Health and the Environment

In the run-up to SERA's next big public conference, we reproduce the introduction to "Health and the Environment", a document jointly published last year by SERA and the Socialist Health Association.

Labour’s new statement of aims and values commits the Party to work for "a healthy environment, which we protect, enhance and hold in trust for future generations." The wording expresses an important link between health and environment, a link which this report explores in more detail.

A healthy nation is not just a question of better health services. Social, economic and environmental policies have enormous importance, which is recognised but often ignored. Social and economic policies affect income, employment, food, housing and the environment. Throughout our lives from birth to old age, those at the bottom of the social scale have much poorer health and quality of life than those at the top. Gender, where we live and our ethnic origin also have a great impact. This was well established by the Black report on inequalities in health, published in 1980.

Issues of inequality, pollution and health

The work of the Black Report has been followed up with damning evidence that during the 1980s the health divide has worsened. A series of reports from public health bodies have demonstrated the consequences of inequalities on society. In particular:

The wider the gap between rich and poor in society the shorter the life expectancy of everyone, rich and poor. The most effective way of improving health is to make incomes more equal.
Agricultural policies damage the environment, put up tariffs against the third world and subsidise unhealthy foods, resulting in obesity, coronary heart disease, diabetes and rotten teeth. The total costs of these policies is about Ł12 billion a year. This could be spent on healthy food produced by ecologically sound methods from fertile Soil.
Accidents are not random events. The main causes of accidents arise as a result of social and economic policies. The disadvantaged in society are most at risk - on roads, at work and at home. The prevention of accidents lies in the reduction of poverty, concern for the well-being of workers, a sound economy and a socially and environmentally acceptable transport policy.
Poor housing, both in the public and privately rented sectors, leads to poor health. The lack of decent affordable housing is becoming an important public health issue. Capital investment is needed in new housing, as well as renovation and repairs. A well planned, comprehensive, local strategy based on mixed tenure is required, and including real opportunities for participative democracy, and an enactment of housing rights for all.
Pollutants from vehicles are the prime cause of poor air quality that damages human health. Policies must be aimed at reducing dependence on motorised transport and moving towards sustainable alternatives.

Health professionals are often frustrated because they are only treating effects, not the root causes of illness. Preventing poverty, improving housing conditions and cleaning up the local environment; these are all health policies too. In spite of this, the health debate revolves around health services and new treatments and cures - often for diseases that public policies could have prevented in the first place. Health education still concentrates on expecting individuals to change their behaviour - whether drinking less or not smoking - rather than looking at the causes of this behaviour.

At the same time, those involved in issues of social care, the environment and employment policies have not always been part of the health debate. This is now changing. Environment and health professionals are increasingly recognising the many overlaps in their agendas: improved quality of life, reducing health hazards in the home and workplace, the principle that prevention is better than a cure.

The impact of the environment on health is incalculable, as this report shows. Health professionals need to understand the issues and join in the debate and lobby for public policies to deliver a healthy environment at local, national and international level. Similarly environmentalists need to address human needs more directly, rather than concentrating on nature conservation.

Health and sustainable development

Sustainable development is a term almost unknown outside the environmental field. Because of this it is often assumed to be another phrase for environmental protection but its definition actually goes much further than that. It describes a form of development which ‘meets the needs of present generations whilst not undermining the ability of future generations to meet their needs’. When extrapolated into policy terms this is a radical concept, both socially and environmentally. And what's more, it is a concept to which countless governments, business organisations, trade unions and other public bodies are signed up to.

Its relevance to the health debate is clear. Meeting the needs of present generations must include improving the health of the population. However, if these improvements are to be sustainable, then the means of improving this generations's health should not result in our offspring being disadvantaged. Essentially this means expanding our understanding of inequality and health to inequalities between generations as well as within them. For example, the use of asbestos prevented a large number of deaths by fire. However, the consequences of lung disease for this generation have been arguably more damaging We are only just beginning to appreciate the longer term effects on health created by industrialised society.

Health impacts are also an indicator that our society is not on the correct,or sustainable, path. If our transport policy’ results in increased childhood asthma; if our poor sewage treatment disposal gives swimmers diarrhoea; if discharges from our power plants give future generations cancer; then our economy and lifestyle cannot be considered sustainable.

Impact of the environment on health

If we are to understand better how to promote people’s health, we must look at the many national and international factors that influence our health and the increasingly adverse consequences in the future of the actions and decisions we are taking now. The papers in this book outline areas of environmental policy and how they affect health.

It starts by looking at the personal environment: housing, food and water supply. What effect does the combination of low income and poorly insulated housing have on the health of Britain’s ageing population? Do the cheap prices of intensively produced food hide the true costs of environmental damage and long term health effects? Is the privatised water industry delivering water of a quality which is totally safe?

When we leave our home environment, we face other health risks. Can we swim safely in Britain’s coastal waters knowing the amount of sewage which is discharged close to many beaches? And, of course, the actual act of travelling creates pollution and associated health problems. How can transport policy be changed so that we move away from modes which exacerbate asthma and accidents towards ones which actually benefit individual health like cycling and walking?

Finally, our lifestyle has developed large sources of pollution which affect whole regions and eventually create global health risks. What health problems are we creating as a species by burning fossil fuels and reprocessing nuclear materials? What possible health consequences could flow from climate change in the next century?

These papers show how important it is to look at the wider picture and its impact on health. Environmental policies are an intrinsic part of the health debate and meeting human needs are central to the concept of sustainable development.