This issue of Family & Community Health addresses environmental health in its broadest sense. It refers to both the natural and built environments for their impact on human health. Health problems resulting from environmental causes are on the rise for several reasons, two of which are (1) the growing populations that reside near areas vulnerable to natural disasters and (2) the polluting of soil, water, and air with chemical and other toxic substance discharges.
A growing number of acute and chronic health problems result from environmental conditions. The physical body absorbs toxins through inhalation, ingestion, and skin, but mental health is also affected through such things as conditions and safety of the built environment. Environmental threats affect many health conditions ranging from tick-borne illnesses to asthma to obesity.
What was once the purview of public healthcare professionals has now become requisite knowledge for all practitioners in all health sectors and organizations. Increasing healthcare professionals' awareness of health threats within the environment is foundational to health promotion.
To understand injuries related to the environment, Sanchez and colleagues identify visits to emergency departments as a result of environmental exposure over a 3-year time period to identify nonfatal environmental injuries. On the basis of their findings, heat-related injuries were the most common. Recommendations are made for the prevention of these adverse events.
Several articles in this issue discuss environmental threats and focus on the entire community. Greger and Koneswaran, for example, provide a review of the health impacts of concentrated animal feeding operations. During the past several decades, animal production has become much more concentrated, and, although some threats are known, such as the documented fish kill after several million gallons of manure leaked into a river in New York, the total impact on local communities is unknown.
How communities interact with their natural environment is the subject of the article by Longo and colleagues. In 2008, after increased volcanic activity and higher emissions of sulfur dioxide, this interdisciplinary research team conducted an assessment of indoor air quality for the most vulnerable groups, children, and hospitalized patients. In collaboration with schools, a hospital, and other community agencies, they provided recommendations specific to each unit's room to improve the indoor air quality and decrease exposure to sulfur dioxide and particulate matter from vog following eruptions from Kilauea Volcano.
In a study related to the prevention of lead exposure, Kegler and colleagues evaluated a community-based intervention, using lay advisors to reduce lead exposure among young children. This article addresses the effectiveness of an educational program aimed at teaching parents of young children about the necessary behavior changes to prevent lead exposure.
Cutt and colleagues describe correlates of regular dog walking and increased physical activity by owners. Although dog owners walk more than other people, some owners do not walk regularly. The authors describe the importance of the physical environment, specifically dog-friendly parks, in adopting this behavior. With rates of diabetes and obesity climbing, automatic ways to build in exercise are welcomed.
Redwood and colleagues provide an interesting look into the perceptions of low-income African Americans in Atlanta about their community and how the built environment affects them. Through the use of Photovoice and community-based participatory research, they identify 4 themes that residents believe affect their health, including housing conditions, gentrification and displacement, housing disinvestment, and speculative development. The results are reviewed in the context of an environmental justice framework.
Increasingly, the built environment is scrutinized for its impact on health. The review of studies on the built environment by Renalds and colleagues identifies that the manner in which the physical environment is structured and maintained can be a factor in the amount of physical activity undertaken by residents, obesity levels, social capital, and mental health.
These authors address an impressive array of concerns about the environment, yet this work is only a fraction of the research and policy efforts that are necessary to bring change and eliminate health threats. Their work inspires us to increase awareness of environmental conditions that affect health and to involve all levels of communities in collaboration to positively influence individual and community health.
-Patty J. Hale, PhD, RN, FNP, FAAN
Professor, Graduate Program Coordinator, Department of Nursing, James Madison University, Harrisonburg, Virginia