Poor countries and poor people carry a disproportionately large part of the global burden of ill health. On average one-fifth of this burden is attributable to environmental factors, but the environmental contribution in poor countries is ten times higher than in rich countries.
A healthy population is necessary for poverty reduction and economic development, and investments in health have proven to be cost efficient. Although the links between a healthy environment and a healthy population are gaining recognition and attracting investigation (for examples read the full Linking Health and Environment report advertised below), these have rarely been quantified. Here we give a graphical representation of one commonly-recognised causal relationship – that between inadequate sanitation and cholera, and one complex synergistic relationship, which is only recently gaining momentum – that of hiv/aids and the environment.
Also in this section, John Roberts makes the case for an integrated financial accounting system to illustrate to policy makers that investing in the environment gives financial returns in the health sector, which in turn leads to greater economic activity and growth.
The poor carry a larger burden of environment-related disease due to their more direct dependence on natural resources, greater vulnerability to environmental hazards, inadequate access to affordable health care, and often greater vulnerability to climate change. However, as our understanding of these relationships expands, so do the possibilities for meeting the multiple goals of eradicating poverty and hunger, reducing child mortality, improving maternal health, combating aids, malaria and other diseases, and ensuring environmental sustainability, through an integrated, holistic approach. What is required is a health development programme that targets the poor and helps them to create and maintain a healthy environment, whilst providing support through greater access to health services, which include hygiene promotion, traditional healing, and accident prevention.