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PHYSICAL ENVIRONMENT AND HEALTH HTH SCI 1RR3 Land Acknowledgement McMaster University recognizes and acknowledges that it is located on the traditional territories of the Mississauga and Haudenosaunee nations, and within the lands protected by the “Dish with One Spoon” wampum agreement. That wampu...

PHYSICAL ENVIRONMENT AND HEALTH HTH SCI 1RR3 Land Acknowledgement McMaster University recognizes and acknowledges that it is located on the traditional territories of the Mississauga and Haudenosaunee nations, and within the lands protected by the “Dish with One Spoon” wampum agreement. That wampum uses the symbolism of a dish to represent the territory, and one spoon to represent that the people are to share the resources of the land and only take what they need. https://healthsci.mcmaster.ca/docs/librariesprovider59/resources/mcmaster-university-land-acknowledgment-guide.pdf?sfvrsn=7318d517_2 Land Acknowledgement Cont’d. ● We also acknowledge that Mohawk College’s Fennell Campus is situated on the traditional territory of the Haudenosaunee and Anishnaabeg nations, within the lands also protected by the Dish with One Spoon Wampum agreement, and is currently home to many indigenous peoples from across Turtle Island. Land Acknowledgment & Climate Change How can acknowledging the traditional territories and agreements of the Mississauga and Haudenosaunee nations guide our actions to address climate change and health at McMaster University? Think of principles like stewardship, reciprocity, and sustainability. AGENDA 1. Review Learning Aims 2. Geography, Physical Environment, & the link to Health 3. Climate Change 4. Globalization 5. Plans for next week Unit 10: The Physical Environment & Health Aims AIMS: In this unit learners will examine the interaction between the physical environment and human health, recognizing that the environment includes both a broad, global perspective (eg. resource management, toxic contaminants) and also a narrower, more locally focused one (eg. Communities, workplaces, and households). KEY CONCEPTS: Climate change, carbon offsetting, planetary health KEY TERMS: Carbon offsetting, vector borne disease, ecosystem, climate resilience, resource efficiency. 1: Physical Environment & Geography PHYSICAL ENVIRONMENT AND HEALTH Key Message “Downstream” determinant impacted by socioeconomic and political context and socioeconomic position Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health: Social determinants of health discussion paper 2. Geneva, Switzerland: World Health Organization Press. How does Geography influence our health? “Geography & health are intrinsically linked” “Where we are born, live, study & work directly influences our health experiences: the air we breathe, the food we eat, the viruses we are exposed to & the health services we can access.” (Dummer, 2008, cited in Raphel, 2020, p. 52) ● ● Air, food, water, environmental pollution & exposure to vectors of disease ● “Rural, remote, isolated, northern & urban geographies determine physical aspects of the environment, & other SDoH such as access to health care, food, education, employment & housing”. (Raphael, 2020, p. 52). Geography: ● ● involves how humans organize themselves & create “places”. illuminates interrelations between land, space, territory & human experiences - these are shaped by socio-political & economic dimensions of society. ● ● ● Average life expectancy: in Canada is 84.0 years for women & 79.9 years for men in B. C. it is 84.6 years for women & 80.1 years for men in the territory of Nunavut, it is 73.4 years for women & 70.8 years for men (Raphael, 2020, p. 52). Why are there such differences in life expectancy in different regions of Canada? Preventable Mortality Rates: Urban vs Rural Life ● Numerous studies show associations between health & the geographies of urban versus rural life. ● Death rates from treatable diseases are related to geographical remoteness, with rates significantly higher for ‘remote’ and ‘very remote’ areas, especially for males (see Figure 13.1 – next slide). Raphael, 2020, p. 54 Geography: ● specific vulnerabilities & health risks in both rural & urban areas. ● eg. public policies that create housing insecurity intersect with racial discrimination & urban ghettoization directed towards recent immigrants of colour. ● Gentrification of urban areas deepens disadvantages for immigrant & communities of colour across local geographies. ● Policies R/T environmental protections & urban planning, determine locations of toxic waste dumps, levels of air & water pollution, & other types of environmental contamination. ● An important determinant for those risks such as: racism, colonialism & oppression enable the location of toxic waste sites, landfills & incinerators to be in close proximity to communities of colour, poor neighbourhoods & Indigenous lands. (Raphael, 2020, p. 52). Map (Figure 13.2) plots marginalization index scores across Toronto neighbourhoods (Raphael, 2020, p.54). Geography as a determinant of health is especially important for its impact on Indigenous people’s health. ● De Leeuw - geographic lens for understanding the health of Indigenous people. ● Policymakers need to learn from Indigenous cosmologies - physical geography of the world is understood as intrinsic to human wellbeing. ● Indigenous scholar Robin Wall Kimmerer: “[w]e make a grave error if we try to separate individual well-being from the health of the whole.” ● (Raphael, 2020, p. 53). Climate Crisis Changes landscapes eg. with erosion of coastal areas, severe floods, draughts & massive wildfires – making land unsuitable for humans & wildlife. ● Human responsibility to live on Earth within boundaries, that limit destructive activities of humans. ● ● Shift in how we conceptualize health – within a holistic model (Raphael, 2020, p. 53). CLIMATE CHANGE: WHAT CAUSES IT? o Fossil Fuels – byproducts (e.g., gasoline/oil, coal, and natural gas) of decayed plants and animals – release carbon dioxide and other green house gases and trap heat o CONSEQUENCES: glaciers melt, waters rise, extreme weather https://en.wikipedia.org/wiki/Greenhouse_gas#/media/File:Greenhouse-effect-t2.svg World Health Organization. (2018). Climate change and health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health https://storage.googleapis.com/lancet-countdown/2019/10/2018-lancet-countdown-policy-brief-canada.pdf Climate Change and Health • Climate change contributes to more frequent and severe humanitarian emergencies (heatwaves, wildfires, floods, and tropical storms) • Research indicates that 3.6 billion people live in areas highly susceptible to climate change. • By 2030-2050, climate change is projected to cause an additional 250,000 deaths per year due to undernutrition, malaria, diarrhea, and heat stress WHO (2023) Healthcare Costs and Vulnerable Areas • • • Direct damage costs to health (excluding other sectors) may reach $2-4 billion annually by 2030. Areas with weak health infrastructure (mainly in developing countries) will struggle to cope without assistance. There is a disproportionate impact on vulnerable (WHO, 2023) populations. Impact on Health and The Environment • • • Climate change affects health directly (heatwaves, storms) and indirectly (disease outbreaks, mental health issues). It undermines social determinants of health, i.e., livelihoods and access to healthcare. Vulnerable populations i.e., women, children, and minorities, are most affected. (WHO, 2023) Climate-Related Health Challenges Water and Foodborne Illnesses: Food and Nutrition Crises: Vector-Borne Diseases: • 2 billion lack safe drinking water; 600 million suffer from foodborne illnesses annually. • Children under 5 bear 30% of foodborne fatalities. • Climate stressors heighten waterborne and foodborne disease risks. • In 2020, 770 million faced hunger, predominantly in Africa and Asia. • Temperature and precipitation changes enhance the spread of diseases. • Without preventive actions, annual deaths may rise from 700,000. (WHO, 2023) Understanding Climate-Sensitive Health Risks (WHO, 2023) Case Study: Meet Sarah A 38-year-old single mother in a coastal community. Works part-time in the fishing industry. 1. Direct Health Impact: Endured an extreme heatwave last summer. Sarah and her daughter suffered heat-related illnesses. 2. Indirect Health Impact: Prolonged heatwave strained local water resources. Son, Ethan, contracted a waterborne disease. 3. Social Determinants of Health: Changing ocean conditions threaten Sarah's livelihood. Reduced access to nutritious food and healthcare. 4. Vulnerable Populations: Sarah's family represents a vulnerable population. Women, children, and minority groups are at heightened risk. (OpenAI, 2023) Broader Impact Heat-Related Deaths and Mental Health: ● 37% of heat-related deaths attributed to human-induced climate change. ● Heat-related deaths among those over 65 rose by 70% in two decades. Impact on Global Health and Poverty Reduction: ● Climate crisis threatens to undo the last 50 years of progress in development, global health, and poverty reduction. ● Worsens health inequalities and compounds the existing burden of disease. (WHO, 2023) Need for Urgent Action and WHO Response • • • Urgent action is necessary to limit temperature rise to 1.5°C and prevent catastrophic health impacts WHO's response focuses on (1) promoting emissions reduction, (2) building resilient health systems, (3) protecting health from climate change, and (4) raising awareness. Collaboration and evidence-based approaches are central to addressing this global challenge. WHO (2023) Lytton, B.C. – June 30, 2021 https://www.cbc.ca/news/canada/british-columbia/bc-wildfires-2021-timeline-1.6197751 Flood waters cover Hwy 1 in Abbotsford, B.C. THE CANADIAN PRESS/ Jonathan Hayward Tuesday, Nov. 16, 2021. Properties inundated by flood waters are seen in Abbotsford, B.C. THE CANADIAN PRESS/ Jonathan Hayward Tuesday, Nov. 16, 2021. BC Wildfires & Impact on Public Health Note: Not a required/testable resource ● British Columbia's recurring struggle with increasingly destructive wildfires, leading to severe consequences (safety of firefighters, destruction of communities, and widespread air pollution) ● Climate change plays a pivotal role in exacerbating the frequency, intensity, and duration of these devastating wildfires. ● The impacts of climate change, such as heatwaves, prolonged drought, increased lightning strikes, and extreme weather conditions, have collectively contributed to the alarming rise of wildfires. (CBC, 2023) Public Health Implications & Mitigation Strategies Note: Not a required/testable resource ● Wildfires have impact on public health. Leading to issues such as ● respiratory problems, mental health concerns, and the exacerbation of pre-existing health conditions. ● Various strategies can be employed. These strategies may involve controlled burning practices and the removal of potential fuels like woody debris to reduce fire risks. ● Public awareness, community actions, and adaptation are crucial in minimizing health risks. (CBC, 2023) What are the direct and indirect impacts of the wildfire on health? (WHO, 2023) https://www.canada.ca/content/dam/phac-aspc/documents/services/reports-publications/canadacommunicable-disease-report-ccdr/monthly-issue/2019-45/issue-4-april-4-2019/ccdrv45i04a01-eng.pdf REMEMBER: those most excluded will experience the most negative impact. https://www.theguardian.com/environment/2019/nov/08/gretathunberg-effect-driving-growth-in-carbon-offsetting Summer 2019 – Hamilton Climate March in response to Greta Thunberg’s speech https://www.climatestewards.org/offset/ Climate Crisis – “biggest Public Health emergency” CBC news report from COP26 – interview with Dr. Courtney Howard an ER physician from the NWT’s who is attending COP26 in Glasgow (Nov. 2nd, 2021). ● https://www.cbc.ca/player/play/1970254403935 RNAO Advocates for Climate Action ● ● ● ● Emphasizing equity in the distribution of costs and benefits. They urge government levels to establish stringent GHG emission targets, comprehensively address all emission sources, ensure transparent reporting, and support just transitions. Their approach includes respect for Indigenous rights, international leadership, carbon pricing, phasing out fossil fuels, sustainable transportation, and dietary transition. RNAO underscores the need for conserving natural spaces and a lower-meat diet while promoting strong climate policies that benefit all segments of society. (RNAO, 2022) NOTE: Not a required resource 2: ENVIRONMENT AND THE LINK TO HEALTH ENVIRONMENT HEALTH.. hard to prove ASSOCIATION VS. CAUSATION – relationships vs. direct cause and effect 1. ASSOCIATION ○ Relationship between two random variables (statistically significant), without understanding the direction of the relationship ■ 2. Example: ice cream and crime CORRELATION ○ Measure of the strength of the relationship between two variables (change of one based on change of another) ■ Example: education and income HAZARDS TO HEALTH 1. TRADITIONAL HAZARDS Associated with lack of development: drinking water, sanitation, plumbing, indoor cooking, etc. 2. MODERN HAZARDS Associated with unsustainable development: water pollution, industry, intensive agriculture, urban air pollution, vehicular traffic, climate change, ozone changes, etc. Note price of water vs. pop https://thenarwhal.ca/this-ontario-first-nations-boil-wateradvisory-has-been-in-effect-for-25-years/ WATER AND HEALTH “Some advisories are so old, explains Dawn Martin-Hill, one of the founders of the Indigenous Studies Program at McMaster University, that you could have a 16-year-old girl growing up in northern Ontario who has never been able to drink or bathe In the water that they have access to.” https://globalnews.ca/news/5887716/first-nations-boil-wateradvisories/ REQUIRED MEDIA FILE: https://youtu.be/ibWLCYknpNc https://www.sac-isc.gc.ca/eng/1506514143353/1533317130660 Remaining long-term drinking water advisories – as of Nov. 1, 2021 https://www.sacisc.gc.ca/eng/1614387410146/16143 87435325 Shoal Lake An Indigenous Community’s Transformational Fight For Clean Water ● ● ● This community achieved a significant milestone by opening their water treatment plant last year, finally ending a 20-year boil water advisory Their mission was driven by pursuing human rights, health, and securing a better future Community meetings played a pivotal role in planning this transformation (emphasizing the need to engage with bureaucrats) CBC News (2022) Shoal Lake & : Winnipeg Challenges and Persistence ● ● ● Individuals experienced bacterial infections during the boil water advisory Some resorted to driving over an hour to bathe their children in a hotel during the advisory Even after the plant's opening, trust in the water supply remained challenging for community members CBC News (2022) Shoal Lake & Winnipeg • • • Freedom Road Winnipeg had left the community cut off without roads or access. The construction of Freedom Road was finally built (a lifeline for Indigenous residents) This became a 'life and death situation' for the community, leading locals to convince all levels of government to contribute to this vital project Negotiations and secret meetings were held CBC News (2022) Shoal Lake & Winnipeg Impact of Clean Water • • • Elders have noted a significant difference in both health and the community's economic well-being since the water treatment plant's inception The achievement of clean water now allows residents to save money spent on bottled water and transportation The money is going towards improving infrastructure to deliver water directly to homes and investing in housing projects to encourage members to return and boost the local economy CBC News (2022) Shoal Lake & Winnipeg As aspiring future nurses, how does this situation make you feel? Considering the importance of your role in promoting and providing healthcare? CBC News (2022) Shoal Lake & Winnipeg Consider the following factors concerning the story of this Indigenous community's fight for clean water and their journey to end a 20-year boil water advisory: ● Colonization ● Reconciliation ● Health Disparities ● Equity ● Economic Impact ● Empowerment ● Engaging with Bureaucrats (government organizations) ● Accessibility and geography ● Health and Economic Well-Being ● Infrastructure CBC News (2022) A WORD ABOUT PLASTIC… https://www.unenvironment.org/news-and-stories/story/whats-your-bathroom-hidden-plastics-your-beautyproducts o End up in the ocean o May end up on our plates o Unknown health risks https://www.unenvironment.org/news-and-stories/story/whatsyour-bathroom-hidden-plastics-your-beauty-products https://www.beatthemicrobead.org/product-lists/ “To find out if your product contains microplastics, you can scan it using the ‘Beat the Microbead’ app, or look for the following commonly used plastic ingredients: polyethylene (PE), polymethyl methacrylate (PMMA), nylon, polyethylene terephthalate (PET) and polypropylene (PP).” https://www.unenvironment.org/annualreport/2018/index.php#cover https://www.cnbc.com/2020/06/28/coronavirus-plastic-waste-surges-as-restaurants-use-more-disposable-packaging.html LEAD AND HEALTH INHALATION OF LEAD PARTICLES o Burning materials containing lead (recycling; stripping leaded paint) o Leaded gasoline or leaded aviation fuel INGESTION OF LEADCONTAMINATED DUST o Water (leaded pipes) o Food (lead-glazed or lead-soldered containers) https://www.who.int/news-room/fact-sheets/detail/lead-poisoning-and-health https://www.thestar.com/news/investigations/2019/11/04/20000-hamilton-homes-have-toxiclead-pipes-carrying-water-to-taps-the-city-says-it-will-take-40-years-to-fix-the-system.html Grassy Narrows – Mercury-Care Home Funding ● Grassy Narrows funding pact for mercury-poisoning care home spurs joy and bitter memories ● https://www.cbc.ca/news/canada/thunder-bay/grassy-narrows-celebratesmercury-care-home-funding-1.6124129 ● CBC News – Thunder Bay July 31, 2021 3: Globalization “The current path of globalization must change. Too few share in its benefits. Too many have no voice in its design and no influence on its course.” Commission on the Social Dimension of Globalization, 2002 cited in Raphael et al., 2020, p. 75. Globalization ● Not a new phenomenon ● Started with Europe’s worldwide colonizing pursuits ● In “1990’s term globalization gained political & scholarly currancy” ● Labonte & Torgerson def’n.: “Processes by which nations, businesses, & people are becoming more connected & interdependent via increased economic integration & communication exchange, cultural diffusion […] & travel.” Raphael et al., 2020, p. 75. Disparities between nations: What allows some people & nations to remain healthier & wealthier, & others to fail to rise ….above…extreme poverty”? Raphael et al., 2020, p. 75. Neoliberalism An extreme form of classical liberalism ● ● o o o o • • • • Arose with capitalism in 18th century Theory of political economy – emphasis on: Free markets Trade Finance liberalization Minimal state governance 1980’s - IMF & World Bank encouraged “Roll-back” of state welfare & social safety net 1990’s - “Roll-out” of liberalized & deregulated global finance – allowed investors to speculate & ‘game’ global economy….leading to 2008 global financial crisis 1995 – birth of World Trade Organization…many bilateral & regional trade & investment treaties ( often benefitting wealthier people within wealthier countries). OXFAM estimates: richest 26 billionaires = wealth (& political power) as bottom ½ (3.8 billion people) Raphael et al., 2020, p. 75. Why is it important to know about Globalization? • • • Increased trade & globalization has led to increased use of ecological resources Leading to climate change crises, mass species extinction, & collapse of ecosystems essential to sustaining life. Harmful health effects of climate crisis – affects the poor & poorer countries more than wealthy ● Wealth inequalities, severe poverty & climate change (drought, famine & floods) has led to mass migration, often resulting in xenophobic & nationalist protectionist responses ● There is Hope in more social activism led on social media, intergovernmental agreements thro’ UN eg. 2015 – Sustainable Development Goals (SDG’s), Paris Accord on Climate Change & recent COP 2021 in Glasgow, Scotland. Raphael et al., 2020, p. 76. PRIORITIZING ENVIRONMENT https://www.un.org/sustainabledevelopment/blog/2015/12/sustainable-development-goals-kick-off-with-start-of-newyear/#iLightbox[gallery13821]/0 https://www.un.org/sustainabledevelopment/development-agenda/ o Aim: reduce greenhouse gases o Signed by 195 countries o USA initially signed https://news.un.org/en/story/2016/04/527372-un-says-parisagreement-climate-change-must-aim-long-term-environmental CRITICAL THINKING QUESTIONS 1. How do the SDoH account for differences in drinking water quality throughout Canada? 2. Which do you think has a larger impact on the health of the planet: human population growth or inequity between populations? THANK YOU FOR PARTICIPATING! In addition to the readings review the required media files found in the syllabus References CBC News (2020). Article: Grassy Narrows First Nation and federal government sign agreement to build on-reserve mercury care home. https://www.cbc.ca/news/canada/thunder-bay/grassy-narrows-framework-1.5520501 CBC News. (2023, November 9). Wildfires becoming more extreme due to climate change, say experts. CBC News. https://www.cbc.ca/news/canada/british-columbia/wildfire-factors-climate-change-1.6939911 Ogden, N. H., & Gachon, P. (2019). Climate change and infectious diseases: The challenges: Climate change and infectious diseases: What can we expect? Canada Communicable Disease Report, 45(4), 76. https://www.canada.ca/content/dam/phac -aspc/documents/services/reports-publications/canada-communicable-disease-report-ccdr/monthly-issue/2019-45/issue-4 -april-4-2019/ccdrv45i04a01-eng.pdf OpenAI. (2023). ChatGPT (November 11) [Large language model]. https://chat.openai.com/chat Raphael, D., Bryant, T., Mikkonen, J., & Raphael, A. (2020). Social Determinants of Health: The Canadian facts (2nd ed.). Ontario Tech University Faculty of Health Sciences and York University School of Health Policy and Management. (Chapter 13: Geography; Chapter 19: Globalization) Registered Nurses' Association of Ontario. (2023, April 21). Position Statement on Climate Change. RNAO. https://www.rnao.ca/resources/position-statements/position-statement-climate-change World Health Organization. (2021). Climate change and health. https://www.who.int/news-room/fact-sheets/detail/climate-change-andhealth

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