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The impact of air quality on health

The impact of air quality on health. Steve Turnbull Assistant Director Public Health Barnsley MBC / PCT. What I’m not covering. Lecture, teaching Technical air quality issues In-depth epidemiology. What I hope to achieve. Why air quality is important to public health

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The impact of air quality on health

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  1. The impact of air quality on health Steve Turnbull Assistant Director Public Health Barnsley MBC / PCT

  2. What I’m not covering • Lecture, teaching • Technical air quality issues • In-depth epidemiology

  3. What I hope to achieve • Why air quality is important to public health • Placing air quality in a wider context • Stimulus

  4. Down to business • Does air quality affect health • 29,000 deaths • 340,000 life years lost

  5. Is this news? • Yes • If • New report • Episodes, e.g. March 2012 • Why not all the time • Imagine

  6. 29000 deaths because our water is not up to standard

  7. What is health? • ‘a state of complete, physical, mental and social well-being and not merely the absence of disease or infirmity’ • World Health Organisation, 1946

  8. What does it feel like? • Think of a time when you felt healthy. • What did it feel like?

  9. The Experience of Health • Having Energy • Being loved, loving • Being in control • Fit, fitting in • Stress-free • Outdoors, nature • Friends, family • Giving/receiving, sharing • Meaning in life • Able to do things I enjoy • Peak Physical shape • Happiness • Creativity • Spiritual contentment • Wholeness • Playfulness • Belonging

  10. Physical Vitality, energy Ability to do things one enjoys Good social relations Well being Mental Social Meaning and purpose Connectedness to community Control over life Labonte 1998

  11. Medical Approach Behavioural Socioenvironmental Approach Approach ‘What is wrong with ‘Why are you ‘What is stopping you you ?’ unhealthy ?’ from being healthy ?’    Heart Disease Smoking  • Powerlessness • Isolation • Pollution • Stress • Hazardous living conditions Cancer  Poor diet  HIV / AIDS   Lack of fitness  Diabetes  Drug and alcohol  Obesity misuse Mental Health Poor coping skills    Hypertension  Lack of lifeskills Improving Health

  12. Work against reductionism • Health as a concept needs constantly to be contrasted with a medical reductionist model which emphasises fragmentation, towards a model of health as integral to and as a result of social justice • Adams and Armstrong 1996

  13. Social Justice • The burdens and benefits of society are fairly and equally distributed

  14. The special case of air quality • Obesity: Eat less, move more • Smoking: Don’t – if you do - Stop – with help if you need it • Alcohol: in moderation • Water: clean it and provide it – society will pay • Air: No cost to distribute, no behaviour of consumption to modify or blame (please don’t stop breathing)

  15. The burden of collective action • The pollution of air gives utility • We do not individually or collectively discount the cost and impact • Tragedy of the commons

  16. Public Health Outcomes Framework • Air Pollution: Inclusion of this indicator in the PHOF will enable DsPH to prioritise action on air quality • Not without persuasion • . • “Attitudes count, not numbers, and control is rooted not in hierarchy but in values and beliefs” Hunter, 2003

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