Our guest blogger for World Environmental Health Day is Herman Koren HSD, MPH, DLAAS, REHS, Professor Emeritus of Environmental Health and Safety at Indiana State University. His new book, Best Practices for Public Health: Environmental Pollution, Protection, Quality and Sustainability, enhances the goals of World Environmental Health Day by helping professionals, students and citizens increase their level of environmental literacy.


herman-korenThe International Federation of Environmental Health has declared September 26, 2017, as World Environmental Health Day. This is an important opportunity to shed light on disparities related to air quality — this year’s theme — and other pressing environmental health concerns.

Environmental pollution, as well as infectious and communicable diseases, affects all people, but even more so vulnerable populations, such as children, the elderly, those with chronic diseases and conditions, the poor and homeless. Everything from lack of food and water to exposure to environmental pollutants on a regular basis decreases the resistance of vulnerable populations.

Major factors affecting our society today include: financial stress on individuals and communities; regulatory reform resulting in the removal of rules and regulations that protect the health and safety of the public; environmental pollutants, reactions and interactions that affect workers and the general public from pre-birth to old age, putting all body systems at risk; global warming that is producing vicious storms and huge rainfalls in some areas and drought in others.

Other factors include emerging and reemerging diseases over the last 35 years, particularly of a zoonotic nature; exposure to environmental stressors and pollutants based on where we live, work, play and are educated; and the mobile and growing population of the world that is projected to increase from 6.9 billion people in 2010 to 9.3 billion people in 2050, thereby consuming an enormous amount of existing environmental resources.

Urban plight
Unintended consequences resulted from the 1963 Community Mental Health Centers Act. Certain individuals, who had been de-institutionalized and could not adjust to society, did not receive adequate supervision, care and housing. This has led to homelessness, incarceration and violence among some of the approximate 1.8 million people who suffer from severe brain disorders. A portion of these individuals make up the homeless of today.

In addition, a number of our nation’s veterans are homeless and hungry. The poor always have had greater rates of disease, limited access to health care, a heightened inability to pay for basic needs and a greater potential for helplessness and homelessness. They are mostly uninsured and so do not get preventive care, resulting in many serious chronic illnesses.

Environmental pollution, as well as infectious and communicable diseases, affects all people, but even more so vulnerable populations, such as children, the elderly, those with chronic diseases and conditions, the poor and homeless.

Today, poverty no longer affects just the lower economic class, but rather has moved into the middle economic class. Today’s homeless are primarily women, children and families, not the mentally ill or street people who decide to live without a home. Some women, children and youth have left abusive families and have no place to live. Others lost their jobs and then their homes.

Past housing and foreclosure crises have contributed substantially to this problem. Further, global warming resulting in massive storms, heavy rainfall in some areas and severe drought in other areas will further exacerbate the problem because of massive destruction of housing, loss of businesses and jobs and destruction of agricultural areas.

A substantial amount of flooding disrupts not only housing and transportation, but also sources of safe food and water, operation of water and sewage treatment plants and highly contaminated industrial sites. This can lead to potentially catastrophic contamination, both of a chemical and microbiological nature.

In the United States today, over five million families with over four million children live in houses where there is overcrowding, poor living conditions and inadequate facilities. Despite best-practices-for-ehgovernment’s help in paying for shelter, millions of individuals cannot find appropriate, affordable housing.

Rural challenges
Over nine million impoverished people live in homes and communities in rural areas that are moderately or severely substandard. Rural poverty varies considerably from one area of the country to another. Further, because some rural areas are isolated and have poor infrastructure and limited economic development, there is little opportunity to improve these areas or the living conditions of the residents.

Rural homelessness is different than urban homelessness. Those affected are most likely to be white, female, married, working and homeless for the first time. Families, single mothers and children are part of this group. There is also a substantial amount of homelessness among Native Americans and migrant workers. Unfortunately, there are very few shelters available to help these individuals.

In rural areas, some places are highly transient. These areas typically have migrant labor living in poor housing with questionable water and sewage. Migrant labor camps have highly congested and unsanitary living quarters for the workers and their children. Migrant workers are subjected to high levels of agricultural chemicals, including fertilizers and pesticides.

Lack of communication skills in English for many of the individuals living in these areas is a real problem. The language barrier has led to even more problems of disease and injury and an inability to get appropriate medical care of a preventive or curative nature.

Environmental justice
Environmental justice decrees by law that all people share an equally high standard of environmental protection and improvement of existing hazardous situations regardless of race, color, national origin, income or education. Poverty, poor housing, homelessness, joblessness and environmental hazards are so overwhelming in certain areas, though, it is clear that many people do not share in the same level of environmental justice.

As citizens of the US and the world, it behooves us to take care of those who are less fortunate. This can only be done by ensuring state regulatory enforcement of federal policy; developing programs based on local situations that will improve education for children, provide health care for everyone, insure adequate food and reasonable housing and offer training for workers. As public health professionals, we must lead the way, nationally and locally. We must raise the banner for environmental justice everywhere.

Receive a 20 percent discount on Best Practices for Public Health with the promo code HEAL1. For more information about this year’s World Environmental Health Day air quality theme, check out APHA’s resource page, and explore the National Environmental Public Health Partnership Council’s new report that makes the case for healthy environments for all across the US.