2.4 Public health and sustainability

Learning objectives

After reading this module, students should be able to

• understand what public health is
• recognize public health impacts of non-sustainable development
• identify key public health impacts of climate change

Introduction

“Much discussion about sustainability treats the economy, livelihoods, environmental conditions, our cities and infrastructure, and social relations as if they were ends in themselves; as if they are the reason we seek sustainability. Yet their prime value is as the foundations upon which our longer-term health and survival depend.” ( McMichael, 2006 )

Ecological sustainability is more than just continuing the resource flows of the natural world to sustain the economic machine, while maintaining diversity of species and ecosystems. It is also about sustaining the vast support systems for health and life which could be considered the real bottom line of sustainability. Before examining the public health effects of non-sustainable development, we should define public health.

• The website for UIC’s School of Public Health says “we are passionate about improving the health and well-being of the people of Chicago, the state of Illinois, the nation and the world.”
• The Illinois Department of Public Health is responsible for protecting the state's 12.4 million residents, as well as countless visitors, through the prevention and control of disease and injury.”
• The New Zealand Ministry of Health defines it as “the science and art of promoting health, preventing disease and prolonging life through organized efforts of society.”
• The National Resources Defense Council an NGO devoted to environmental action, states that public health is “the health or physical well-being of a whole community.”

Impacts of non-sustainable development

We have built our communities in ways that are unsustainable from many aspects. Not only does development create urban sprawl, impact land use, and fuel consumption, we can identify negative health consequences related to these development trends.

Obesity

If our communities are not walkable or bikeable, we need to drive to schools, shops, parks, entertainment, play dates, etc. Thus we become more sedentary. A sedentary lifestyle increases the risk of overall mortality (2 to 3-fold), cardiovascular disease (3 to 5-fold), and some types of cancer, including colon and breast cancer. The effect of low physical fitness is comparable to that of hypertension, high cholesterol, diabetes, and even smoking ( Wei et al., 1999 ; Blair et al., 1996 ).

Economic segregation

Walkable and safe communities provide sidewalks, bike paths, proximity, and connections to community services such as grocery stores, schools, health care, parks, and entertainment. Community design that creates a segregated housing environment with only expensive housing and no affordable housing segregates people by socio-economic level (i.e. poor from non-poor) and this generally leads to segregation by race. Lack of physical activity will occur in neighborhoods with no good green and safe recreational sites. If we have poor public transit systems partly due to lack of density (only more expensive, low-density housing) and our love of the automobile, then we have increased emissions that contribute to global warming.