Experts concerned about equity gap in environment-related morbidity and mortality

To discuss the latest evidence on the magnitude of environmental inequalities, European experts on environmental health equity met on 23–24 May 2017 in Bonn, Germany. Together, they examined the national data on inequalities in exposure to environmental risks and their contribution to the equity gap in both morbidity and mortality within population groups throughout Europe.

Concluding the meeting, the experts recommended that WHO/Europe prepare and publish an update of its 2012 assessment report, “Environmental health inequalities in Europe”. They also suggested that WHO/Europe provide an information document on environmental inequalities and how to tackle them.

Each year, at least 1.4 million Europeans die prematurely due to polluted environments. This corresponds to at least 15% of Europe’s total deaths. Altogether, European citizens annually lose 50 million years of healthy life from environmental risks. This environmental burden of disease, however, is not equally distributed within national populations: most often, disadvantaged groups are more affected by environmental hazards.

Environmental inequalities and health – an ongoing challenge

WHO/Europe’s past work on environmental health inequalities highlighted the relevance of unequal exposures to environmental risks. Its 2012 assessment report showed that these inequalities exist, although at different levels, in all countries of the WHO European Region.

Five years later, challenges remain regarding the distribution of environmental risks across population groups. These include the following examples.

  • Social disadvantage as well as foreign nationality and migrant status are associated with increased levels of air pollution in many cities across Europe
  • Soil metal concentrations are higher in the more socially deprived areas of Glasgow, United Kingdom.
  • The variability of infant mortality risk in 2 French cities (Paris and Lille) is largely due to measures of socioeconomic deprivation and associated elevations in environmental risks.
  • In Berlin, 5% of all neighbourhoods have poor environmental conditions combined with low socioeconomic status, reflecting a high degree of environmental injustice.
  • In many central Asian countries, problems with water and sanitation are much more frequent among the poorest population groups.

International statistics on environmental conditions show success in reducing environmental health inequalities in some countries and for some environmental risks. However, the statistics also indicate increasing inequalities. One area of increasing inequality is heating problems in winter, which are experienced disproportionately by low-income households in various European countries. Cold homes are associated with an increased prevalence of respiratory and cardiovascular diseases as well as mortality, and also raise the risk that people will use inadequate and harmful fuels for heating.

Taking the environmental health equity agenda forward

Participants at the consultation reviewed a draft version of an environmental health equity resource package to inform decision-makers on the importance of addressing these issues. The package will provide practical tools and examples for embedding aspects of environmental health equity into daily work. It will also include summary data and key messages for research, policy formulation and practical action to improve the status of environmental health equity in Europe.

The meeting supplied WHO/Europe with expert views on present and future environmental health equity priorities. These include developing the knowledge base on the magnitude of environmental inequalities affecting health, and identifying the respective causes and the most affected and/or most vulnerable population groups.

Data on environmental health inequalities are a valuable contribution to global and regional commitments, including the Sustainable Development Goals (SDGs). The SDGs are guided by a dedication to “leave no one behind”, and include a goal on reducing inequalities. These data are also key to the European policy framework Health 2020, which includes the creation of supportive and resilient environments as one of its priorities.

Issues of environmental health equity were central to discussions at the Sixth Ministerial Conference on Environment and Health, held in Ostrava, Czechia, on 13–15 June 2017. At the Conference, delegates discussed priorities for the European Environment and Health Process and made commitments to advance the environment and health agenda in the Region.