HESO 449: Ecohealth SDS

Environmental Public Health Tracking definitely falls under the umbrella of Ecohealth as, similar to Ecohealth, EPHT makes clear connections between the effects of poor air quality and health indicators. However, EPHT seems to be biased towards the health implications, using the environmental implications as a way to highlight the importance of human health. In comparison, Ecohealth provides us with a more balanced framework to address both the environmental and the health issue of concern.

Ecohealth and EPTH seen to strive for similar goals, one of which is to illustrate the inseparable relationship between health and the environment. The ability to strongly communicate these links, with the goal of creating change on micro and macro levels, requires effective education which targets community members, researchers and politicians. Given the importance of effective communication to progress these ideas, the public health framework is superior to the Ecohealth approach as Ecohealth is significantly less invested in the public education sector compared to public health. This point is alluded in the EPTH article, “The benefit of generating public health impact estimates is that the information can more clearly communicate the effects of air pollution to policy makers than separate air or health indicators.”

As described by the Chen & Kan article the severity of air pollution of developing countries and developed countries depends on the initial measures taken on emission controls. The concentration of air pollution is lower at the start of development if emission controls are considered. If not, there is a sharp increase of air pollution as the country continues to develop. Once the country reaches a higher level of development and did initiate emission controls earlier on, the air pollution decreases dramatically. If emission controls were implemented later on, air pollution still decreases with higher stages of development but not as much.

Thus, developing countries and countries in transition still have higher amount of air pollution than developed countries although it may seem to be stable and slightly decreasing. Also, developing countries can’t meet the strict criteria of the WHO air quality guidelines so interim goals of the individual country are encouraged. But even then if the guidelines of the WHO or the individual country are met, increased health risks still exist.

The Perez-Padilla, Schilmann, and Riojas-Rodriguez article goes into depth of the effects of indoor pollution in developing countries. Women in developing countries, that are forced to be cooking indoors, are exposed to a lot of indoor pollution. The stoves in developing countries don’t have proper ventilation that developed countries have. So, lower stages of development show increased health risks due to indoor pollution compared to developed countries. As the article concludes, evaluation of better stove programs is needed in lower developed countries to help them develop their own programs. So, in this article it seems like health risks can be decreased when guidelines are met.

Aside from the alarming rates of indoor air pollution in countries at all stages of development, the bigger picture is even more concerning. While electric and gas stoves are more efficient and less polluting in terms of their outputs, they are still problematic sources of energy that damage ecosystems and impair global health. In developing countries there are also apparent resource and health problems related to the use of solid fuels for cooking. The lack of adequate ventilation of stoves and the related health effects on human health is severe, especially for women who do the majority of cooking as well as young and elderly family members who are more susceptible to the pollutants.

Outside of these immediate effects, there are serious implications with the sourcing of solid fuels. If you take a birds eye view look at the island of Hispaniola, the Dominican Republic portion still has intact forests, while Haiti appears barren and is severely deforested. I remember learning that this reality is largely because of the people’s reliance on wood to make charcoal which they use as their primary source of fuel for cooking. My point is that while improving the ventilation of indoor stoves does improve one’s immediate health, there are larger issues at hand, namely poorly managed resources. So what are we going to do about that…?!

I was very surprised to see the Environmental Kuznet Curve being used in the air pollution and population health article. I personally think that it is an inappropriate tool to use in talking about resource and especially health issues, for it ends up glorifying industrial development. Yes, after the inflexion point, with efficiency, structures in place, and technology, pollution emission will decrease, but how far past acceptable standards is the inflexion point? How much pollution has been emitted and how poor is the existing environment in the aftermath?

I was pleased with the solution of more efficient biomass burning stoves instead of trying to convert the world to gas and electric. However they failed to mention the outputs of pollution and detriments to human health in the making of these gas and electric stoves which produce less emissions when functioning. I realize these articles are written by westerners, but I can’t help but be frustrated with how one sized, and pro-industrial these articles are written.

Amy, it’d be great for you to bring out some of those critiques of the articles during Dr. Brauer’s discussion period. I wonder how much of our air quality problems are linked with the way research and development is done and where the funding comes from. I would imagine that there are other “solutions” and ideas floating around without industrial backing, which means that they are much less likely to get funding. Definitely worth exploring further…

Amy brings up a really interesting point with the Environmental Kuznet Curve and where the acceptable limits for pollution lay from the inflection point. While we know now how damaging industrial development is to the environment and human health, the impacts of burning fossil fuels during the age of industrial development for today’s developed countries were not understood. Because of the increasing research and evidence of global warming and the effects of pollution on health, policies to prevent pollution have been implemented to create a standard on what is considered an acceptable amount of pollution; however, not every country accepts these limits.

This creates a problem for developing countries who in order to be competitive in the world economy have to develop industrially like the developed world has, but now are also being told to reduce their industrial emissions, a consequence of development. In other words, developed countries never had limits placed on their pollution from development, but now these limits are being pushed onto developing countries.

Developing countries understandably see emissions restrictions as harmful and unfair for their country’s development, but pollution is a global issue and affects everyone. The ideal outcome would be for developing countries to develop in a sustainable and environmentally- friendly way, but this method is not yet totally feasible.

As the two articles point out, people with a low socio-economic status are among those who are most greatly impacted by indoor and outdoor pollution, along with women and children. These inequalities in health are based around social factors and reflect the bigger issues at play here, poverty and gender inequality, problems that take many generations and changes in social thought to change. I would be curious to know if in creating the solution to use efficient biomass burning stoves how much input and involvement was incorporated from the poorer and female community members

Also, the second article got me thinking about indoor pollution in Canada and the U.S. and reminded me of article I saw a few years back about a popular air purifier that after being tested was supposedly found to be not only ineffective, but was also producing large amounts of ozone. I just thought that was ironic so I thought I’d share that:
http://www.msnbc.msn.com/id/7391185/ns/health-health_care/

What intrigued me about air quality in general after reading the Talbot et al article was that it can lead to severe conquences in those who may not even realize they are being affected (e.g. myocardial infarctions in pilots due to ozone exposure). I researched more about the EPTH program on the CDC website and it really sparked my interest to keep following up on the progress of such an intervention. Their biomonitoring approach (measuring toxin levels in urine, blood, body fluids) is a great step forward on a public health level to monitor trends and possibly prevent future outbreaks of disease.

http://www.cdc.gov/nceh/tracking/about.htm

Research interventions such as the EPTH create inclusiveness and active community participation (not just physically, but also the psychological reassurance that collaboration is happening and goals are being set). It think this is crucial to not only directly responding to a population’s concerns, but also making a project sustainable and creating an atmosphere of inclusiveness rather than one of ‘outside aid’ as being the only solution. The only challenge in the EPTH is, of course, having the financial means to maintain it; the involvement to policymakers I believe, is crucial in incorporating such a system, and making it worth the extensive effort and resources that are drawn into it.

Countries at different levels of development are exposed to different types of air pollution. For instance, in third world countries women are more frequently exposed to the air pollutants resulting from home cooking fuels. We don’t have that problem really in countries like Canada and the US because of our gas and electric stoves. In developed countries the air pollution comes more from big factory smoke or indoor fireplaces or vehicles. With already difficult health situations and limited access to medical care, air pollution is even more serious for poorer countries. EPTH and Ecohealth have similar goals in sustainability and focusing on long term goals. They also both emphasize the importance of the relationship between health and the environment.

What surprised me the most is that those who are most exposed to these substances and are living in developing countries most often don’t know how much harm they are doing to their bodies. Even when they become aware, they have no choice but to continue with their life styles in order to feed and comfort their families.
As in almost every other problem, it is the women of poor socioeconomic status that are most affected. This and the fact that in most developing countries, the government is ignorant about the affected individuals as long as the country can maintain a good image.
An issue that was brought up by Dr. Brauer during class is that although there are organizations like The Chinese National Improved Stoves Program that install stoves in rural homes, they do not take into consideration the outcomes of broken stoves. In other words, what the individuals would do if a part of their stoves were broken and so the stove would no longer work? Another issue that was brought up was that instead of using the stoves and ventilation systems that were placed into their homes, individuals would sell the parts in order to make money. I would say it seems like a great approach to decreasing air pollution but in reality, it wouldn’t be considered as the best approach since it results in other issues and individuals in some communities are not too accepting of the solutions.
What I have been thinking about is what other solutions are there that would actually work in reducing pollution, and if there are solutions, how cheap can they be made in order to allow individuals of rural communities full access to them.

The immediate effects of improved ventilation can be thought of as the intermediary step to more sustainable solutions. Siena brings up some great points on the externalities of modern appliances, as well as shortcomings of solid fuel.

However, if wood stoves are already a current practice, then improving the user’s health can only be a step forward. At this point in time, we should consider what system is currently in place and what alternatives are available, without being too concerned about an “ideal” solution. Every system will have their pro’s and con’s…

I do appreciate the points Siena raised though, it’s always important to factor in the long term impacts of such interventions, and be aware of their implications.