Australia in 2030: what is our path to health for all?

CHAPTER 1: HOW AUSTRALIA IMPROVED HEALTH EQUITY THROUGH ACTION ON THE SOCIAL DETERMINANTS OF HEALTH: Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non-existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID-19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality. CHAPTER 2: ABORIGINAL AND TORRES STRAIT ISLANDER CONNECTION TO CULTURE: BUILDING STRONGER INDIVIDUAL AND COLLECTIVE WELLBEING: Aboriginal and Torres Strait Islander peoples have long maintained that culture (ie, practising, maintaining and reclaiming it) is vital to good health and wellbeing. However, this knowledge and understanding has been dismissed or described as anecdotal or intangible by Western research methods and science. As a result, Aboriginal and Torres Strait Islander culture is a poorly acknowledged determinant of health and wellbeing, despite its significant role in shaping individuals, communities and societies. By extension, the cultural determinants of health have been poorly defined until recently. However, an increasing amount of scientific evidence supports what Aboriginal and Torres Strait Islander people have always said - that strong culture plays a significant and positive role in improved health and wellbeing. Owing to known gaps in knowledge, we aim to define the cultural determinants of health and describe their relationship with the social determinants of health, to provide a full understanding of Aboriginal and Torres Strait Islander wellbeing. We provide examples of evidence on cultural determinants of health and links to improved Aboriginal and Torres Strait Islander health and wellbeing. We also discuss future research directions that will enable a deeper understanding of the cultural determinants of health for Aboriginal and Torres Strait Islander people. CHAPTER 3: PHYSICAL DETERMINANTS OF HEALTH: HEALTHY, LIVEABLE AND SUSTAINABLE COMMUNITIES: Good city planning is essential for protecting and improving human and planetary health. Until recently, however, collaboration between city planners and the public health sector has languished. We review the evidence on the health benefits of good city planning and propose an agenda for public health advocacy relating to health-promoting city planning for all by 2030. Over the next 10 years, there is an urgent need for public health leaders to collaborate with city planners - to advocate for evidence-informed policy, and to evaluate the health effects of city planning efforts. Importantly, we need integrated planning across and between all levels of government and sectors, to create healthy, liveable and sustainable cities for all. CHAPTER 4: HEALTH PROMOTION IN THE ANTHROPOCENE: THE ECOLOGICAL DETERMINANTS OF HEALTH: Human health is inextricably linked to the health of the natural environment. In this chapter, we focus on ecological determinants of health, including the urgent and critical threats to the natural environment, and opportunities for health promotion arising from the human health co-benefits of actions to protect the health of the planet. We characterise ecological determinants in the Anthropocene and provide a sobering snapshot of planetary health science, particularly the momentous climate change health impacts in Australia. We highlight Australia's position as a major fossil fuel producer and exporter, and a country lacking cohesive and timely emissions reduction policy. We offer a roadmap for action, with four priority directions, and point to a scaffold of guiding approaches - planetary health, Indigenous people's knowledge systems, ecological economics, health co-benefits and climate-resilient development. Our situation requires a paradigm shift, and this demands a recalibration of health promotion education, research and practice in Australia over the coming decade. CHAPTER 5: DISRUPTING THE COMMERCIAL DETERMINANTS OF HEALTH: Our vision for 2030 is an Australian economy that promotes optimal human and planetary health for current and future generations. To achieve this, current patterns of corporate practice and consumption of harmful commodities and services need to change. In this chapter, we suggest ways forward for Australia, focusing on pragmatic actions that can be taken now to redress the power imbalances between corporations and Australian governments and citizens. We begin by exploring how the terms of health policy making must change to protect it from conflicted commercial interests. We also examine how marketing unhealthy products and services can be more effectively regulated, and how healthier business practices can be incentivised. Finally, we make recommendations on how various public health stakeholders can hold corporations to account, to ensure that people come before profits in a healthy and prosperous future Australia. CHAPTER 6: DIGITAL DETERMINANTS OF HEALTH: THE DIGITAL TRANSFORMATION: We live in an age of rapid and exponential technological change. Extraordinary digital advancements and the fusion of technologies, such as artificial intelligence, robotics, the Internet of Things and quantum computing constitute what is often referred to as the digital revolution or the Fourth Industrial Revolution (Industry 4.0). Reflections on the future of public health and health promotion require thorough consideration of the role of digital technologies and the systems they influence. Just how the digital revolution will unfold is unknown, but it is clear that advancements and integrations of technologies will fundamentally influence our health and wellbeing in the future. The public health response must be proactive, involving many stakeholders, and thoughtfully considered to ensure equitable and ethical applications and use. CHAPTER 7: GOVERNANCE FOR HEALTH AND EQUITY: A VISION FOR OUR FUTURE: Coronavirus disease 2019 has caused many people and communities to take stock on Australia's direction in relation to health, community, jobs, environmental sustainability, income and wealth. A desire for change is in the air. This chapter imagines how changes in the way we govern our lives and what we value as a society could solve many of the issues Australia is facing - most pressingly, the climate crisis and growing economic and health inequities. We present an imagined future for 2030 where governance structures are designed to ensure transparent and fair behaviour from those in power and to increase the involvement of citizens in these decisions, including a constitutional voice for Indigenous peoples. We imagine that these changes were made by measuring social progress in new ways, ensuring taxation for public good, enshrining human rights (including to health) in legislation, and protecting and encouraging an independent media. Measures to overcome the climate crisis were adopted and democratic processes introduced in the provision of housing, education and community development.

Environmental health: emancipatory care challenges and possibilities by the nurse.

OBJECTIVES: to discuss challenges and possibilities for the construction of Environmental Health emancipatory care practices by the nurse. METHODS: reflective analysis based on conceptual, theoretical, and methodological aspects of nursing care, under the emancipatory and critical perspective. RESULTS: contemporary environmental issues involve complex determinants of the health-disease process. This fact requires the accomplishment of educative actions that encourage the change of environmental attitudes related to health-risk situations. In this sense, there are significant demands for emancipatory practices of primary care in Environmental Health by nurses, which need to be systematized by health and education institutions. FINAL CONSIDERATIONS: the nurse, as an educator and social actor, should offer emancipatory practices of risk management, empowerment, and shared social and environmental responsibility, with a view to recovering an ecological well-being and social transformation, to improve environmental quality and human life.

Continued Efforts on Nanomaterial-Environmental Health and Safety Is Critical to Maintain Sustainable Growth of Nanoindustry.

Nanotechnology is enjoying an impressive growth and the global nanotechnology industry is expected to exceed US$ 125 billion by 2024. Based on these successes, there are notions that enough is known and efforts on engineered nanomaterial environmental health and safety (nano-EHS) research should be put on the back burner. However, there are recent events showing that it is not the case. The US Food and Drug Administration found ferumoxytol (carbohydrate-coated superparamagnetic iron oxide nanoparticle) for anemia treatment could induce lethal anaphylactic reactions. The European Union will categorize TiO2 as a category 2 carcinogen due to its inhalation hazard and France banned use of TiO2 (E171) in food from January 1, 2020 because of its carcinogenic potential. Although nanoindustry is seemingly in a healthy state, growth could be hindered for the lack of certainty and more nano-EHS research is needed for the sustainable growth of nanoindustry. Herein, the current knowledge gaps and the way forward are elaborated.

Health impacts of bushfire smoke exposure in Australia.

Smoke exposure from bushfires, such as those experienced in Australia during 2019-2020, can reach levels up to 10 times those deemed hazardous. Short-term and extended exposure to high levels of air pollution can be associated with adverse health effects, although the most recent fires have brought into sharp focus that several important knowledge gaps remain. In this article, we briefly identify and discuss the existing Australian evidence base and make suggestions for future research.

Salud mental y salud ambiental. Una visión prospectiva. Informe SESPAS 2020 / Mental health and environmental health. A prospective view. SESPAS Report 2020

El ambiente ha sido, desde los albores de la psiquiatría, un factor fundamental en el estudio y la comprensión de las enfermedades mentales. La relación entre genoma y ambiente ha constituido tradicionalmente un tema central en la investigación de la etiopatogenia de los problemas de salud mental y en la concepción misma de esta. En su aplicación a la psicopatología y a la salud mental, la ambiómica psiquiátrica se ha definido como «el estudio de las condiciones y procesos ambientales que promueven la salud mental o incrementan los riesgos de trastornos mentales». Sin embargo, la salud ambiental, al menos en España y en relación con sus competencias dentro del sistema de salud general, ha centrado su atención en los aspectos relativos a los riesgos ligados a la contaminación física, química o biológica del aire, el agua o la tierra, así como a su correlato alimenticio. Aunque los riesgos ambientales, como la calidad del aire, las temperaturas extremas, el ruido, el cambio climático y distintos tóxicos ambientales, pueden desempeñar un papel muy importante, difícilmente pueden ser identificados como elementos etiopatogénicos únicos. Este trabajo revisa la literatura reciente sobre la investigación ambiental y los problemas de morbimortalidad psiquiátrica. Si bien los resultados son poco concluyentes, las futuras líneas de investigación deberían considerar una colaboración interdisciplinaria más ágil, que permita, por un lado, entender mejor la enfermedad mental, y por otro, avanzar desde la salud ambiental «tradicional» a una que contemple los factores ambientales de tipo social abordando el concepto aún poco estudiado de «contaminación social»

Since the dawn of psychiatry, the environment has been an essential factor in the study and understanding of mental illness. Traditionally, the interrelationship between genome and environment has been a central theme in research on the etiopathogenesis of mental health problems and in the very conception of mental health. In its application to psychopathology and mental health, psychiatric enviromics was defined as «the study of environmental conditions and processes that promote mental health or increase the risk of developing mental disorders». However, environmental health -at least in Spain and in connection with its powers within the Spanish General Health System- has paid attention to aspects pertaining to risks associated with the physical, chemical and biological pollution of the air, the water and the ground, as well as to its correlation with food pollution. Although environmental risks such as air quality, extreme temperatures, noise, climate change and various environmental toxicants can play a particularly important role, they can hardly be identified as single etiopathogenic elements. This work reviews the recent literature on environmental research and problems of psychiatric morbidity and mortality. Although the results are inconclusive, future lines of research should consider a more agile interdisciplinary collaboration, allowing, on the one hand, a better understanding of mental illness and, on the other hand, to be able to shift from "traditional" environmental health to an environmental health that takes social environmental factors into account and seriously addresses the still little studied concept of "social pollution"

Qualitative Assessment of Environmental Health Risk Perceptions and Community Challenges in a Puerto Rican Community: Change and Continuity in Response to Hurricanes Irma and María.

Culebra, a geographically isolated island located 17 miles from the eastern coast of Puerto Rico's main island, suffers from an amalgam of significant environmental health risk and associated social determinants of health that are affecting the community. In 2017, two major Hurricanes (Irma and María) impacted Culebra, resulting in an increase of preexisting environmental health risk. The present study's primary aim was to explore community attitudes, beliefs, and perceptions of environmental health risk, and to describe the social priorities of Culebrenses in relation to these risks and challenges. Semi-structured interview guide and Rapid Qualitative Inquiry (RQI) focused on topics of environmental health risk was followed. Qualitative focus groups and individual interviews were conducted among community members in Culebra before and shortly after Hurricanes Irma and María affected the island. Environmental health factors identified included: presence of mosquitoes, trash disposal, water quality and tourism. Additionally, a strong sentiment of island pride was found potentially generating a sense of community that could facilitate solutions to the existing environmental health challenges. Preexisting environmental health risk magnified after the pass of Hurricanes Irma and María. Sustainable and community engagement approaches are needed to develop strategies that can assist in the mitigation and resolution of the identified environmental health risk and challenges, including factors associated with threats such as disasters and pollution.

Compromiso con la Salud Planetaria / Commitment to Planetary Health

No disponible

[Achievements and prospects on environmental health and sanitary engineering in China].

According to different epochs and development needs, a series of practices on environmental health and sanitary engineering were carried out, which played significant roles in promoting national economic and social developments and protecting the public health. This paper reviewed the main achievements in the past 70 years infields of patriotic health campaign, water sanitation and toilet improvement in rural areas, surveillance and investigation, health standard system, sanitary engineering equipment, stove improvement etc., and then proposed several prospects in the future.

Embracing microbes in exposure science.

Although defined more broadly, exposure science has mainly focused on exposures to environmental chemicals and related stressors, such as airborne particulate matter. There is an opportunity for exposure science to contribute more substantially to improving public health by devoting more attention to microorganisms as key stressors and agents in exposure. The discovery that pathogenic microbes cause disease in humans precipitated a revolution in public health science and disease prevention. With a continued global urgency to address spread of pathogenic microbes, contributions of microorganisms to both infectious and noninfectious processes merit more attention from the exposure science community. Today, discoveries of the importance of the human microbiome as a determinant of health and disease are precipitating a second revolution. Emerging knowledge creates a major opportunity to expand the scope of exposure science to incorporate the human microbiome as a target and modulator of exposure. A study committee of the National Academies of Sciences, Engineering, and Medicine has defined a research strategy to address health risks that pertain to the interaction of environmental chemicals with the human microbiome. Some aspects of this strategy pose important challenges and opportunities for the exposure science community.

Relatório luz da Agenda 2030 de desenvolvimento sustentável: síntese III / Relatório Luz / Spotlight report on the 2030 sustainable development agenda: synthesis III Brazil

O Grupo de Trabalho da Sociedade Civil para a Agenda 2030, GTSC A2030, foi formalizado em setembro de 2014 e é resultado do encontro entre organizações não governamentais, movimentos sociais, fóruns e fundações brasileiras durante o seguimento das negociações da Agenda pós-2015. Desde então, atua na difusão, promoção e monitoramento da Agenda 2030, assim como da Agenda de Ação de Adis Abeba, em âmbito local, nacional e internacional.

This summary version of the Civil Society Spotlight Report indicates the magnitude of Brazil's challenges, whose policies to promote equality, and access to social and environmental justice have been losing status, budget, or have been simply eliminated in the last six months. It shows a rapid dismantling of strategic programs to achieve the Sustainable Development Goals, permeated by scandals in the three levels of power, fuelled by ultra-liberal, elitist, and ineffective policies that deepen the social-economic crisis which, in turn, is used to justify environmental degradation and social aggression. The federal government ignores laws and evidence, insisting on simplistic and misguided solutions to complex challenges, including by reorienting the foreign policy to the point of alienating historic geopolitical allies. The data presented here is from official sources, revealing a trend toward increasing inequalities and violence, which, if not reversed, will make Brazil an unsustainable country by 2030.

Salut mediambiental pediàtrica a Catalunya: un camí d'oportunitats / No disponible

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[Policies of zoonosis in Colombia: from health Code to environmental health]. / Políticas de zoonosis en Colombia: del Código Sanitario a la salud ambiental.

OBJECTIVE: To analyze public policies of zoonosis in Colombia, in the period of 1975 to 2014, as State responses. METHODOLOGY: Used the policy cycle analysis approach or sequential approach. This analysis was carried out by means of the following aspects: content, processes, actors, and vertical and horizontal relationships between policies. RESULTS: Zoonosis policies were very different in scope, contents and forms, and results are part of a history of successes and failures, who have only managed to partially transform the general and regional overview of the zoonosis. CONCLUSIONS: The implementation of decisions that have operational scope is relatively slow and scattered in areas of zoonosis in the country. A major achievement has been the shift from policies that are individualized to the great policy of health environmental-PISA.

OBJETIVO: Analizar las políticas públicas de zoonosis en Colombia, en el período de 1975 a 2014, como respuestas estatales. METODOLOGÍA: Se utilizó el enfoque de análisis de ciclo de política o enfoque secuencial. Este análisis se llevó a cabo por medio de los siguientes aspectos: contenidos, procesos, actores y relaciones verticales y horizontales entre las políticas. RESULTADOS: Las políticas de zoonosis son muy diversas en su alcance, contenidos y formas, y hacen parte de una historia de éxitos y fracasos, que sólo han logrado transformar de manera parcial el panorama general y regional de las zoonosis. CONCLUSIONES: La implementación de las decisiones que tienen alcance operacional es relativamente lenta y dispersa en las zonas de zoonosis del país. Ha sido un logro importante el viraje desde las políticas individualizadas a la gran política de salud ambiental-PISA.