Environmental Inequalities: Air Quality Policy Options

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Environmental InequalitiesAir Quality Policy
Options

• Dr Patrick Saunders
• Head of Environmental Health and Risk Assessment
• Chemical Hazards and Poisons Division
• Health Protection Agency

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Introduction

• Incontrovertible evidence that deprivation is
  intrinsically linked to health and disease
• Chief Medical Officer noted the relationship
  between deprivation, mortality and region which
  showed that while relatively affluent populations
  experienced relatively good and similar levels of
  health irrespective of region, mortality rates in
  deprived populations showed a marked north-south
  trend

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Introduction

• Some of these differences will be due to
  lifestyle factors but there is almost certainly
  an environmental dimension to this variation-how
  much, what are the consequences, are they fair
  and what can we do about it if anything?
• Considerable evidence of environmental
  inequalities with deprived communities
  experiencing the worst environments
• Differential has persisted despite major
  investment aimed at reducing inequalities and
  improving environmental health and for some
  environmental stressors is predicted to widen
  further over the next decade

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Introduction
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Indoor Air Quality

• Neuropsychological effects of chronic exposure to
  carbon monoxide in indoor air
• measured CO concentrations in a sample of
  potentially vulnerable homes and tested the
  neuropsychological function of a sample of
  occupants
• c. 20 of low-income families with gas appliances
  could be regularly exposed to CO levels above WHO
  guideline values
• Further research in this area is being planned
  including extending CO project, input to
  developing WHO guidance, and a proposal for a
  systematic review of CO poisoning under
  consideration by WHO/DH

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Children

• Some evidence suggesting that deprived
  communities are also disproportionately
  vulnerable to its effects
• Exposure to air pollution during pregnancy may
  interfere with weight gain in the foetus
• Some adult diseases, even those that emerge much
  later in life (e.g. hypertension, type 2
  diabetes, ischemic heart disease) have some of
  their origins in utero/childhood and childhood
  exposures may therefore constitute a source of
  inequity between generations

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Policy context

• Environmental inequalities recognised in public
  health strategies including Choosing Health
  reduce inequalities in opportunities for
  children to make healthy choices and address
  environmental inequalities that can undermine
  those choices and CMOs working group on key
  environment and health priorities
• The HPA is committed to a strategy to protect
  children against infections, chemical and
  radiation threats which specifically addresses
  the impact of health inequalities

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Inequalities

• Evidence of inequality in the location of
  industrial sites in terms of childhood
  deprivation and non-white communities
• There has been some discussion about the need for
  tailored risk assessment and perhaps even the
  designation of appropriate standards to take
  account of residential proximity of some
  vulnerable social groups to some industrial sites
  
• Proximity to a site is not necessarily associated
  with higher exposure to pollution or increased
  risk of a related adverse public health outcome

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Environmental Inequalities

• Regulators ensure that industry complies with
  statutory standards (often health based) and
  simple distance from site takes no account of
  operational, topographical or meteorological
  conditions or that most people spend large parts
  of their day indoors and/or away from home
• Some have no effect thresholds-may have an effect
  in some populations
• No standards for the majority of environmental
  chemicals or mixtures of chemicals
• There may also be indirect effects -property
  values, visual impacts and place stigma

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Environmental Inequalities

• Transport is the main contributor to poor air
  quality in Air Quality Management Areas, and the
  cause of respiratory illness and deaths amongst
  vulnerable groups such as young children
• These groups are least likely to live in areas of
  high car ownership
• Traffic related pollutants might have contributed
  to the asthma epidemic that has taken place
  during recent decades among children?

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Policy Options

• If we accept that deprived communities, which
  may be more vulnerable to the pressures of poor
  environmental conditions, should not bear a
  disproportionate burden of negative environmental
  impacts this requires prioritising action on
  deprived communities
• Ensure strategies for tackling health
  inequalities recognise environmental factors
• Encourage Local Strategic Partnerships, Local
  Area Agreements, New Deal for Communities,
  Neighbourhood Renewal and Community Planning to
  address environmental inequalities through the
  development of Community Strategies in deprived
  areas

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Policy Options

• Regeneration strategies to encourage quality
  economic growth that does not compromise peoples
  health or the environment
• Ensure sites located in deprived areas are within
  the top performing level for their sector
• Integration of Air Quality Action Plans with
  Local Transport Plans
• Tighter standards for vehicles and industrial
  processes
• National road charging and incentives for cleaner
  vehicles

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Policy Options

• Clear public health focus for indoor air
• Ensure that communities continue to be supported
  and involved in decisions that affect their local
  environment-in the US communities can apply for
  funding for environmental scientists/advocates to
  represent them
• Research into the most effective ways of
  addressing environmental health inequalities,
  differential exposures, indoor air quality,
  impact of climate change, the development of
  appropriate indicators of environmental
  inequalities

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Policy Options

• Development of an effective national
  environmental public health tracking system that
  links environmental, health, exposure and social
  factors such as deprivation