Photo of Tara traveling in Kenya
Each chapter in this textbook includes an autoethnographic account of an environmental issue or risk factor (e.g. air quality). Auto is the self, ethno represents culture, and graphy means to analyze or write; simply put, an autoethnography is a personal story taking place in another culture. These experiences were accomplished either simply by living abroad and experiencing daily life or by specifically targeting an issue; both methods revolved around an immersion into the local culture. Each chapter occurred in various countries, so before delving into the autoethnography, an introduction to the country (e.g. population, economic, and lifestyle facts) was provided to properly set the tone for the story. Moreover, a picture has been included in each chapter. Pictures are oftentimes used in qualitative research because they provide a tool to help with thick descriptions, which contribute to validity of the study. A thick description is a detailed account of the field experience described by the researcher to explain culture and society [1]; it can provide interpretive depth and detail that allows the study findings to be generalizable to a similar context or provide adequate details for replicability in another setting. Similarly, for the reader, the photo is a visual image used to evoke emotions, abstract ideas, and shared human experiences [2]. Ultimately, it was my hope that the reader would feel involved in each story while learning about the issue in environmental health. Before we begin, an introduction on environmental health and qualitative research, specifically autoethnographies, has been provided.
Environmental health refers to a set of public health efforts that seek to prevent disease, death, and disability by reducing exposure to risk factors associated with environmental conditions. These conditions can be physical, chemical, biological, social, and psychosocial factors within the environment [3]. The environment in public health emphasizes the importance of adequate safe drinking water, air quality, and occupational and home environments.
While it may not have been as clearly defined, environmental health has been integrated in society for thousands of years. In fact, ancient ruins provide evidence of water pipes, toilets, and sewage lines dating back more than 4000 years ago [4]. We can infer that these societies learned to separate water sources from areas of defecation in order to avoid cross-contamination. Several thousand years later, a similar event transpired. In the mid-1800âs, the most famous environmental epidemiological study occurred; Dr. John Snow linked the cholera disease outbreak to the Broad Street pump in Londonâagain, reinforcing the importance of separate clean water and sanitation areas. More recent efforts in environmental health began around the beginning of the nineteenth century and focused on reducing epidemics associated with urbanization (e.g. waste) [5]. However, in todayâs world, environmental health has become an encompassing field that reviews more than just water , waste, and sanitation . The field includes all aspects of the physical, chemical, ergonomic, and biological environment in order to identify risk factors that contribute to adverse health effects [6, 7]. A few examples are the amount of sun exposure that a person receives and the potential development of skin cancer or whether or not a person drinks contaminated water and contracts a diarrheal disease. Both of these examples provide a brief understanding for the depth of the field, ranging from radiation exposure to water safety. Thus, the field of environmental health has expanded to include all of the following subjects and more: drinking water, infectious diseases , air quality , toxicology , occupational health and safety , food safety, sanitation, and animal and vector control.
In a pendulum-like fashion, modern environmental health scientists assess the impact of both people on the environment and the environment on people. For example, the human population contributes to climate change by burning fossil fuels when they drive cars; alternately, climate change affects human populations by altering the weather, thereby affecting agricultural production, sustenance, and water availability. The environment and health dovetail together, thereby showing the inexplicable interwoven nature of the field. However, some environmental exposures are not from human intervention and are actually from natural variation. These types of exposures are primarily due to geography, weather patterns, physical disasters, and/or natural contaminants (e.g. arsenic in water) [6]. Both human-made and natural arising issues in the field include outcomes of climate change,radiation protection, food quality and safety, solid waste management, hazardous waste management, water and air quality, noise control, environmental management of recreational areas, housing, and animal and vector control [6].
Because of this large variation, there is a wide range of occupations associated with the field of environmental health. Experts focus on health risks related to specific geography, geology, or climate; other specialists focus on where these health risks occur, such as the home, community, or workplace. Lastly, the modern field of occupational medicine has taken a different approach on environmental health and focuses more so on the outcomes of exposuresâordiseases . All of these practitioners contribute to environmental health in both upstream and downstream approaches. For instance, an industrial hygienist could work on noise control in a factory where workers could potentially experience hearing loss, while a physician in occupational medicine could treat asthma resulting from chronic exposure to air pollution. Despite the difference between preventing potential illnesses or treating diseases, there is one common goal for environmental health expertsâto understand conditions causing poor health in order to seek preventative solutions to ultimately mitigate negative outcomes [5].
It is important to understand the types of diseases or adverse health effects that occur within environmental health because there are hundreds of thousands of illnesses each year that result from these types of exposures [8]. Experts continue trying to assess the worst exposures and the location of these hazards in order to streamline efforts focusing on identifying, evaluating, and controlling contaminants and sequential diseases. However, before we address the ailments, we must mention the associated risk factors that are contributing to these rates of diseases. Environmental risk factors include air, water, and soil pollution, chemical exposures, climate change, and ultraviolet radiation, while social risk factors on health include socioeconomic status, social support and networks, occupational stress, unemployment, retirement, social cohesion, and religious belief [9, 10]. While social risk factors are difficult to estimate, the World Health Organization (WHO) does suggest that environmental risk factors contribute to more than 80% of regularly reported diseases. Moreover, the WHO estimates that 23% of all deaths worldwide are attributed to environmental health risk factors [3, 8, 11]. Some diseases and conditions include asthma, autism, autoimmune diseases (e.g. lupus), breast cancer, cancer, lung diseases, obesity, Parkinsonâs disease, and reproductive disorders [12].
Because a quarter of all diseases are caused by environmental exposures, the field of environmental health has moved to the forefront of concerns in global health [13]. In fact, the Sustainable Development Goalsâa set of world health goals defined and created by world leaders at the United Nations summit in 2016âlists 5 out of 17 goals that focus specifically on environmental health [14]. The issues include climate change; water and sanitation; oceans; biodiversity, forests, and desertification; and sustainable consumption and production [14]. A few facts supporting the development of these goals include:
- Climate change. From 1980 to 2012, the average global temperature increased 0.85 °C, thereby disrupting grain yields to only 95% of the historical total [15].
- Water and sanitation. Water scarcity affects more than 40% of the world and is expected to rise in the future [16].
- Oceans. Approximately 40% of the world oceans are heavily affected by human activities, including pollution, depleted fisheries, and loss of coastal habitats [17].
- Biodiversity, forests, and desertification. Around 1.6 billion people depend on forests for their livelihood; approximately 75% of the worldâs population is also affected by land degradation [18].
- Consumption and production. Currently, humans are polluting water faster than nature is able to recycle and purify it [19].
These facts provide alarming evidence on possible outcomes associated with the environment in respect to population health. Ultimately, these goals request a call for action to be made by each individual person worldwide in order to secure a healthy planet for future generations [14].
Fortunately, the United Nations is not the only organization concerned with producing constructi...