Assessment of Environmental Impacts on Health: Examples from the Pacific Basin.

Assessing environmental impacts on health in the Pacific Basin is challenged by significantly varying data types - quantities, qualities, and paucities - because of varying geographic sizes, environments, biodiversity, ecological assets, and human population densities, with highly varied and unequal socio-economic development and capacity to respond to environmental and health challenges. We discuss three case-based methodological examples from Pacific Basin environmental health impact assessments. These methods could be used to improve environmental health evidence at all country and regional levels across a spectrum of big data availability to no data. These methods are, 1) a risk assessment of airborne particulate matter in Korea based on the chemical composition of these particulates; 2) the use of system dynamics to appraise the influences of a range of environmental health determinants on child health outcomes in remote Solomon Islands; and 3) precision environmental public health methodologies based on comprehensive data collection, analyses, and modelling (including Bayesian belief networks and spatial epidemiology) increasing precision for good environmental health decision making to prevent and control a zoonotic disease in Fiji Islands. We show that while a common theme across the three examples is the value of high quality and quantity data to support stronger policy decisions and appropriate prioritizing of investment, it is also clear that for many countries in the Pacific Basin, sufficient data will remain a challenge to inform decision makers about environmental impact on health.

Applications of Systems Science to Understand and Manage Multiple Influences within Children's Environmental Health in Least Developed Countries: A Causal Loop Diagram Approach.

Least developed countries (LDCs) are home to over a billion people throughout Africa, Asia-Pacific, and the Caribbean. The people who live in LDCs represent just 13% of the global population but 40% of its growth rate. Characterised by low incomes and low education levels, high proportions of the population practising subsistence living, inadequate infrastructure, and lack of economic diversity and resilience, LDCs face serious health, environmental, social, and economic challenges. Many communities in LDCs have very limited access to adequate sanitation, safe water, and clean cooking fuel. LDCs are environmentally vulnerable; facing depletion of natural resources, the effects of unsustainable urbanization, and the impacts of climate change, leaving them unable to safeguard their children's lifetime health and wellbeing. This paper reviews and describes the complexity of the causal relationships between children's health and its environmental, social, and economic influences in LDCs using a causal loop diagram (CLD). The results identify some critical feedbacks between poverty, family size, population growth, children's and adults' health, inadequate water, sanitation and hygiene (WASH), air pollution, and education levels in LDCs and suggest leverage points for potential interventions. A CLD can also be a starting point for quantitative systems science approaches in the field, which can predict and compare the effects of interventions.

Children's Environmental Health Indicators for Pacific Island Countries.

Healthy environments support the wellbeing of children and the environment thus play a cardinal role in the future of Pacific Island Countries (PICs). Children are more vulnerable and at risk to environmental hazards than adults because they breathe, drink, and eat much more relative to body weight, resulting in greater exposures in the different environments in which children find themselves every day. We examine the role that children’s environmental health indicators (CEHI) can play for PICs to highlight priorities and we prioritise actions to improve children’s environmental health and thus achieve their ‘Healthy Islands’ vision. We conducted a systematic search of relevant documented and publicly available Pacific Island Country information on children’s environmental health indicators using the general Internet, as well as databases such as PubMed, Google Scholar, relevant UN agencies, as well as regional databases. Information on CEHI was available—mainly in grey literature—but not specifically aimed at PICs. Likewise, similar observations were made for peer-reviewed literature. From this review, we compiled summaries and a framework to propose the requirements as well as provide a foundation for the development of CEHI for PICs. CEHI development for PICs should ideally be a multi-sectoral endeavour within each PIC as well as for the region. This can be achieved through public, private, and academic sector initiatives to draw in all sectors of government as well as the relevant UN agencies and regional PIC-representative organisations.

Children's Environmental Health Indicators in Context of the Sustainable Development Goals for Small Island Developing States.

The unique environmental vulnerability of small island developing states (SIDS) is likely to impact negatively on children's health. Children's environmental health indicators (CEHI) are standardized measures that can be used to assess the environmental exposures and their resulting health outcomes in children. This study sought to utilize the United Nations (UN) global Sustainable Development Goals (SDGs), with their associated targets and indicators, as a framework for a CEHI proposal for SIDS. Exposure-side indicators were taken from key themes from the 2012 Rio+20 UN Conference on Sustainable Development, and health-side indicators were selected based on the most significant contributors to the burden of disease in children. The multiple-exposures⁻multiple-effect (MEME) framework was then used to show the relationships between environmental exposures and children's health outcomes. The framework was populated with available data from the World Bank's DataBank. Whilst there was some data available at a population level, major gaps in both exposure-side and health-side indicators were revealed. In order to progress children's environmental health in SIDS, a further piece of work is required to propose a fully prioritized set of exposure-side and health-side CEHIs; based on, but not exclusively linked to, the SDGs.