Geneva Health Forum 2024

Environmental Health challenges : priorization by socioeconomic cost as a tool to decision making

Not scheduled

15m

Geneva

Oral presentation Health and the environment, time for solutions

Description

1. Introduction
   The health system is taking care of health outcomes often partially or entirely linked to environmental factors (chronic diseases, cancer, overweight, heatwaves, etc.), but also contributes to local environmental degradation (pollution) and global warming through it’s greenhouse gases emissions. In parallel, it is estimated that more than 70% of non-communicable diseases might be due to environmental factors (Inserm, 2021).

Hence, the hypothesis is set that by acting through health prevention and promotion on environmental health determinants, it is possible to reduce the burden of environmentally linked diseases on the society and health system, therefore supporting its resilience and transition.

Objective
The goal of this study is to conduct an analysis of health risks linked to the environments through “environmental health determinants”, and prioritize them in regard of their socioeconomic cost, as a support to health care system ecological transition and policy-making.

1. Method
   The scoping review method was used to define the environmental health perimeter and the environmental health determinants it encompasses. Once relevant databases have been selected, data on sanitary (mortality, morbidity, years of life lost (YLLs)) and environmental impacts (material damage, ecosystemic services) of those determinants and their translation in socioeconomic cost have been collected in an analysis frame. Those costs were aggregated: added when methodologically possible if the costs linked to the health or material outcomes are independent (ex: asbestos and noise exposure). If not, the cost of the most representative factor of the determinant has been kept (ex : cost of mortality attributable to PM2.5 pollution is representative of the cost of outdoor air quality in France).
   Most of the time, the economic translation of mortality (3 million euros per premature death, Quinet, 2013) represents the highest portion of the global socioeconomic costs (over medical costs and material damages).

2. Results and Discussion
   In France, the environmental health determinants weighting the most on society are the noise exposure (147 billion euros per year (B€/yr), nutrition and physical activity (overweight/ obesity: 20.4 B€/yr; physical inactivity/ sedentary lifestyle: 140 B€/yr), outdoor air quality (130 B€/yr).

However, the wide and ecosystemic understanding of environmental health make it particularly complex to address. And the socioeconomic indicator should not be used on its own to define priority in environmental health. It has to be implemented with studies using other indicators such as mortality, environmental risk factors, biodiversity toll, and so on.

Here are some other major environmental challenges that uses other indicators of exposure and mortality, that are to be considered :
• Continental flooding as the first natural risk in terms of exposure and damage,
• Severe cold and heat waves episodes as the deadliest climatic events.

1. Conclusion
   Conducing public policies on noise, air pollution, nutrition and physical activity could be synergistic (policy on transportation, healthy urban planning, soft mobility etc.) and have positive impacts on health, environment, climate and economy. On a long term, it should reduce the weight of those factors on health and the health sector hence contributing to its transition and resilience.