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Global Environment = Health Status

A J McMichael and colleagues in their recent article in BMJ discuss the impact of global environment change and its impact on the helth status of population. They argue that human health is not an independent variable but dependent on the larger scale environmental changes that take place on earth. Doctors should be more sensitive to the global changes in environmental conditions as most of the time they are irreversible and cause greater damage than those hazazrds that are confined to a smaller area.
The authors argue that the millinium development goals of UN do not take into full account the impact the environment change has on the human health. It is therefore possible that we may not be able to realize the goals if environment destruction continues.
The millennium development goals are:
  1. Eradicate extreme poverty and hunger.
  2. Achieve univeral primary education.
  3. promote gender equality and empower women.
  4. reduce child mortality.
  5. improve maternal health.
  6. Combat HIV/AIDS, malaria and other diseases.
  7. ensure environmental sustainability.
  8. Develop global partnership for development.
The seventh millennium development goal also takes a limited view of environmental sustainability, focusing primarily on traditional localised physical, chemical, and microbial hazards. Those hazards, which are associated with industrialisation, urbanisation, and agriculture in lower income countries, remain important as they impinge most on poor and vulnerable communities. Exposure to indoor air pollution, for example, varies substantially between rich and poor in urban and rural populations. And the World Health Organization estimates that a quarter of the global burden of disease, including over one third of childhood burden, is due to modifiable factors in air, water, soil, and food.
Doctors and health professionals can do a great deal of good if they keep in their mind the overall impact of global environment change. Health professionals should realize this unique opportunity to teach and train their patient populations about the ill effects of global environment change.
Here is what doctors can do:
• Public education, especially through healthcare settings such as doctors’ waiting rooms and hospital clinics.
• Preventive programmes—eg, vaccines, mosquito control, food hygiene and inspection, nutritional supplementation.
• Health care (especially mental health and primary care) for communities affected by environmental adversity.
• Surveillance of disease (especially infectious disease) and key risk factors.
• Forecasting future health risks from projected climate change.
• Forecasting future health risks and gains from mitigation and adaptation strategies.
• Health sector workforce training and in-career development
Strategies that extend beyond health sector:
• Early warning systems for impending extreme weather (eg, heat waves, storms).
• Neighbourhood support schemes to protect the most vulnerable people.
• Climate-proofed housing design, urban planning, water catchment, and farming practices.
• Disaster preparedness, including capacity of the health system
Some useful websites for health professionals:
Centers for Disease Control and Prevention (US) (www.cdc.gov/nceh/climatechange)
Doctors for the Environment Australia (www.dea.org.au)
Global environmental change and human health project (www.essp.org/en/joint-projects/health.html)
Intergovernmental Panel on Climate Change (www.ipcc.ch)
International Society of Doctors for the Environment (www.isde.org)
Medact UK (www.medact.org/env_climate_change.php)

The article can be read here at BMJ.com


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