Healthy Environment, Healthy People

Investing in environmental sustainability can serve as an insurance policy for health and human well-being

The degradation of the environment – the air we breathe, the food we eat, the water we drink, and the ecosystems which sustain us – is estimated to be responsible for at least a quarter of the global total burden of disease, according to a new UNEP report entitled Healthy Environment, Healthy People

The 2030 Agenda for Sustainable Development and its Sustainable Development Goals (SDGs) reflect the common understanding that a healthy environment is integral to the full enjoyment of basic human rights, including the rights to life, health, food, water and sanitation, and quality of life.

Directly tackling the inter-linkages between environment and human health presents new and interwoven opportunities to meet the SDGs in a more cost-effective and beneficial manner. To “ensure healthy lives and promote well-being for all at all ages” (SDG3) – which includes a specific target related to air quality - cannot be achieved over the long term without explicit action on terrestrial ecosystems (SDG15), oceans (SDG14), cities (SDG11), water and sanitation (SDG6).

Air pollution is the world’s largest single environmental risk to health (some 7 million people across the world die each year due to everyday exposure to poor air quality), but it cannot be viewed in isolation.

Environmental degradation is costly
Environmental degradation is estimated to cause 174-234 times as many premature deaths as occur in conflicts annually. Disproportionate impacts of environmental harms are evident on specific groups: the poor, the young, the elderly, women and migrant workers, the report says.

Zika, Ebola, MERS, SARS, Marburg… new zoonotic diseases (spread from animals to humans) are currently emerging every four months, with the main drivers being exponential population growth, intensive livestock breeding, (there are 36 billion domestic animals on the planet) and concomitant disturbed environments and biodiversity loss. Strengthening healthy ecosystems is key to preventing or slowing the emergence of these costly diseases. A key need is for greater investment in integrated surveillance of wildlife, livestock and human health.

The financial costs of environmentally related health risks are generally in the range of 5-10 per cent of GDP, with air pollution taking the highest toll. Evidence exists, however, of the catalytic and multiple benefits of investing in environmental quality in terms of development, poverty reduction, resource security, reduced inequities and reduced risks to human health and well-being.

A 2012 UNEP report entitled The Role and Contribution of Montane Forests and Related Ecosystem Services to the Kenyan Economy showed that well-managed montane forest cover reduced malarial disease prevalence, and that malaria resulted in additional health costs to the Government as well as labour productivity losses.

The montane forests of Kenya, better known as Kenya’s `Water Towers’, produce direct economic value for its citizens. This value accrues not only from the production of various timber- and non-timber forest products, but also from a range of regulating ecosystem services that provide an insurance value to several key economic sectors. There is also a secondary or indirect multiplier effect associated with the direct economic value of the Water Towers... Montane forests have consistently been undervalued in conventional national accounting, says the abstract of the report.

The UNEP Healthy Environment, Healthy People report indicates that lack of access to clean water and sanitation causes 58 per cent of cases of diarrhoeal diseases in low and middle-income countries. Unsafe water, inadequate sanitation or insufficient hygiene result in 3.5 million deaths worldwide, representing 25 per cent of the premature deaths of children younger than 14, it says.

Mental health
There is growing evidence to suggest that exposure to natural environments can be associated with mental health benefits.

Clean air and water, sanitation and green spaces, safe workplaces can enhance people’s quality of life: reduced mortality and morbidity, healthier lifestyles, improved productivity of workers and their families, improve lives of women, children and elderly and are crucial to mental health.

Mental health issues rank among the 10 largest non-fatal threats in most countries, according to the report.

There is growing evidence to suggest that exposure to natural environments can be associated with mental health benefits. Proximity to greenspace has been associated with lower levels of stress and reduced symptomology for depression and anxiety, while interacting with nature can improve cognition for children with attention deficits and individuals with depression. A 2014 epidemiological study has shown that people who move to greener urban areas benefit from sustained improvements in their mental health.
“It is becoming increasingly evident that the 2.2 million years our genus has spent in natural environments are consequential to modern mental health… The accumulating strength of research from multiple disciplines makes it difficult to dismiss the clinical relevancy of natural environments in 21st century mental health care,” says another report.

An integrated approach
Based on evidence of the linkages between poor environmental quality and health, the report identifies several priority problem areas for urgent policy attention, including:

  1. Unsafe water, inadequate sanitation or insufficient hygiene which cause mortality, morbidity and lost economic productivity;
  2. Nutritionally poor diet composition and quality, as well as increased physical inactivity, which has increased the growth of non-communicable diseases throughout the world; and
  3. Degraded ecosystems and stresses to the Earth’s natural systems, which reduce ecosystem services that support human health, enhance exposure to natural disasters, food security, and at times give rise to disease outbreaks.
Climate change is exacerbating the scale and intensity of these environment-related health risks, and is acknowledged as a major health risk multiplier, with existing impacts that are expected to increasingly affect human health including through negative changes to land, oceans, biodiversity and access to freshwater, and the increasing frequency and higher impact of natural disasters.

The report’s findings provide a strong basis for adopting an integrated approach for improving human health and well-being through increased engagement by the health sector in ecosystem management and decision-making. They also identify integrated actions and strategies, such as:

DECOUPLE RESOURCE USE AND CHANGE LIFESTYLES: Use fewer resources per unit of economic output produced and reduce the environmental impact of any resources used in production and consumption activities through more efficient practices.

ENHANCE ECOSYSTEM RESILIENCE AND PROTECTION OF THE PLANET’S NATURAL SYSTEMS: Build capacity of the environment, economies and societies to anticipate, respond to and recover from disturbances and shocks through: agro-ecosystem restoration and sustainable farming systems; strengthening ecosystem restoration, in particular wetlands, dryland vegetation, coastal zones and watersheds, including through reforestation; reducing livestock and logging pressures to increase resilience and mitigate extreme weather conditions of storms, drought and floods.

Addressing the nexus between environment and human health through delivering on environmental sustainability can provide a common platform for meeting many of the Sustainable Development Goals (SDGs). Through multiplier effects that can accelerate and sustain progress across multiple SDGs, investing in environmental sustainability can serve as an insurance policy for health and human well-being, the report concludes.