Is Environmental Health a Social Determinant of Health?

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Amid the global pandemic, many have noticed a silver lining: nature is “healing” itself. With shelter at home orders taking cars off the road, the air pollution is 30 percent lower in some cities.

There is an often overlooked intersection of environmental health, healthcare, and health outcomes. In observation of World Environment Day, we’ll explore this vital relationship to learn how it relates to social determinants of health and how providers can make a difference.

Environmental Health: A Physical or Social Determinant?

Environmental health is interesting in that it is both a “physical” determinant that overlaps with many of the social determinants of health. We know that higher temperatures affect mental health and that air pollution is linked to all-cause mortality. How might the environment impact social determinants?

  • Economic stability – “Indoor air pollutants, which are a leading cause of respiratory disease, are found in homes in many poor neighborhoods; experts say that pollution can make the indoor air quality worse than it is outside,” Modern Healthcare reported.
  • Housing insecurity – “Extreme weather” can lead to “geographic displacement,” according to MedPage Today. A United Nations report found that extreme weather events are responsible for more than 600,000 deaths worldwide over a 20-year period.
  • Food shortages – Closely related to extreme weather events, climate change can affect food production and availability. The U.S. Global Change Research Program’s Fourth National Climate Assessment reported that increasing temperatures and related weather events “increasingly disrupt agricultural productivity.”

How Healthcare Providers Can Help

Healthcare is a major contributor to pollution. In the United States, the sector accounts for approximately 10 percent of greenhouse gas emissions and “ would rank seventh in the quantity of such emissions internationally if it were its own country,” the New England Journal of Medicine noted. In high-income countries, hospitals produce more than one pound of waste per hospital bed every day. The World Health Organization states that improper disposal of this waste can even “lead to the contamination of drinking, surface, and ground waters.”

Thankfully, health systems such as Kaiser Permanente are making a difference. A portion of their $200 million Thriving Communities Fund is dedicated to removing mold and toxic pollutants to make more homes available, thereby improving housing security. The group also set a goal to buy 100 percent of their food locally or from sustainable farms.

However, there are many things that smaller practices and independent providers can do to be a part of the solution.

  • Go paperless – There are many reasons to switch to an electronic health record (EHR), and reducing paper waste is a great one! Digitizing patient charts may seem difficult, but finding a good vendor can simplify the process.
  • Add a patient portal – Take the paperless initiative one step further by cutting “snail mail” bills and enabling patients to pay their bill online through a patient portal. Portals have many other helpful features: appointment scheduling and reminders, secure messaging, prescription refills, and more.
  • Incorporate telehealth – Telehealth has skyrocketed in response to the coronavirus, and more providers than ever before are using this technology. Encouraging patients to avoid driving to the office also helps cuts down on use of fossil fuels.
  • Revamp your practice – Consider adding some green plants around the office. Not only do plants reduce stress, but they also potentially filter the air. And if your practice is growing or changing locations, consider moving into a LEED-certified building.

There is an added benefit of going green: providers may see more patients. As healthcare consumerism continues, more patients consider “shopping around” for their provider. Data shows that two-thirds of consumers prefer sustainable products, and more than half factor environmental impact into the buying process. So make the shift to a more eco-friendly practice; the earth and your patients will thank you!

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