Environmental Health Equity: A Concept Analysis

2019 ◽  
Vol 38 (1) ◽  
pp. 183-202 ◽  
Author(s):  
Teresa Dodd-Butera ◽  
Margaret Beaman ◽  
Marissa Brash

Public health practice and ethics address both individual and environmental health, in order to optimize the well-being of an entire population. Consideration of environmental health equity (EHE) is an evolving component of environmental ethics and public health, with evidence of disparities in exposure to vulnerable communities. Related terms for studying EHE include elements of justice, social determinants of health (SDOH), disparities, and environmental racism. The unequal protection from environmental exposures, specifically considering vulnerable and marginalized populations is significant to science, society, and health. Analyzing the environmental impact includes examining equity principles to assist policy and decision-making in the public arena, in order to address unfair burdens placed on vulnerable populations. However, the lack of a common and precise term for the idea makes it to instruct and evaluate the experiences of inequities in diverse populations. The purpose of this research is to use a concept analysis to examine the idea, utility, and conditions surrounding “EHE” for use in public health, nursing, environmental ethics, policy development, and interprofessional collaboration. A concept analysis will be conducted following the eight-step method developed by Walker and Avant (2011). Data sources will include empirical and descriptive literature; and the results will identify defining attributes of the concept. A set of operationalized standards for EHE is established through this concept analysis. This study proposes an examination of the concept in order to assess and evaluate the ethics and experiences in EHE, and determine how this impacts population health outcomes.

Author(s):  
David B. Resnik

This chapter provides an overview of the ethics of environmental health, and it introduces five chapters in the related section of The Oxford Handbook of Public Health Ethics. A wide range of ethical issues arises in managing the relationship between human health and the environment, including regulation of toxic substances, air and water pollution, waste management, agriculture, the built environment, occupational health, energy production and use, environmental justice, population control, and climate change. The values at stake in environmental health ethics include those usually mentioned in ethical debates in biomedicine and public health, such as autonomy, social utility, and justice, as well as values that address environmental concerns, such as animal welfare, stewardship of biological resources, and sustainability. Environmental health ethics, therefore, stands at the crossroads of several disciplines, including public health ethics, environmental ethics, biomedical ethics, and business ethics.


2017 ◽  
Vol 3 (1_suppl) ◽  
pp. 73S-80S ◽  
Author(s):  
Michelle Carvalho ◽  
Lisa C. McCormick ◽  
Laura M. Lloyd ◽  
Kathleen R. Miner ◽  
Melissa Alperin

Experiential learning links knowledge to real practice through seasoned mentor support, professional reflection, and hands-on experience in authentic work environments. While academic public health programs seek to train the future workforce, the current workforce has a critical need for training as well. The Region IV Public Health Training Center’s Pathways to Practice Scholar program gives public health students the opportunity to apply knowledge to competency-based experiences while fulfilling the current workforce’s short- and long-term human resource needs. Placements are offered in all eight states of the region to broaden opportunities for both agencies and student scholars. On completion of the program, scholars are required to submit an executive summary, reflection statement, photos of the experience, and a draft abstract suitable for submission to a professional conference. Since 2015, 36 scholars have been placed in positions across Region IV, 11 in states other than those of their home universities. Students were placed at state, local, and tribal health departments; area health education centers (AHECs); and other agencies (e.g., primary care settings), and the most common work plan domains selected by scholars were analytic/assessment, policy development/program planning, and leadership/systems thinking skills. Scholars’ perceived confidence increased across all domains with the highest increases in financial planning/management and cultural competency. Program implementation and evaluation findings are described, including types of projects, differences in confidence in performing competency domains, and confidence and interest in working with underserved populations. Evaluation findings indicate that the Region IV Public Health Training Center scholars increased their confidence in performing practice competencies while providing support for public health agencies serving underserved populations.


2019 ◽  
pp. 183-192
Author(s):  
Fran Baum

This chapter distills the contents of the book into six central messages: (1) reducing inequities is the central, vital mechanism for building population health; (2) human health is intimately connected to planetary health and needs to be viewed as part of the broader ecosystem; (3) how we govern is vitally important to how healthy, sustainable and equitable we are: good governance is centrally concerned with the involvement of all sectors to promote health and reduce inequities; (4) regulation is a powerful and essential tool for public health; (5) new ways of measuring progress are important; (6) ubiquitous leadership is required for health, equity, and well-being. The chapter elaborates on each of these and then ends with a consideration of the importance of maintaining hope and acting with courage.


SAGE Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 215824402096277
Author(s):  
Leena Eklund Karlsson ◽  
Anne Leena Ikonen ◽  
Kothar Mohammed Alqahtani ◽  
Pernille Tanggaard Andersen ◽  
Subash Thapa

In the Kingdom of Saudi Arabia (KSA), no studies have been documented to analyze the equity aspects of public health policies. The aims of the study were to identify policy documents in the KSA relevant to public health and to explore whether these include an equity approach. Twenty health-related documents were identified from various ministries’ websites and analyzed through directed content analysis. The results showed that the term “equity” was neither defined nor explained in the documents and suggestions on how to tackle health inequities were lacking. None of the suggested measures communicated an explicit focus on promoting health equity or the social gradient. Several upstream, midstream, and downstream measures were suggested to improve justice and public health for the people. The study reveals that there is a need for an in-depth assessment of the policy measures across sectors and their influence on health equity to inform future health policy development and action in the KSA.


2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Xaver Baur ◽  
Colin L. Soskolne ◽  
Lisa A. Bero

Abstract Background The sciences, and especially the research subspecialties of occupational and environmental health, are being misused. The misuse serves to interfere with the advancement of policies that depend on rational evidence needed for policies to protect public health. Methods We selectively surveyed the independent scientific literature. In addition, the efforts of respected international professional organizations of scientists whose focus is on maintaining and improving public health have been considered. This commentary is unique in assembling not only the factual basis for sounding alarms about significant bias in occupational and environmental health research, but also about the manipulative mechanisms used, and, in turn, the methods needed to keep science honest. Results Scientific integrity is based on the principle that research is conducted as objectively as possible; it cannot be compromised by special interests whose primary goals are neither to seek truth nor to protect human health. Evidence demonstrates a significant risk of bias in research reports sponsored by financial interests. Practices of corporate malfeasance include the orchestrated contamination of editorial boards of peer-reviewed scientific journals with industry apologists; interference with activities of national regulatory bodies and international review panels engaged in safeguarding occupational and public health; constructing roadblocks by capitalizing on uncertainty to undermine scientific consensus for much-needed government regulation of carcinogenic, endocrine-disrupting and/or immunotoxic agents; promoting “causation” criteria that lack foundation and effectively block workers’ access to legal remedies for harms from occupational exposures resulting in morbidity and premature mortality; and, violating standards of professional conduct by seducing reputable scientists with financial incentives that make them beholden to corporate agendas. Conclusions Well-orchestrated assaults on science continue unabated and must now be met head-on. Success could be achieved by promoting and protecting the integrity of research. Furthermore, avoiding influence by conflicted corporate affiliates in occupational and public health regulations is needed. Identifying, managing and, ideally, eliminating corporate influence on science and science policy are needed to protect research integrity. Protecting the public’s health, preventing disease, and promoting well-being must be the unambiguous goals of research in occupational and environmental health.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Anne De Biasi ◽  
Megan Wolfe ◽  
Jane Carmody ◽  
Terry Fulmer ◽  
John Auerbach

Abstract Background and Objectives The public health system in America—at all levels—has relatively few specialized initiatives that prioritize the health and well-being of older adults. And when public health does address the needs of older adults, it is often as an afterthought. In consultation with leaders in public health, health care, and aging, an innovative Framework for an Age-Friendly Public Health System (Framework) was developed outlining roles that public health could fulfill, in collaboration with aging services, to address the challenges and opportunities of an aging society. Research Design and Methods With leadership from Trust for America’s Health and The John A. Hartford Foundation, the Florida Departments of Health and Elder Affairs are piloting the implementation of this Framework within Florida’s county health departments and at the state level. The county health departments are expanding data collection efforts to identify older adult needs, creating new alliances with aging sector partners, coordinating with other agencies and community organizations to implement evidence-based programs and policies that address priority needs, and aligning efforts with the age-friendly communities and age-friendly health systems movements. Results, and Discussion and Implications The county health departments in Florida participating in the pilot are leveraging the Framework to expand public health practice, programs, and policies that address health services and health behaviors, social, and economic factors and environmental conditions that allow older adults to age in place and live healthier and more productive lives. The model being piloted in Florida can be tailored to meet the unique needs of each community and their older adult population.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Megan Wolfe ◽  
Anne De Biasi ◽  
Jane Carmody ◽  
Terry Fulmer ◽  
John Auerbach

Author(s):  
Rachel Fields

For my practicum, I worked with the Health Equity Integration Team (HEIT) to improve the application of Sex- and Gender-Based Analysis + (SGBA+) at The Public Health Agency of Canada (PHAC). SGBA+ is an analytical tool used in the federal government to ensure the consideration of diversity and intersectionality in programs and policies. One of the training resources on SGBA+ at PHAC is called Toward Health Equity: The SGBA+ Guide. This guide provides an overview of SGBA+, associated concepts, and a case study. I was part of a team tasked with updating this document to make the guide more applicable to current agency priorities. However, in revising the guide it became clear that there was a significant gap in understanding what document users needed. To make this guide as user-friendly and relevant as possible, I suggested that we conduct interviews with key informants throughout the agency to gather feedback and identify barriers to SGBA+ application. This project was part of a Knowledge Translation (KT) process that involved employees from many different roles and divisions at PHAC. The interviews allowed readers to identify the guide’s strengths, weaknesses, and gaps in clarity and content. Improving SGBA+ application at the federal public health level is important, because it is the agency’s way of applying a health equity lens to the work that they do. This project was also significant because it interrupted the standard process of KT, which follows a linear path and only integrates user feedback at the end. Instead, this project promoted an iterative process, involving document users throughout the development and revision of the guide to create a final product that is more tailored to their needs. Clear and effective communication is crucial to public health practice; this project is an example of how to achieve that by incorporating constructive feedback.


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