The document discusses how the environment is a major determinant of health. It presents research showing relationships between environmental factors like climate, agriculture, energy use, and coastal damages, and health outcomes like mortality, labor productivity, and crime rates. The goal should be a "health in all policies" approach where health considerations are incorporated into decision making across all sectors and policy areas, using structural interventions and themes of context, engagement, optimal timing and unintended consequences. Anchor institutions like universities can play a key role by utilizing their data and resources to map risks and take actions to protect community health.

1. Environment as a
Determinant of
Health
Jeremy Hess, MD, MPH
Professor, Emergency Medicine, Environ and Occup Health Sci, &
Global Health
Director, Center for Health and the Global Environment (CHanGE)
University of Washington

2. Environment Attribution Small

3. Yet Environmental Influences
Pervade

4. The Exposome
Zota et al. 2021

5. Slide courtesy of Dr. George Luber, CDC

6. Changing Determinants of Health

7. Hsiang et al. 2017
Agricultural Yield and Mortality

8. Hsiang et al. 2017
Energy Expenditures and Low-Risk
Labor

9. Hsiang et al. 2017
High-Risk Labor and Coastal Damages

10. Hsiang et al. 2017
Property and Violent Crime

11. Overall Damages
Hsiang et al. 2017

12. Changing our Risk Calculus

13. Challenge: Operate At Multiple
Levels
Kolak et al. 2020

14. WA Environmental Health
Disparities

15. The Goal – Health in All Policies
> “A collaborative approach to improving the health of all
people by incorporating health considerations into
decision-making across sectors and policy areas.”
> Many historical examples of successful efforts
– Immunization
– Anti-smoking programs
– Exercise programs
– Water fluoridation
– Air pollution control
– Seatbelts and child car seats

16. Hallmarks of Effective Policies
> Structural interventions
> Themes
– Context
– Authentic engagement
– Disease-agnostic
– Optimal timing and
location
– Unintended
consequences
Brown et al. 2019

17. Anchor Institutions
> Core products / services
> Purchaser
> Employer
> Workforce developer
> Cluster anchor
> Infrastructure builder
> Real estate developer
> Mapper and data analyst
Koh et al. 2020

18. From Service to Individual Patients .
. .

19. … To Local Data for Better Health

20. NOAA Heat Mapping 2020

21. Synthesizing Data for Action

22. Protecting Health
Negev et al. 2020

23. Thank You!
Jeremy Hess, MD, MPH
jjhess@uw.edu