Population Health Curriculum for Health Professionals

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Environmental ImpactsOn Health
Dorothy Cumbey, Ph.D., RN Jerry Dell Gimarc,
MA with the special help of Lill Mood, MPH,
RN, Community Liaison, EQC South Carolina
Department of Health and Environmental Control
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Developed as part of an Enhanced AHEC Community
Partnership for Health Professions Workforce and
Educational Reform project funded by the Health
Resource and Service Administration (HRSA)
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Objectives

• Discuss environmental impacts on health
• Describe the role of public health in responding
  to environmental threats
• Identify your role as citizen and health care
  provider

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Environmental Impactson Health

• Much of our health improvement has come from
  clean water and pure air
• Health and the environment are inextricably
  linked
• New data are emerging that demonstrate this
  linkage

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Health and the Environment Are Inextricably Linked

• Air quality
• Water quality
• Soil contamination

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Health Care Providers must be knowledgeable and
active to

• Relate to patient concerns
• Communicate effectively about real concerns and
  fears
• Be active as citizens in policy decisions that
  affect the environment
• Understand how human health is affected

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EverythingIs Connected to Everything

• Air to water and soil
• Water to air and soil
• Soil to water and air
• Soil and water to food
• Waste has to go somewhere
• Population pressures - especially in vulnerable
  areas like coast

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Discussion Time

• Identify at least 3 ways your community has been
  altered in recent times in a way that might
  affect health status

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New Concerns

• Growing number and complexity of chemicals in
  everyday life
• No data on small doses of many chemicals over a
  long term or on vulnerable populations
• Continuing data on health effects of small doses
  of some contaminants (lead)

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Everything Is Connected The Case of Lead

• Naturally occurring
• Used for centuries because of its malleablity
  and chemical properties
• Found in air, water, soil and food
• Has known health effects

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Everything Is Connected The Case of Lead

• Children and other vulnerable populations are at
  particular risk
• Removal of lead from gasoline has dramatically
  lowered childrens blood lead levels
• Researchers are identifying impacts at smaller
  doses

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Challenges to Minimize Impacts on Health

• Challenges
• Prevention
• Education
• Waste Minimization
• Land Use Planning

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Environmental Protection to Minimize Impacts on
Health

• Challenges
• Prevention
• Regulation for protection and control
• Permitting based on environmental standards
• Monitoring
• Compliance and enforcement

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DISCUSSION

• Identify roles of health care providers as
  citizens and professionals in the community

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Your Role as Citizen and Health Care Provider

• Trusted source of information
• Interpreter of scientific information
• Spokesperson for citizen concerns
• Data gatherer on community concerns
• Leader in community mobilization
• Evaluator of public policy with implications for
  health

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Public Communication

• Risk
• Magnitude X Probability
• Perceived Hazard
• Outrage
• Perceived Hazard Outrage
• Perceived Risk

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Sandmans Outrage Factors

• Decreases Outrage
• Voluntary
• Natural
• Familiar
• Not memorable
• Not dreaded
• Chronic

• Increases Outrage
• Involuntary (Coerced)
• Industrial (Artificial)
• Exotic
• Memorable
• Dreaded
• Catastrophic

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Sandmans Outrage Factors

• Decreases Outrage
• Knowable (Detectable)
• Individual controls
• Fair
• Morally irrelevant
• Trustworthy sources
• Responsive process

• Increases Outrage
• Unknowable (Undetectable)
• Controlled by others
• Unfair
• Morally relevant
• Untrustworthy sources
• Unresponsive process

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Discussion Time

• Discuss the difference in challenge to public
  health when
• the threat is real, but not perceived
• the outrage exists but has the wrong target

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Resources for the Health Professional

• National Library of Medicine (NLM)
• NLM toxicology data bases
• CDC
• EPA
• Scorecard

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Summary

• The complex environment in which we live will
  continue to present threats to our health and we
  must continue to work as a community to minimize
  those threats