The prerequisite for human health is a healthy ecosystem. This ecosystem includes natural, built and social environments. Degradation of these environments, particularly the natural one, now threatens human health on a global scale.
This chapter discusses those measures that try to modify the effects of, and adapt to, environmental changes in order to ensure the health of humans and the environment over time. In particular, we look at international efforts that guide national governments in policy development. Some successes and failures in this endeavour are outlined.
International policies have failed to arrest the widening gap of human health inequalities between the most and least deprived and failed to arrest escalating rates of environmental degradation (Brown, L., 2009; nef, nd). The health, and perhaps the very survival, of humans is under threat.
The toxic combination of bad policies, economics and politics is, in large measure, responsible for the fact that a majority of people in the world do not enjoy the good health that is biologically possible. (CSDH, 2008: 1)
There is now overwhelming evidence that the interaction between human biology and the natural and social environments determines health. See Figure 8.1 for a summary of the determinants of health. The conditions in which people are born, live, work and age have a powerful influence on their health. There is generally no single cause or contributing factor to health or illness. Inequalities in these conditions lead to unequal health outcomes, and the majority are avoidable and also inequitable (Wilkinson and Marmot, 2003; Marmot and Wilkinson, 2006;WHO, 2009a;Wilkinson and Pickett, 2009).
We begin by reviewing some of the key literature on health, sustainability and the quality of the environment.