Environmental health inequalities research – assessment report, systematic reviews and a resource package for the WHO European Region

By Jon Fairburn, Professor of Sustainable Development @ProfJonFairburn

I have been working with the World Health Organization for 10 years on the topics of environmental health inequalities and environmental justice. 2019 saw the culmination of a body of work that was started as a result of the Sixth Ministerial Conference on Environment and Health (also known as the Ostrava Declaration) in 2017. Anyone working in this topic area should have a good read of that document!

The Ostrava Declaration was signed by governments and commits them to a series of actions including:

“to consider equity, social inclusion and gender equality in our policies on the environment and health, also with respect to access to natural resources and to the benefits of ecosystems”;

“improving indoor and outdoor air quality for all, as one of the most important environmental risk factors in the Region, through actions to meet the values of the WHO air quality guidelines in a continuous process of improvement”;

“to actively support open, transparent and relevant research on established and emerging environment and health risks in order to strengthen the evidence-base to guide policy-making and preventative action.”

As such the WHO has co-ordinated a range of experts to meet and support the above commitments.

Firstly, a major report has been produced WHO (2019) Environmental Health Inequalities. Second Assessment Report and there is also a supplementary report providing country profiles

Environmental Heall Ineqaulities in Europe: Second Assessment Report
Environmental Health Inequalities in Europe: Second Assessment Report

Systematic Reviews

Teams of international experts were asked to carry out systematic reviews on a number of themes. Working with a team of colleagues in Germany we looked at air quality and social inequalities in the region.

Main findings of the systematic review into air quality

This systematic review has been published, it was pre-registered on PROSPERO, and uses the Preferred Reporting Items for Systematic Reviews and Meta- Analyses: The PRISMA Statement

There is good evidence from ecological studies that higher deprivation indices and low economic position are usually linked with higher levels of pollutants such as particulate matter (particulate matter under 2.5 and 10 microns in diameter, PM2.5, PM10) and oxides of nitrogen (e.g., NO2, and NOx). There is also evidence that ethnic minorities experience a mixed exposure in comparison to the majority population being sometimes higher and sometimes lower depending on the ethnic minority under consideration. The studies using data at the individual level in this review are mainly focused on pregnant women or new mothers, in these studies deprivation and ethnicity are more likely to be linked to higher exposures of poor air quality. Therefore, there is evidence in this review that the burden of higher pollutants falls disproportionally on different social groups.

Here is a short film about the paper

References – open access and free

Fairburn, J.; Schüle, S.A.; Dreger, S.; Karla Hilz, L.; Bolte, G. Social Inequalities in Exposure to Ambient Air Pollution: A Systematic Review in the WHO European Region. Int. J. Environ. Res. Public Health201916, 3127. htt://mdpi.com/1660-4601/16/17/3127

Other systematic reviews in the series

The other four systematic reviews in the series are available open access:

Schüle, S.A.; Hilz, L.K.; Dreger, S.; Bolte, G. Social Inequalities in Environmental Resources of Green and Blue Spaces: A Review of Evidence in the WHO European Region. Int. J. Environ. Res. Public Health, 201916, 1216.

Dreger, S.; Schüle, S.A.; Hilz, L.K.; Bolte, G. Social Inequalities in Environmental Noise Exposure: A Review of Evidence in the WHO European RegionInt. J. Environ. Res. Public Health, 201916, 1011.

Pasetto, R.; Mattioli, B.; Marsili, D. Environmental Justice in Industrially Contaminated Sites. A Review of Scientific Evidence in the WHO European RegionInt. J. Environ. Res. Public Health, 201916, 998.

Sengoelge, M.; Leithaus, M.; Braubach, M.; Laflamme, L. Are There Changes in Inequalities in Injuries? A Review of Evidence in the WHO European Region. Int. J. Environ. Res. Public Health, 201916, 653.

The final output from this collaboration has been this document.

Environmental health inequalities resource package: A tool for understanding and reducing inequalities in environmental risk

The resource package explains key concepts and terms associated with the concept of environmental health inequalities and aims to support actions against disparities in exposure to environmental risk at the national and subnational level. The document presents methods for monitoring and assessment and suggests ways to use this evidence for action. It also provides information on a range of tools and guidance documents for those tackling environmental inequalities and striving to improve health and health equity.

About the author

I have been working in the area of environmental inequalities/environmental justice for over 20 years. If you are interested in this subject you can also follow me on twitter @ProfJonFairburn where I also maintain a specific air quality list. You can find my other publications in this area on our eprints system and on my google scholar profile.

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