In light of the substantial evidence linking environmental hazards to potential adverse health effects, various organizations are attempting to estimate the environmental burden of disease (EBD – the morbidity and mortality caused by exposure to preventable environmental hazards. It is an important endeavour because it highlights the magnitude of environmental harm and may identify specific risk factors that affect public health.In this table in particular you can observe the estimation of EBD across North America. The health outcomes selected – respiratory and diseases, cancer, and congenital affliction were selected because of the strength of evidence for environmental aetiology, availability of data. As well, respiratory and cardiovascular diseases, and cancer are among the most important causes of morbidity and mortality throughout North America.For example, in the United States the burden of asthma is enormous – nearly 26 million Americans (one in 12 persons) are affected by this chronic respiratory disease, including 7 million children. A panel of experts in environmental and pulmonary medicine estimated the EAF (environmental attributable factor) between 10% and 35% of cases are only related to outdoor and non-biologic pollutants (such as vehicle exhaust and emissions from stationary sources). [The only in this case is attributed to the fact that the range didn’t include indoor air pollutants, infections, and/or climatic conditions. If these factors were to be included practitioners estimated that the asthma incidence could be doubled.] The information presented in this table is of outstanding importance and can be used to: direct research; inform public education efforts; empower communities, assist physician in providing advice to patients; guide health and environmental policy making; and evaluate the effectiveness of policies, programs, and other interventions.
The Diagram describes the underpinning foundations on which the Framework to Improve the Environmental Health in North America would be based upon. It recognizes the social, cultural, and socioeconomic dimensions of human health, and intent to address health as a state of complete physical, mental, emotional, spiritual and social well-being. An interdisciplinary approach embracing three key components: the environment, health outcomes, and the Socio-economic and cultural context where crucial interventions are to be focused on. Considering these components as a whole in order to enhance public health, will aid to identify interconnected indicators to assess vulnerability characteristics of communities exposed to environmental contamination while concomitantly contemplating the multifaceted levels of complexity (such as time, individual versus home and community level, national and NA considerations as well as international components – notably to the mobilization dynamics of pollutants in the ocean and the atmosphere). I would like to draw your attention to one example of how climate change and variability emerge as an important indicator of vulnerability and how it can potentially impact on communities and particularly to those individuals exposed to pesticides. Heat waves, the human body responds to heat stress by activating three key systems to dissipate heat excess (cardiovascular, respiratory, and sweating). Changes in the blood flow combined with increased sweating are an effective mechanism to dissipate excess body heat. But the combination of increased moisture (caused by sweating), warm temperatures on bare skin, and augmented skin blood flow also provides an ideal environment to accelerate the transcutaneous absorption of many types of pesticides. Likewise, the increased demand for heat production in a cold environment results in an elevation in respiratory rate, thus increasing the intake of airborne toxicants.
(it was the 23rd most watched network show in Feb 2007).An investigation into a potential child pornography case actually uncovers a chemical company testing possibly toxic products on a group of building tenants.It dramatized health effects of toxic chemical exposure on children.
Interfaith collaboration: members of the Tsleil-Waututh nation, Anglican priest and Baha'i and Buddhist representatives.Aboriginal spirituality: Add the secular environmental health movement the conviction that the things of nature should be loved as relatives.
(Culturally Important Marine Subsistence Diet)Contaminants are accumulated and biomagnified in the web food:Pregnant women and women of childbearing age:Limit consumption of marine mammals Narwhal, Walrus, BelugaChoose country food: Caribou, Char, MuskoxChoose between sacred traditions and cultural practices and protecting the health and safety of childrenIt can lead to: Substantial stress (psychological and social) within and among families (e.g. disagreements, fragmentation)Give thanks to our food, Elders and Ancestors daily” Inuit saying
Framework Document to Improve the Environmental Health of Vulnerable Communities across North America: JPAC Workshop Merida presentation from CEC Program Manager Orlando Cabrera:
Framework Document to Improve the EnvironmentalHealth of Vulnerable Communities across North America CEC’s Air Quality and Pollutant Releases Program JPAC Workshop, Mérida, México December 13-14, 2012
Capacity Building to Improve the EnvironmentalHealth of Vulnerable Communities in North America Objective: Assist Communities in the identification of potential health risks posed by environmental contamination, and actions to mitigate them Approach: Development of Framework document for building capacity among communities throughout North America (focus on vulnerable populations such as children and indigenous communities) Tri-national collaboration with stakeholders, building on existing tools and resources (e.g., Community Action for Renewed Environment Resource Guide, CEC’s Taking Stock Online, SMOC monitoring initiatives, AirNow, etc.)
Capacity Building to Improve the Environmental Health of Vulnerable Communities in North America Annual Environmental Burden of Disease (selected health outcomes) Chronic Cardiovascular In-utero exposureCountry Obstructive Asthma diseases Cancer and congenital Pulmonary affliction Disease (COPD) 1700 infants deaths4 714,000 affected1 1.3 million affected1 850,000 affected3 25,000 low birth weight 2.7 million affected1 9773 deaths 72,743 deaths 68,322 deaths 1900 stillbirthsCanada 288 deaths 256,461 hospitalizations 447,218 hospitalizations 215,493 hospitalizations 6400-9600 serious EAF: 26-53%2 EAF*: 10-30%2 EAF: 7-23%2 EAF: 5-15%4 (12-29%2) congenital anomalies EAF: 2-10%2 5-10 million affected5Mexico 15.5 million affected2 8946 deaths5 17,000 deaths 86,554 deaths6 92,679 deaths 183,095 low birth weight 128,960 hospitalizations 296,877 hospitalizations5 249,239 hospitalizations 65,584 hospitalizations EAF (COPD): 37-47%2 EAF:12-29%2 EAF:7-23%2 EAF: 3-25%2 EAF (Asthma): 26-53%2 COPD: 5-10% of population7 Asthma: 26 million (7 million children)7,8 3447 deaths 19.4 million adultsUnited 81 million affected7 affected9,10,11 9883 deaths (5.319 < 1yo) 456,000 hospitalizations 599,413 deaths 336,747 low birth weightStates EAF: 10-35%9 567,628 deaths 4 million hospitalizations 1.3 million hospitalizations 25,894 stillbirths12 EAF: 7-23%2 EAF : 2-10%2 EAF: 2-10%9 (12-29%2) *EAF: Environmentally Attributable Factor
Capacity Building to Improve the Environmental Health ofVulnerable Communities in North AmericaFramework to Improve the Environmental Health in North America Levels Context Time; Demographic; Individual, Home, Community Economic; National, North America, Social factors, International etc. Health Outcomes Environment Physical Health Natural & Built; status; Climate variability; Psychological Social environment, etc. factors; Lifestyle, etc. Intervention / Actions Products/Tools Integrated Risk/Health Assessment
Framework to Improve the Environmental Health ofVulnerable Communities in North America Sustainable Products Capacity Outcomes Products/Tools Factors Adaptive Exposure Susceptibility Others Capacity Pillars Health Improvement Justice Community Participation Evidence Based Trans-disciplinary Sustainable Capacity Building
Framework to Improve the Environmental Health of Vulnerable Where do I live? Communities in North America Location Traffic Age Neighborhood Housing, etc Sex Where do I work? Industry Lead batteries recycling What do I eat? Home Source Diet Food SecurityRace/ethnicity Health Status Access to health care Traditional Medicine Access to information Cultural practices
Framework: Communications Approaches and Strategies TV show Fall 2006 – Law and Order: Special Victims Unit Episode: Loophole Audience 13.4 million U.S. viewers Topic: Residential use of pesticides and children vulnerability. BodyLove: Radio soap-opera Reduce environmental health disparities among African AmericansSource: Kennedy M.G. et al. 2011. Effects of a television drama about Environmental Exposure to Toxic Substances Public Health Reports 126:150-159.Chen N. et al. 2009. BodyLove: The Impact of Targeted Radio Educational Entertainment on Health Knowledge, Attitudes and Behavior among African-Americans. Cases in Public Health Communication & Marketing 3:92-113
Framework: Communications Approaches and StrategiesCreating Healthy Environments for Kids Low cost tips for reducing children’s exposures to chemicals at home: Tools: video, brochure and individuals cards (in English, French, Spanish, Tagalog, Punjabi, Chinese and Arabic) Source: Canadian Partnership for Children’s health &environment (www.healthyenvironmentforkids.ca)
Framework: Communications Approaches and StrategiesHuicholes y Plaguicidas: video (12 Mexican native languages, English,Spanish, French and German), Radio and written reports. “Right to be informed, prevention, alternatives, training and technical assistance” Source: Huicholes y Plaguicidas (www.hypinfo.org)
Framework: Communications Approaches and StrategiesTraditional Knowledge"We dont just look after our relativeswho have two legs.We also want to look after our relativeswho have feathers and fins. And whohave roots," member of the Tsleil-Waututh nation. Source: Vancouver Sun. September 22, 2012
Framework: Communications Approaches and Strategies – Tool Developers part of the CommunityContaminants are accumulated andBiomagnified in the web food:Pregnant women and women of childbearing age: Limit consumption of marine mammals Choose country foodIt can lead to: Substantial stress (psychological and social) within andamong families (e.g. disagreements, fragmentation) It is not just about food, it is a traditional way of life Source: Inuit Tapiriit Kanatami (ITK)
Framework: Communications Approaches and StrategiesThe information provided in the framework documentis to be used to produce adapted tools for targetedindividuals or communities. “ Knowing is Not Enough; we must Apply. Willing is Not Enough; we must Do. ” J.W. von Goethe
CEC Air Quality and Pollutant ReleasesFor more informationOrlando Cabrera RiveraProgram Manager,Air Quality/PRTRTelephone: (514) 350-4300Fax: (514) 350-4314Email: firstname.lastname@example.org/takingstock Three countries. One environment.