As a funder, understanding the environmental determinants of health offers exciting opportunities to promote healthy environments, prevent disease, reduce disparities, and protect health.  

A particularly promising new area – environmental health science – is helping people understand links between health trends and the environment: 

Disease trends – like rates of asthma, learning and developmental disabilities, some cancers, infertility, and other health concerns – are rising steadily.  More than 100 million Americans, over a third of the population, now have at least one chronic disease.

• Environmental exposure data – the testing of air, water, soil, household dust, and even people's blood and newborns' umbilical cords – all are finding widespread exposures to chemicals and pollutants.  These contaminants come from many sources, including: synthetic chemicals; pollution from coal-powered power plants, transportation and manufacturing; and, perhaps the best known, tobacco smoke. 
• Research connecting environmental exposures and altered development or disease – the growing scientific literature now includes studies showing links between exposures and nearly 200 human diseases or health conditions.   Researchers also are learning about ways that environmental exposures interact with natural genetic variability to affect gene “expression” that may control later health outcomes.

These puzzle pieces – diseases going up, evidence that people are exposed to pollutants, and science uncovering links between exposures and disease – fit together to shape a new understanding of the profound impacts of the environment on human health. 

The good news is that this suggests dramatic new potential to improve health by improving environmental conditions.

Everyone is exposed to environmental contaminants.

Our generation is living with thousands of human-made chemicals and pollutants.  Most of these, contrary to popular belief, have not been tested for safety.  Many chemicals travel through air, water, or up the food chain to end up far from their point of manufacture.  Some contaminants move globally throughout the environment and/or persist in the environment, even decades after being banned.

For instance, pollution screenings of women in the Arctic – far removed from industrial activity – find disturbingly high levels of mercury and toxic pollutants, like polychlorinated biphenyls (PCBs).  Testing of wildlife, such as whales or birds, find similar widespread contamination.  All of us inhabiting the earth are vulnerable to contaminants in the environment.

For more information:

• Natural Resource Defense Counsel's Guide to Greener Living
• Environmental Working Group's Safer Shopping Guide
• The Collaborative on Health and the Environment

Some groups are more vulnerable to environmental contaminants.

Children, seniors, and people with compromised immune systems are more vulnerable to pollutants than other groups.   The fetus and child are most vulnerable. Even tiny exposures to contaminants during certain stages of development are being shown to alter neurological development, the development of immune function, and the development of reproductive function, with life-time health consequences.

Kids consume more food, water and air relative to their size than adults do, exposing them to higher levels of pollutants than adults. They also tend to eat a less varied diet with greater quantities of food found to have pesticide residue, like apples and grapes.

Children also spend more time on the ground where there may be more dust, pesticide residue, paint chips, and other potential hazards. Last, a child's developing immune system may not yet be able to break down and eliminate toxins the way a fully developed immune system could.

Seniors are also at greater risk to chemicals as, with age, they may have difficulty breaking down and excreting the toxins to which they are exposed. In addition, there is greater potential for negative effects from the interactions between pharmaceutical drugs and environmental pollutants.

People with compromised immune systems – people with HIV/AIDS, cancers, liver dysfunction – also have a more difficult time breaking down and excreting pollutants.

Workers, people of color, and low-income communities are hardest hit.

Some groups are regularly exposed to unusually high levels of harmful pollutants or chemicals, including workers "on the production line" and neighborhoods living "along the fenceline" of polluting facilities.

Poor communities and communities of color are disproportionately exposed to toxic pollution from polluting industries, highways and ports, and waste sites located in their communities.  Race, even more than poverty, is correlated strongly with the siting of hazardous facilities, making environmental justice a concern.

The same communities whose health is influenced by environmental contaminants are battling other poverty-related challenges as well, such as job insecurity and poor access to health care and healthy food. This can make it more difficult for these communities to focus the economic resources to combat environmental health problems, or access the political power to change health-threatening environmental conditions. 
 
Environmental protection, equity and community capacity can prevent disease.

Health researchers studying women through pregnancy and their babies through childhood have learned a lot about the interplay of health, environment, poverty, and lifestyle. When mothers, during pregnancy, breathed more polluted air, were exposed to more indoor pesticides, or had more poverty-related stress, their kids had more health problems (physical, mental and behavioral) throughout childhood.

In contrast, when any of these environmental stressors were reduced during pregnancy, mothers' kids tended to be healthier.

Research demonstrates the vulnerability of human health to the environment, but it also shows that work to protect the environment can support the health of communities as well.  Grantmaking to reduce pollution, promote smart land use strategies, and protect the quality of water and air also can improve health.

More resources:

• Environmental Health News
• Collaborative on Health and the Environment
• Columbia University Center for Children's Environmental Health