Be well

Cheonggyecheon is a public recreation space in Seoul, South Korea. The massive urban renewal project is seven miles long.

In my first Health Yourself column I described six pillars of optimum wellbeing. These include the physical, emotional, intellectual, interpersonal, spiritual, and environmental domains.

Regular readers will know that I have written extensively about the physical and interpersonal domains, stressing mostly nutrition, physical activity, and stress reduction as ways to preserve and promote wellbeing.

This month I will illustrate the ways in which enhancing environmental health enhances total wellbeing.

The realization of just how much disease and poor health can be prevented by promoting healthy environments should provide an incentive for us to develop more strategies, interventions, and technologies to enhance personal wellbeing. In addition, it’s time to push our local and national politicians, health-care policymakers, and medical practitioners to increase efforts that will promote healthy environments, eliminate health hazards, and reduce corresponding risks to wellbeing.

What is environmental wellness?

Environmental wellness is defined as the health and livability of our surroundings. The term addresses all the physical, chemical, and biological factors external to a person that impact wellness behaviors. Someone who practices environmental wellness is creating health-supportive environments to mitigate disease.

Environmental risks account for a large fraction of the global burden of disease. In 2012 researchers completed a major study that estimates how much disease can be prevented by reducing environmental health risks, and brings together quantitative estimates of the disease burden attributable to the environment. Researchers used a combination of approaches that included epidemiological data, transmission pathways, and expert opinion.

The overall evidence links 133 diseases and injuries that could be prevented through healthier environments. These results reinforce the public health principle that “creating and maintaining healthy environments should be a priority of primary disease prevention.” 

This report is a call-to-arms to all of us to do what we can — now — to reduce environmental health risks.

Direct links between environmental risks and disease

Research evidence mounts demonstrating a direct link between environmental risks and disability-adjusted life years (referred to as DALY – a combined measure of years of life lost due to mortality and years of life lost due to disability). These data are sobering. They suggest the need for global awareness and direct public health interventions and regulations to reduce disease risk. In addition, we all need to take personal responsibility, where we can, to lower our environmental health risks.

Here are some of the highest preventable disease burdens, with percentages that directly link to specific environmental hazards.

Modifiable environmental areas to improve wellbeing

There are eight main environmental areas with the greatest influence on disease burden. If we concentrate our efforts to modify these specific environmental risks we can have a substantial influence on increasing our collective wellbeing.

1.         Pollution of air (including second-hand tobacco smoke), water, or soil with chemical or biological agents

2.         Ultraviolet and ionizing radiation

3.         Noise, electromagnetic fields

4.         Occupational risks, including physical, chemical, biological, and psychosocial and working risks

5.         Built environments, including housing, workplaces, land-use patterns, and roads

6.         Agricultural methods

7.         Man-made climate and ecosystem change

8.         Behavior related to environmental factors, e.g., the availability of safe water for washing hands, physical activity fostered through improved urban design.

Primary prevention opportunities to increase environmental wellbeing

It will take a concerted effort by people and governments worldwide to begin to influence changes in global wellbeing.

But we must start now!

Here are some common-sense examples of actions we all can take to improve our environmental wellness.

1. Increase efforts to preserve our natural resources – use only what you need; only support those businesses that demonstrate environmental stewardship.
2. Reduce pollution and waste. For example:
   • Don’t use disposable plastics (i.e., bags at the grocery store).
   • Do purchase reusable or refillable products.
   • Don’t purchase liquids in plastic bottles.
   • Do start a compost bin — adding the compost to your garden soil increases water retention, decreases erosion, and keeps organic materials out of landfills.
   • Raise the cutting height of your lawnmower to keep grass roots shaded and cooler, reducing weed growth, browning, and the need for watering.
   • Leave grass clippings on your lawn instead of bagging them – clippings return nutrients to the soil instead of taking up space in landfills.
   • Save ashes from your wood-burning fireplace – once cooled, ashes can be mixed into your compost heap.
   • Turn off or unplug lights during the day – doing so saves energy and helps your lights last longer.
   • Use rechargeable batteries whenever possible.
3. Support policies that prohibit smoking in public areas, particularly where there are children.
4. Be an outspoken advocate for preserving air quality by reducing carbon emissions. Here are 10 substances that cause the most concern for air quality:
   • carbon monoxide
   • sulfur dioxide
   • carbon dioxide
   • volatile organic compounds (VOCs)
   • particulates
   • nitrogen oxides
   • ozone
   • chlorofluorocarbons
   • unburned hydrocarbons
   • lead and heavy metals
5. Purchase electric or hybrid cars, lawn mowers, and trimmers that use less or no gasoline.
6. Use alternatives to poisonous, polluting chemicals like plant pesticides and weed killers – learn what chemicals, if any, are safe for our environment.
7. Support policies and practices that maintain sustainable communities – become involved in community affairs and learn best practices.

Our evolving knowledge about environment-health interactions will support the design of more effective strategies and interventions to prevent, reduce, and eliminate risks that threaten global public health.
 
 
References

• Environmental Health. 2015.WHO.
• Lind, L., Lind, P.M. 2012. “Can persistent organic pollutants and plastic associated chemicals cause cardiovascular disease?” Journal of Internal Medicine. 271(6):537. doi: 10.1111/j.1365-2796.2012.02536.x.
• Ling, S.H., Van Eeden, S.F. 2009. “Particulate matter air pollution exposure: role in the development and exacerbation of chronic obstructive pulmonary disease.” International Journal of Chronic Obstructive Pulmonary Disease. 4:233.
• Navas-Acien, D., et. al. 2007. “Lead exposure and cardiovascular disease — A systematic review.” Environmental Health Perspectives. 115(3):472. doi:10.1289/ehp.9785.
• Ndrepepa, A., Twardella, D. 2011. “Relationship between noise annoyance from road traffic noise and cardiovascular diseases: A meta-analysis.” Noise Health. 13(52):251. doi:10.4103/1463-1741.80163.
• Prüss-Ustün, A., et al. 2016. “Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks.” World Health Organization; ISBN 978 92 4 156519 6.
• The Global Health Observatory. 2015. WHO.
• Urban Health. 2015. WHO.
• www.theworldcounts.com/stories/Chemical_Pollution_Examples.