1. Jan 16, 2008, 12:15 pmGeog 361b1 Introduction: Key Concepts (Moeller Chapter 1) Geography 361a Environment and Health Discussion: Is the world more dangerous? Historical Context Concepts/Definitions

2. Jan 16, 2008, 12:15 pmGeog 361b2 Context: Discussion Is the world more dangerous now than it was 20 years ago? What are some useful ways to qualify/refine the question above? Break into groups of 4 and discuss.

3. Jan 16, 2008, 12:15 pmGeog 361b3 Context healthier than ever highest life expectancy ever awareness of hazards and risk high –e.g., 46,962 articles on “hazards” in major Canadian dailies 1985 to present. –(reference: “free trade” – 76,531) population “at risk” increasing

4. Jan 16, 2008, 12:15 pmGeog 361b4 Life Expectancy http://www.undp.org/hdr2003/indicator/indic_1_2_1.html http://www.cia.gov/cia/publications/factbook/rankorder/2102rank.html

5. Jan 16, 2008, 12:15 pmGeog 361b5 Life Expectancy Time-trends For USA

6. Jan 16, 2008, 12:15 pmGeog 361b6 Life Expectancy Time-trends For Canada

7. Jan 16, 2008, 12:15 pmGeog 361b7 Causes of Death Canada For

8. Jan 16, 2008, 12:15 pmGeog 361b8 Causes of Death Source: Thomas and Hrudey (1997) Risk of Death in Canada

9. Jan 16, 2008, 12:15 pmGeog 361b9 World Population Growth Source: http://www.prb.org/ world population clock

10. Jan 16, 2008, 12:15 pmGeog 361b10 Concepts/Definition Environmental Health “That segment of public health that is concerned with assessing, understanding, and controlling the impacts of people on their environment and the impacts of the environment on them." (Moeller 1997, 1) Human Health emphasis of this course is the latter half of this definition former half is an “undercurrent” of the course

11. Jan 16, 2008, 12:15 pmGeog 361b11 Concepts/Definitions Contamination when substance exceeds capacity of “environment” to eliminate it aggregate output of substance exceeds some sensory or predetermined limit e.g., wood fires “allowed” in rural vs urban areas.

12. Jan 16, 2008, 12:15 pmGeog 361b12 Selective Historical Context Early Writings Hippocrates (460 BC) On Airs, Waters and Places winds, seasons and sources of water important for physician diagnosis occupational diseases – e.g. “lead colic” in miners explanation for decline of Rome? –water delivery lead pipes/aqueducts –lead-lined vessels – aristocracy

13. Jan 16, 2008, 12:15 pmGeog 361b13 Selective Historical Context Occupational Health Georgius Agricola (1556) De Re Metallica (12 books!) occupational diseases among miners – joints, lungs (e.g. silicosis, tuberculosis, lung cancer), eyes

14. Jan 16, 2008, 12:15 pmGeog 361b14 Selective Historical Context Occupation and Cancer Percival Pott (1775) First detailed writing about occupationally- induced cancer scrotal cancer in chimney sweeps soot + tar + infrequent washing

15. Jan 16, 2008, 12:15 pmGeog 361b15 Selective Historical Context John Snow (1855) On the Mode of Communication of Cholera well intake near sewage outfall “graph on map to mark cholera deaths” Broad Street pump linked to cholera

16. Jan 16, 2008, 12:15 pmGeog 361b16 water sanitation dramatically decreased several water borne diseases Selective Historical Context

17. Jan 16, 2008, 12:15 pmGeog 361b17 Contamination Natural Contamination e.g., sulfur, radionuclides, radon Anthropogenic Contamination e.g., CO, pesticides focus of most attention (not always deservedly so)

18. Jan 16, 2008, 12:15 pmGeog 361b18 Scope Some Problems Studied toxic chemicals waste (e.g., toxic, municipal, radioactive) workplace stress built environment overpopulation food supplies acid deposition global warming resource depletion …

19. Jan 16, 2008, 12:15 pmGeog 361b19 Practitioners Some Disciplines (Multidisciplinary) toxicologists epidemiologists economists geographers (health, hazards) sociologists lawyers planners engineers managers …

20. Jan 16, 2008, 12:15 pmGeog 361b20 Defining “Environment” Inner vs Outer Environment protective barriers between inner and outer: –skin –GI tract –lungs which barrier makes humans most vulnerable? Why problems with this categorization of “environment”?

21. Jan 16, 2008, 12:15 pmGeog 361b21 Defining “Environment” Personal vs Ambient Environment personal = individual control ambient = outside individual control problems with this categorization of environment?

22. Jan 16, 2008, 12:15 pmGeog 361b22 Cancer Caused by Environmental Exposures categorize each above as “personal” or “ambient ”

23. Jan 16, 2008, 12:15 pmGeog 361b23 Defining “Environment” gaseous, liquid and solid each linked with particular routes of exposure to humans problems?

24. Jan 16, 2008, 12:15 pmGeog 361b24 Defining “Environment” Chemical, Biological, Physical, Socioeconomic Chemical - contaminants Biological – disease organisms Physical – e.g., noise, temperature, radiation Socioeconomic – e.g., SES, environmental justice problems with this categorization?

25. Jan 16, 2008, 12:15 pmGeog 361b25 Exercise: Defining “Health” Define “health”.

26. Jan 16, 2008, 12:15 pmGeog 361b26 Defining “Health” WHO (1948) “Health is a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity.” physical mental social well-being

27. Jan 16, 2008, 12:15 pmGeog 361b27 Disease Classification infectious vs non-infectious infectious –e.g., malaria, cholera, diarrhea –pathogenic organisms –major killer in the past –not typically considered an “environment and health” issue (e.g., Nadakavukaren, 2000) – but Walkerton! –historically mono-causal non-infectious –e.g. cancer, heart disease, asthma –major killer now –multi-causal model –typical environment and health concern these outcomes

28. Jan 16, 2008, 12:15 pmGeog 361b28 Disease Classification endemic vs epidemic endemic –pathogen carried by many people –typically not considered an environmental illness issue –e.g., ? epidemic –pathogen carried by many people –sudden and severe outbreak of a disease in a population –e.g., ?

29. Jan 16, 2008, 12:15 pmGeog 361b29 Disease Classification acute vs chronic acute –severe short term disease –or disease/symptoms due to short term high dose exposure to environmental substance –QOL: if survive, no long-term effects –e.g., ? chronic –long term disease/condition –or disease/condition due to long term low dose exposure to environmental substance –QOL: long-term effects often duration of life –e.g., ?

30. Jan 16, 2008, 12:15 pmGeog 361b30 Systems Approach controlling one form of environment and health problem can lead to other problems e.g., chlorination, fluoridation of water e.g., pesticides risk analysis and cost/benefit analysis helpful not strictly a technical problem

31. Jan 16, 2008, 12:15 pmGeog 361b31 Components of Assessing Environment and Health Problems 1.determine the source of contamination/stress 2.determine how contamination/stress contacts humans 3.measure the resulting effects 4.assess the seriousness of the effects 5.apply controls as necessary How “social” is this process?

32. Jan 16, 2008, 12:15 pmGeog 361b32 Models of Environment and Health

33. Jan 16, 2008, 12:15 pmGeog 361b33 Models of Environment and Health: Multicausality source: Jones and Moon (1987) Health Disease and Society