Environmental health can be defined as the discipline and practice of preventing human injuries, illnesses and diseases by promoting well-being, recognising and assessing environmental sources of hazardous agents and reducing exposures that may adversely affect human health. It involves a focus on health protection by monitoring, regulating and eliminating physical, chemical, and biological hazards in all parts of the physical environment such as air, water, soil, food, and other environmental media or settings.Environmental Health is that branch of public health that promotes healthy and safe relationships between people and their environment. As one of the major arms of a complete public health system, environmental health involves advocating, implementing and evaluating policies and programs to reduce health hazards in the environment, especially during and after emergencies.
Emergencies and disasters, including natural disasters, chemical or radiological accidents and complex conflicts are inevitable.Hence, it remains the responsibility of governments and international organizations such as World Health Organization (WHO) to pre-empt and effectively manage these disasters when they occur. The risk factors for disease outbreaks following emergencies or disasters result mainly due to environmental risk factors and population displacement. These factors interact to influence the risk of diseases and death in the affected population, they include availability and accessibility of safe water, the level of crowding and sanitary conditions, existing health condition of the population and the availability of healthcare services (Watson, J. T., et. Al. (2007).
In a study that reviewed potential infectious diseases resulting from the after-effects of natural disasters between 2000 and 2011,researchers found that those disasters including floods, tsunamis, earthquakes, hurricanes, typhoons and tornadoes were associated with infectious diseases such as diarrhea, acute respiratory infections, malaria, leptospirosis, measles, typhoid fever, meningitis, tetanus, dengue fever, viral hepatitis and cutaneous mucormycosis (Kouadio, I. K., et. al (2012).
To completely prevent these emergencies may be impossible because they’re natural, however, handling and managing them can be better. It’s also possible to reduce the probability of their occurrence as well as the resulting consequences and the community’s vulnerabilityif they occur, through vulnerability assessment and other technical means.To reduce the chances of these disasters happening as well as their impact on health and lives, proper planning (emergency preparedness) and actions must be in effect. These plans are usually more cost-effective compared to the costs of dealing with the disasters. Some activities recommended by WHO to reduce the probability and impact of emergencies and disasters include raising awareness, and emergencies, sustainable management of land and infrastructure,effective warning systems, development of relevant national policies, construction of earthquake-resistant buildings, providing water supplies and sanitation systems in earthquake-prone regions and learning from experiences of previous disasters. These activities all require the participation of federal, state and local governments
Given the many differences between developed and developing countries, there are variations in how global health is accepted and practiced in these countries. Developed countries are sovereign states with well urbanized economies and advanced industrial, technical and scientific infrastructure compared to developing or less developed nations. Most commonly, the criteria for evaluating or assessing the degree of economic development include gross domestic product (GDP), gross national product (GNP), the per capita income, level of industrialization, amount of widespread infrastructure and general standard of living. Furthermore, global health practice and health development may be assessed by quality of life, morbidity and mortality rates, research output, amount and availability of funding, life expectancy. Therefore, it is not always black and white which countries should be categorized as developed- and in what areas, and which should be termed developing.
In addition to the differences in the economies and health systems of developed and developing countries, there are also differences in the disease burdens in these countries. The disease burdens in a country- to a large extent, determine its health resources, promotions and global health practice. Developed countries are burdened mostly by chronic diseases such as cancer, diabetes, heart disease and AIDs while developing countries are burdened by infectious diseases such as malaria, diarrhea, pneumonia and flu. Most recently however, developing countries face a double burden of disease due to the consistent adoption of western lifestyle and culture. Infectious diseases in developing countries account for more than 20% of the disease burden world-wide, yet attract less than 1% of the total public and private funds dedicated to health research. Despite bearing 90% of the global disease burden, developing countries receive only 10% of all health research funding used to address these diseases. As a consequence, health care and global health practices are often poorer in developing nations.
It is very important to strengthen healthcare and research capacity in developing countries through national and international funding and collaboration. Currently, several non-profit organizations and governmental bodies, with the help of World Health Organization, Canadian Coalition for Global Health and Commission on Health Research for Development, are making efforts to address this global health research imbalance, commonly known as the 10/90 gap. The imbalance in global health funding, standard of living, GDP and other markers of development between developed and developing countries essentially affect the quality of health care and services in these countries. These in turn affect the practice and progress of global health. Global health, typically defined as the collaborative, multinational, research and action for health promotion, is founded on national public health efforts and organizations. It can be equated principally with individual based and population-wide interventions consisting of strategies for health promotion and improvement, and across all sectors, not just health. Developed countries are pioneers in health research, universal health care and progressive health promotion initiatives mostly because of the amount of funding available for health and also because of their experience and culture.
Despite differences in global health practices, health inequalities exist between population groups in all countries including developed and developing countries. However, the causes of inequalities in these countries may differ significantly. These differences are visible across several groups of social stratification including socioeconomic, political and ethnic.
Victimization refers to the unjustifiable targeting of an individual or a group for subjection to crime, exploitation, unfair treatment, or other wrong. It is the process of hurting someone or a group of people (victims) by perpetuating or committing a crime against them. Victimization can take either psychological forms through as bullying, verbal abuse or physical forms through sexual abuse, murder, torture, burglary robbery and assault. The rate of victimization may be influenced by age, gender, social group and location. Although anyone can be a victim, specific groups such as children, seniors and disabled individuals may be more susceptible to certain types of victimization. For example, bullying or peer victimization is most commonly found in children and adolescents. Victimization is criminal act which is a frightening, unsettling, unexpected and largely unpreventable experience. Sometimes, people are victimized by people who are known to them, not strangers. A peer reviewed study published in PUBMED showed that specific types of victimization such as physical bullying and sibling assaults, were highest prior to adolescence and then declined afterwards. Other types of victimization were influenced by gender- for instance, peer assaults increased in adolescence for boys but not for girls. Child maltreatment and sexual victimization increased in adolescence for girls but not for boys. Symptoms of victimization may vary in several ways and are associated with the type of victimization as well as characteristics and experiences of the victim.
The impacts of victimization can be observed in four broad aspects of life including emotional, physical, psychological and financial aspects. Emotional impacts of victimization include feelings of shock, incredulity and denial. These reactions can last for as short as a few minutes or as long as a few years. Following these reactions are stronger and more aggressive feelings of anger, fear, frustration, confusion, guilt, shame, and grief.
Physical impacts of victimization begin from the moment the event is occurring or after the realization that the event has occurred. Victims are likely to have a number of physical experiences or changes which may include increased adrenalin in the body, increased heart rate, hyperventilation, profuse quivering, tearing, numbness, dryness of the mouth and enhancement of the sense organs. There are also physical injuries that result from crime and they can be classified as: minor, moderate and major injuries. Minor injuries include scratches; moderate injuries may include bruises while major injuries are broken bones and damage to internal organs. Some victims may experience long-term health-related side effects such as ongoing headaches, chronic pains, stomachaches, disability and depression.
Psychologically, common reactions to crime can include feeling helpless, paranoid and disorganized. These are closely followed by distressing thoughts about the event, nightmares, depression and a loss of confidence. Behavioral responses to these psychological effects include increased alcohol or substance abuse, fragmentation of social relationships and social withdrawal. The financial impact of victimization occurs in victims who lost money or possessions and have been financially injured. It also occurs when victims are unable to return to work or find a means of livelihood due to their injuries and experiences. Other ways that victimization can incur costs to victims include repairing or replacing possessions, higher insurance premiums, medical and burial expenses, court appearances and time off from work.
Victimization can be prevented by being aware of their one’s environment, making safety plans such as access to emergency and help hot lines and taking self-defense courses.
The term marginalization is a well recognized social factor and a determinant of health used across disciplines including health, education, sociology, psychology, law, public policy, politics and economics. Marginalization, also known as social exclusion, can be described as a situation whereby individuals or groups are systematically and structurally deprived or denied access to some rights, opportunities and resources that are normally available to other individuals or groups. According to World Health Organization, social exclusion is driven by dynamic processes that consist of unequal power relationships across the economic, political, social and cultural aspects of the society. It occurs at different levels including individual, family, community, national and international levels. Marginalization may be based on factors such as race, age, gender, class, status, religious affiliation, disability, ethnic origin, educational status, prejudice, living standards, or appearance. It is visible in many aspects of the society including healthcare, housing, employment, civic engagement, democratic participation, and due process.
Marginalization is demonstrated through subtle or obvious actions including use of derogatory language, assuming people’s accomplishments are not based on merit, stereotyping, denying people academic or professional opportunities because of their identity, limiting access to certain resources based on membership in a particular group, disregarding people’s cultural or religious traditions and values.
Marginalization results in unequal access to, and use of resources, potentials and rights of people which leads to health inequalities. The consequences of marginalization and social exclusion are evident in societies, as affected individuals or communities are prevented from participating extensively in the economic, social, and political life of their respective societies. Several health problems, notably, mental health problems, can arise from social exclusion. Feelings associated with poor mental health such as low self-esteem, stress, rejection, loss of social connections, loneliness, hopelessness, isolation, resentment, decreased opportunities for engagement, boredom and stigma are experienced by marginalized people and groups. A study published on American Journal of Psychology found that individuals who were marginalized behaved more aggressively compared to those who were not. In the study, several experiments showed that people who were excluded were aggressive towards the people who excluded them and non-aggressive to people who did not exclude them. These responses were specific to social exclusion and when translated to the society implies that marginalization perpetuates division, hatred, paranoia, resentment, aggression and the likes.
Marginalization can be addressed if all individuals can speak up or act when any act of injustice, intolerance, or oppression is being carried out
