Sustainability & the determinants of health
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Healthy Cities
The WHO's Healthy Cities movement is a global movement. It promotes comprehensive and systematic policy and planning for health and emphasizes:
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What are 'determinants of health'?
According to the WHO;
'Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact'. An important environmental factor affecting health is health impacts due to coal pollution in Europe, from this recent HEAL report: 
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The co-benefits concept
One welcome positive point about possible responses to climate change is that there exists a large body of evidence about health and climate ‘co-benefits’, or synergies between improved health and well-chosen climate policy.
In essence, these are (potentially immense) environmental and population health benefits stemming from encouraging more active travel, eg. walking and cycling to school and work1, and from reducing consumption of red and processed meat, amongst other things. They present unparalled opportunities to improve health and cut emissions at the same time, as well as potentially saving the NHS a great deal of money in the long term through prevention – something it very much needs to do.
Overview and implications for policy-makers
Co-benefits strategies to reduce greenhouse-gas emissions: food and agriculture
Co-benefits
Co-benefits of low-carbon electricity generation
A recent study by Aston et al2 modelled a hypothetical scenario in which the proportion of vegetarians doubled based on current UK levels, and the remainder adopted the dietary pattern of in the lowest fifth of current red and processed meat consumers. Comparing a number of very common conditions from CHD to diabetes, they found statistically significant reductions in average risk (across the whole population) ranging from 3.2% (95% CI 1.9 to 4.7) for diabetes in women to 12.2% (6.4 to 18.0) for colorectal cancer in men. People who move from the highest to lowest consumption levels would gain about twice these averages, and the expected reduction in GHG emissions was 27.8 million tonnes CO2 equivalent /year - about 3% of the current total UK emissions.
1. WHO: Health co-benefits of active travel http://www.who.int/hia/green_economy/transport_sector_health_co-benefits_climate_change_mitigation/en/index.html
2. Aston et al., Impact of a reduced red and processed meat dietary pattern on disease risks and greenhouse gas emissions in the UK: a modelling study BMJ Open Access (2012) http://bmjopen.bmj.com/content/2/5/e001072.full.pdf+html
In essence, these are (potentially immense) environmental and population health benefits stemming from encouraging more active travel, eg. walking and cycling to school and work1, and from reducing consumption of red and processed meat, amongst other things. They present unparalled opportunities to improve health and cut emissions at the same time, as well as potentially saving the NHS a great deal of money in the long term through prevention – something it very much needs to do.
Overview and implications for policy-makers
Co-benefits strategies to reduce greenhouse-gas emissions: food and agriculture
Co-benefits
Co-benefits of low-carbon electricity generation
A recent study by Aston et al2 modelled a hypothetical scenario in which the proportion of vegetarians doubled based on current UK levels, and the remainder adopted the dietary pattern of in the lowest fifth of current red and processed meat consumers. Comparing a number of very common conditions from CHD to diabetes, they found statistically significant reductions in average risk (across the whole population) ranging from 3.2% (95% CI 1.9 to 4.7) for diabetes in women to 12.2% (6.4 to 18.0) for colorectal cancer in men. People who move from the highest to lowest consumption levels would gain about twice these averages, and the expected reduction in GHG emissions was 27.8 million tonnes CO2 equivalent /year - about 3% of the current total UK emissions.
1. WHO: Health co-benefits of active travel http://www.who.int/hia/green_economy/transport_sector_health_co-benefits_climate_change_mitigation/en/index.html
2. Aston et al., Impact of a reduced red and processed meat dietary pattern on disease risks and greenhouse gas emissions in the UK: a modelling study BMJ Open Access (2012) http://bmjopen.bmj.com/content/2/5/e001072.full.pdf+html
What can we do now to improve health and reduce greenhouse gas emissions?
(partly adapted from NHS Choices' site)
Change your diet - for a healthier you, and a healthier planet
Exercise and active travel
Look after your mental health
Drink less and quit smoking
Change your diet - for a healthier you, and a healthier planet
- Cutting down on red and processed meat - - has major benefits to health, as well as greatly reducing your carbon footprint. Did you know that the carbon footprint of a 12oz. beef steak is the same as driving an average car 13 miles (over twice that of the same amount of chicken)?
- A healthy diet should also include plenty of fruit and veg - eating at least 400g of fruit and vegetables a day and reducing your intake of salt and fat can lower your risk of serious health problems, including heart disease, type 2 diabetes and obesity.
- 2/3 of Britons' diets include too much saturated fat, putting them at an increased risk of heart disease and stroke. One of the best ways to cut down on this is to reduce how much red meat and high-fat dairy products (eg. cheese) you eat. Two thirds of Britons have too much saturated fat in their diets, putting them at an increased risk of heart disease and stroke. Get more tips in lower your cholesterol and say no to salt; also check out this page for advice on health, carbon and meat-eating.
Exercise and active travel
- There’s more to exercise than losing weight (although it's pretty great for that too - and nearly 1/3 women and 2/5 men in England are currently overweight, more than ever before. On average, obesity reduces life expectancy by nine years.
- You can use this BMI calculator to find out if you’re a healthy weight or overweight.
- Even slim people get multiple health benefits from exercising, including a much lower risk of developing major chronic diseases, such as CHD, stroke and type II diabetes. Regular exercise can cut the risk of premature death by 20-30%. Walking or cycling to work, the shops or to meet friends can also save carbon - and money! NHS Choices has useful lose weight and health and fitness sections
Look after your mental health
- Psychological problems, including stress, are the underlying reason for 1 in 5 visits to a GP. If left unchecked, stress can lead to further health problems such as high blood pressure, anxiety and depression. More exercise and more time spent in contact with nature have both been shown to have very positive effects on psychological wellbeing.
- Sleep is also key to feeling good - If you’re not getting enough sleep, it can affect relationships, your performance at work, and recovery from illness. Sleeping more could even reduce your carbon footprint... within limits! A good bedtime ritual and some simple lifestyle changes can help. Other useful resources are NHS Choices' top 10 stress busters, advice on good time management and relaxation tips.
Drink less and quit smoking
- Regularly drinking more alcohol than is advised by the NHS can lead to a wide range of long-term health problems, including cancers, strokes and heart attacks. Men who regularly drink more than 3-4 units a day are at 3x the risk of a stroke.
- The health benefits of quitting smoking are immediate: after 20 minutes, your blood pressure and pulse return to normal. After three days you can breathe more easily, and your energy increases - keep it up and you’re adding years to your life; for example, men who quit smoking by the age 30 add 10 years to their life.
- Both steps can also help to save you money and reduce your carbon footprint (assuming that you don't spend the money saved on high-carbon goods/flights!) More information on NHS Choices' drinking and alcohol and quit smoking sections.
What's the single most effective health intervention we have to tackle obesity, heart disease, cancer, diabetes and numerous other 'non-communicable diseases' like these?Something which:
improves heart health, mental health, joint and back pain; reduces the risk of diabetes, stroke and many cancers; improves bone strength, reducing the risk of fractures... Which is: Usually CHEAP or FREE (and may even save you money!) Which is also both LOW CARBON & ENJOYABLE? Watch Dr. Mike Evans' video '23 and 1/2 hours to find out more about the intervention and the evidence... |
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