Abstract
The profound impact of the environment on both individual and public health is a long-standing issue in healthcare. Its effects range from the development of health conditions to the general decline of health-related quality of life. Four categories of environmental effects can be identified: quality of water, quality of outdoor air, housing conditions, and urban planning. Importantly, only a fraction of issues in each category can be addressed on an individual level whereas the majority requires the involvement of numerous stakeholders including policymakers, regulatory agencies, and non-governmental organizations. Also, an individual action often requires both pieces of knowledge of the possible health effects and the availability of strategies and techniques for addressing the problem. Nurses can participate in the process both by providing the necessary information to the population and by taking the role of advocates of changes in the environment. Such an approach would facilitate the necessary support and contribute to the process of health care.
Introduction
The environment has a profound impact on a person’s life. At least some of its impacts are associated with adverse health effects. Unfortunately, some of these impacts cannot be addressed at an individual level. Therefore, a coordinated effort is required to produce a desirable effect. The following paper identifies the most important environmental factors and describes the nurse’s roles in minimizing the environmental impact on health.
Synopsis
The environment is commonly understood as a combination of factors that can influence the individual’s state (Watts et al., 2015). In other words, any phenomenon that is significant enough to have an impact on humans contributes to environmental influence. While many environmental effects are negligible and, in some cases, neutral, at least some of them have the potential to affect human health. It should also be pointed out that due to the scope and magnitude of the phenomenon, the said effects are expected to be observed with significant frequency and, depending on the exact nature of sources of the impact, may manifest themselves on a community-wide scale. Thus, environmental factors are commonly viewed as determinants of public health. Another important point that needs to be acknowledged is the fact that unlike small-scale factors such as individual exposure to health risks, environmental factors are usually hard or impossible to avoid without major changes in lifestyle.
Also, the process of preventing and mitigating adverse environmental influence requires a significant allocation of resources both on the part of the responsible party (e.g. the organization producing industrial waste) and the individuals. As a result, the former may choose to minimize their involvement to avoid losses. More importantly, the latter may exhibit increased vulnerability depending on their socioeconomic status. In other words, vulnerable populations are more susceptible to the described risks. Also, unlike more direct influences, which are in most cases relatively apparent, many of the environmental factors cannot be easily detected, which makes their prevention challenging. While this issue can be addressed through education, it is reasonable to expect difficulties in the delivery of the information to some demographics. Finally, it should be understood that in most cases, environmental factors have a significant influence on the quality of life of the population, and, by extension, the state of a community in general.
Environmental Factors that Impact Health
To better understand the factors in question, it is necessary to identify the most common types of environmental hazards. Since they are viewed in the context of public health, the environmental factors will be categorized based on the mechanism and nature of their influence on people.
The first category is the quality of surface and groundwater. Water is an essential part of the human life cycle and serves as a necessary component in nutrition, hygiene, and food production, among others. Thus, the contamination of the sources of water predictably leads to the occurrence of diseases and a decline in the quality of life. The problem is especially aggravating in the developing countries where the infrastructure is either inadequate or non-existent, and the occurring contamination is hard to contain. Another aspect that needs to be taken into account is the scarcity of water in certain regions which leads to additional difficulties in sustaining the adverse effects such as bacterial and viral infections. Also, the reliance on water for agricultural purposes increases the risk of compromised health due to inadequate nutrition (Watts et al., 2015). Some of the risks associated with this factor can be reduced through simple precautionary measures while others require major interventions.
The second category is the quality of outdoor air. While air can present a certain risk of bacterial or viral infection, the main health concern is with mechanical pollution, both natural and man-made. The latter is especially common in urban and industrial areas and serves as one of the causes of several health conditions such as chronic obstructive pulmonary disease, heart disease, and numerous respiratory conditions in children (Lelieveld, Evans, Fnais, Giannadaki, & Pozzer, 2015). Importantly, on most occasions, this factor does not necessarily lead to the immediate development of the condition. More often, it contributes to a gradual decline in health-related quality of life (Lelieveld et al., 2015). It is also worth pointing out that in most cases the problem cannot be addressed by individuals and requires a coordinated effort of numerous stakeholders.
The third category is the state of housing. Inadequate living conditions and poor design choices during construction create problems such as inappropriate ventilation, temperature anomalies, and physical injuries (Adamkiewicz et al., 2014). Also, certain communicable diseases spread more rapidly and are more difficult to treat in poor housing conditions. Finally, the development of certain allergies and asthma is more likely in inadequate living conditions.
The fourth category is the urban design quality. The recent increase in cases of obesity and related health conditions is at least partially related to an active lifestyle. The urban environment can either support or impede an active lifestyle (Wolch, Byrne, & Newell, 2014). Also, the availability of green spaces is known to positively affect the perceived quality of life of the population.
My Role in Improving/Eliminating Environmental Barriers to Health
As a nurse, I can identify several areas where my involvement could minimize environmental barriers to health. The first area is education. As was mentioned in the previous section, some of the identified factors can be addressed to some extent at the individual level. However, both the awareness about the issue and the availability of strategies and methods to address the issue are necessary in each case. Therefore, it would be necessary to provide a sufficient level of understanding of the impacted population. This can be done either on the individual basis, by contacting the patients and families, or collectively, by organizing educational events and training sessions. The latter would require support from local organizations that can be facilitated on a collaborative basis. Examples of such activities include explanations of the risks associated with breathing contaminated air, discussion of the possible outcomes of inadequate indoor environment organization, and learning the safety measures of water use.
The second area is advocacy for improvement in the areas where an issue has been identified. This area is especially feasible for addressing the issues that cannot be resolved through the efforts of individual patients such as the renovation of inadequate housing. Due to its scope and scale, advocating for change in any of the identified areas can result in increased public awareness of the issue and may facilitate collaboration with the local activist groups and non-profit organizations. Once sufficient support is gained, it may be possible to initiate the introduction of policies and regulations necessary for the alleviation of the issue. Examples of the possible outcomes include the construction of bike lanes in the neighborhood, the initiation of an affordable housing program, and the introduction of regulation for industrial pollution.
Summary and Conclusion
Environmental factors that impact health are numerous and, in most cases, difficult to address via traditional healthcare means. However, coordinated action of all involved stakeholders can decrease the adverse health effects. Nurses in particular can participate in the process in several roles. In addition to providing treatment and support, nurses can participate in the process by providing necessary knowledge and skills to the vulnerable populations and advocating for the improvement of the inadequate environment either by supporting the introduction of regulations or by raising public awareness of the issue. Such an approach will help to tackle the issue of environmental barriers to health at individual and local/state levels.
References
Adamkiewicz, G., Spengler, J. D., Harley, A. E., Stoddard, A., Yang, M., Alvarez-Reeves, M., & Sorensen, G. (2014). Environmental conditions in low-income urban housing: Clustering and associations with self-reported health. American Journal of Public Health, 104(9), 1650-1656.
Lelieveld, J., Evans, J. S., Fnais, M., Giannadaki, D., & Pozzer, A. (2015). The contribution of outdoor air pollution sources to premature mortality on a global scale. Nature, 525(7569), 367-371.
Watts, N., Adger, W. N., Agnolucci, P., Blackstock, J., Byass, P., Cai, W.,… Cox, P. M. (2015). Health and climate change: Policy responses to protect public health. The Lancet, 386(10006), 1861-1914.
Wolch, J. R., Byrne, J., & Newell, J. P. (2014). Urban green space, public health, and environmental justice: The challenge of making cities ‘just green enough’. Landscape and Urban Planning, 125, 234-244.