 361a Environment and Health. Introduction: Key Concepts (Moeller Chapter 1). Discussion: Is the world more dangerous? Historical Context Concepts/Definitions. Context: Discussion. Is the world more dangerous now than it was 20 years ago?

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Introduction: Key Concepts (Moeller Chapter 1)

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  1. Geography 361aEnvironment and Health Introduction: Key Concepts(Moeller Chapter 1) • Discussion: Is the world more dangerous? • Historical Context • Concepts/Definitions Geog 361b

  2. Context:Discussion • Is the world more dangerous now than it was 20 years ago? • What are some useful ways to qualify/refine the question above? • Break into groups of 4 and discuss. Geog 361b

  3. Context • healthier than ever • highest life expectancy ever • awareness of hazards and risk high • e.g., 46,962 articles on “hazards” in major Canadian dailies 1985 to present. • (reference: “free trade” – 76,531) • population “at risk” increasing Geog 361b

  4. Life Expectancy http://www.undp.org/hdr2003/indicator/indic_1_2_1.html http://www.cia.gov/cia/publications/factbook/rankorder/2102rank.html Geog 361b

  5. Life ExpectancyTime-trends USA For Geog 361b

  6. Life ExpectancyTime-trends Canada For Geog 361b

  7. Causes of Death Canada For Geog 361b For

  8. Causes of Death Geog 361b Source: Thomas and Hrudey (1997) Risk of Death in Canada

  9. World Population Growth world population clock Source: http://www.prb.org/ Geog 361b

  10. Concepts/Definition Environmental Health • “That segment of public health that is concerned with assessing, understanding, and controlling the impacts of people on their environment and the impacts of the environment on them." (Moeller 1997, 1) Human Health • emphasis of this course is the latter half of this definition • former half is an “undercurrent” of the course Geog 361b

  11. Concepts/Definitions Contamination • when substance exceeds capacity of “environment” to eliminate it • aggregate output of substance exceeds some sensory or predetermined limit • e.g., wood fires “allowed” in rural vs urban areas. Geog 361b

  12. Selective Historical ContextEarly Writings Hippocrates (460 BC) • On Airs, Waters and Places • winds, seasons and sources of water important for physician diagnosis • occupational diseases – e.g. “lead colic” in miners • explanation for decline of Rome? • water delivery lead pipes/aqueducts • lead-lined vessels – aristocracy Geog 361b

  13. Selective Historical ContextOccupational Health • Georgius Agricola (1556) • De Re Metallica (12 books!) • occupational diseases among miners – joints, lungs (e.g. silicosis, tuberculosis, lung cancer), eyes Geog 361b

  14. Selective Historical ContextOccupation and Cancer • Percival Pott (1775) • First detailed writing about occupationally-induced cancer • scrotal cancer in chimney sweeps • soot + tar + infrequent washing Geog 361b

  15. Selective Historical Context • John Snow (1855) • On the Mode of Communication of Cholera • well intake near sewage outfall “graph on map to mark cholera deaths” Broad Street pump linked to cholera Geog 361b

  16. Selective Historical Context • water sanitation dramatically decreased several water borne diseases Geog 361b

  17. Contamination Natural Contamination • e.g., sulfur, radionuclides, radon Anthropogenic Contamination • e.g., CO, pesticides • focus of most attention (not always deservedly so) Geog 361b

  18. Scope Some Problems Studied • toxic chemicals • waste (e.g., toxic, municipal, radioactive) • workplace stress • built environment • overpopulation • food supplies • acid deposition • global warming • resource depletion • … Geog 361b

  19. Practitioners Some Disciplines (Multidisciplinary) • toxicologists • epidemiologists • economists • geographers (health, hazards) • sociologists • lawyers • planners • engineers • managers • … Geog 361b

  20. Defining “Environment” Inner vs Outer Environment • protective barriers between inner and outer: • skin • GI tract • lungs • which barrier makes humans most vulnerable? Why • problems with this categorization of “environment”? Geog 361b

  21. Defining “Environment” Personal vs Ambient Environment • personal = individual control • ambient = outside individual control • problems with this categorization of environment? Geog 361b

  22. Cancer Caused by Environmental Exposures categorize each above as “personal” or “ambient” Geog 361b

  23. Defining “Environment” • gaseous, liquid and solid • each linked with particular routes of exposure to humans • problems? Geog 361b

  24. Defining “Environment” Chemical, Biological, Physical, Socioeconomic • Chemical - contaminants • Biological – disease organisms • Physical – e.g., noise, temperature, radiation • Socioeconomic – e.g., SES, environmental justice • problems with this categorization? Geog 361b

  25. Exercise:Defining “Health” Define “health”. Geog 361b

  26. Defining “Health” WHO (1948) • “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” • physical • mental • social well-being Geog 361b

  27. Disease Classification infectious vs non-infectious • infectious • e.g., malaria, cholera, diarrhea • pathogenic organisms • major killer in the past • not typically considered an “environment and health” issue (e.g., Nadakavukaren, 2000) – but Walkerton! • historically mono-causal • non-infectious • e.g. cancer, heart disease, asthma • major killer now • multi-causal model • typical environment and health concern these outcomes Geog 361b

  28. Disease Classification endemic vs epidemic • endemic • pathogen carried by many people • typically not considered an environmental illness issue • e.g., ? • epidemic • pathogen carried by many people • sudden and severe outbreak of a disease in a population • e.g., ? Geog 361b

  29. Disease Classification acute vs chronic • acute • severe short term disease • or disease/symptoms due to short term high dose exposure to environmental substance • QOL: if survive, no long-term effects • e.g., ? • chronic • long term disease/condition • or disease/condition due to long term low dose exposure to environmental substance • QOL: long-term effects often duration of life • e.g., ? Geog 361b

  30. Systems Approach • controlling one form of environment and health problem can lead to other problems • e.g., chlorination, fluoridation of water • e.g., pesticides • risk analysis and cost/benefit analysis helpful • not strictly a technical problem Geog 361b

  31. Components of Assessing Environment and Health Problems • determine the source of contamination/stress • determine how contamination/stress contacts humans • measure the resulting effects • assess the seriousness of the effects • apply controls as necessary How “social” is this process? Geog 361b

  32. Models of Environmentand Health Geog 361b

  33. Models of Environmentand Health: Multicausality source: Jones and Moon (1987) Health Disease and Society source: Jones and Moon (1987) Health Disease and Society Geog 361b

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