The Physical Environment and Health

The Physical Environment and
Session Aims
• To explore some of the key physical
environmental influences on health
• To critique some of the key physical
environmental factors influencing health
drawing on current research and debate
• To understand the extent the physical
environment in which we experience our live
influences our health
Factors of the Physical Environment
Agriculture and food production,
Water and sanitation,
The working environment,
Healthcare services
(*Note that this is not an exhaustive list)
Lalonde’s Health Field concept
Proposes that health can be improved by
addressing four different factors:
individual lifestyles,
health services,
human biology/genetics
environmental influences.
Busfield’s Typology of Health and
• Type 1 – Explanations to do with individual
• Type 2 – Explanations to do with individual
attributes and circumstances
• Type 3 – Explanations to do with the material
environment and allocation of resources
• Type 4 – Explanations to do with social
relationships and human subjectivity
Busfield’s Type 3
According to Busfield’s typology:
• Our material environment and the way that
resources are allocated and distributed have a
significant impact on health.
• These factors are influenced by the way that
society is organised politically and
economically (Busfield, 2000).
Food and Agriculture
Availability of food
Types of food
Production processes
Politics and economics
Water and Sanitation
• Access to clean water & adequate sanitation is
key to good health
• ‘Water problems’
- contamination,
- deficits and shortages,
- safety
- distribution
- links to agriculture & food production
Housing and Health
• Housing and health are linked
• Issues:
– Overcrowding
– Damp and cold
– Poor quality
– Homelessness/temporary accommodation (link to
poorer mental health)
– Growth of urban slums (migration into cities)
Work environment and health
Three ways in which the working environment
can impact on health:
• Working patterns
• Physical working environment
• Psycho-social impact
Working Patterns:
• Irregular shift patterns are detrimental to
health (physical and mental)
- Disruption to sleep patterns
- Patterns of unhealthy behaviour
associated with working shifts
- Stress
(Scott, 2000; Knutsson, 2003)
Physical Working Environment:
• ‘Sick Building Syndrome’ (symptoms caused by
the condition of the building worked in)
• Impacts on health - reduces productivity and
increases absenteeism (Epstein, 2008)
• Whitehall Studies – low levels of work demand,
control and support associated with higher rates
of absence (North et al, 1996)
• Impact of temporary and permanent
employment – latter is better for health
(Aronsson et al, 2002)
Unemployment and health
• Being unemployed is detrimental to health (Lin et
al, 1995)
• Causal link between unemployment and adverse
health outcomes (many factors might contribute
to this)
• Stewart (2001) – people who are unemployed
experience higher death rates than people who
are employed.
• Unemployment causes increased financial
pressure and increases individual vulnerability to
other life events (Kessler et al, 2009)
Education and health
• There is a positive association between
education and health (higher levels of
education lead to better health experience)
• Ross and Wu (1995) offer 3 explanations for
– Work and economic conditions
– Social-psychological resources
– Lifestyle
The more educated you are, the more likely you are
- work full time in fulfilling, subjectively rewarding
- report a sense of control over your life and your
health and greater levels of social support
- reject health-damaging practices such as smoking
and take up health enhancing practices
Healthcare services and health
• The availability and accessibility of healthcare
has a huge impact on health.
• For example, maternal and infant health varies
considerably according to the income of a
• In the UK – ‘Post Code Lottery’ (label used to
describe relative differences in the provision
of healthcare related to geographic location)
• The physical environment (our living and
working conditions) has a large part to play in
our experiences of health (Donaldson and
Scally 2009),
• There are many other factors of our living and
working conditions which impact on health.
• Different environmental factors may interact
with each other to influence health (Green
and Tones, 2010),
Additional factors?
• natural and manmade disasters,
• climate change (Macdonald, 2006),
• out-door air pollution (Donaldson and Scally,
• solid waste disposal (Leonardi et al, 2005)
• transport
• It is important to consider factors within the
physical environment and how these can
influence health and health experience.
• Identifying environmental factors affecting health
can help to address them and potentially make a
real difference to health outcomes
• This can also influence health policy, how fiscal
decisions are made and resource-allocation to
improve health
• There are many aspects of the physical environment which
impact on health and health experience throughout life
through our living and working conditions.
• Research into these factors, and the impact of them, is
challenging because whilst positive relationships and
associations can be demonstrated, the causal mechanisms
(how and why) can be harder to determine.
• The relationship between our living and working conditions
and the way that we live our lives is very complex and
involves the interaction of a large number of different
factors which are hard to separate from each other.

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