1 EcoEnvHealth 2015 Chapter one Introduction.pdf

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1. Debre Berhan University
Asrat Woldeyes Health Sciences
SPH I: Determinants Of Health
Human Ecology and Environmental Health
Asmamaw Abera-MSC, PhD candidate
AWHSC, School of Public Health
Jan-Feb,2023
Debre Berhan, Ethiopia

2. ModuleObjective
➢Attheendofthismodule,themedicalstudentwillbeabletoanalyzebroad
determinantsofhealthatindividual,familyandcommunitylevelsandmobilize
themforaction.
SupportingObjectives
➢Applyimportantdeterminantsofhealthanddiseaseforprotectingand
promotingindividualandcommunityhealth
➢Applyenvironmentalandecologicaldeterminantsofhealthanddiseaseat
individual,familyandcommunitylevels
➢Identifyappropriateactionstopreventandcontroldeterminantsofhealthand
diseaseamongindividualsandfamilies
➢Demonstrateclearandeffectivecommunicationskillsforinteractingwith
individuals,families,communities,PHCUstaff,Woredashealthdepartmentstaff,
Academicstaffandpeers

3. Human Ecologyand Environmentalhealth
1.Introduction to environmental health (2hrs)
2.Environmental health (water supply, waste management, housing
and institutional health,, vector control, food hygiene) (6hrs)
3.Human-environment interaction (1hr)
4.Introduction to Human ecology, Ecology of health and disease (4hrs)
5.Occupational health and safety (4hrs)
6.Infection prevention (3hrs)
7.Biosphere and pollution (2hrs)

4. Constitution:
Proclamation No 1/1995

5. Teaching-Learning Methods
Interactive lecture and discussion
Small group learning activities: assignment, case study
Individual reading
PHCU/Community-based learning and study trip
Student presentation
Personal research and reflection exercise (PRRE)

6. ➢Assessment Methods
Formative assessment-Exercise and assignment, Logbook and
portfolio, 360 degree evaluation, Student presentation and
Global rating of community experience midway during the
module
➢Summative assessment
Personal research and reflection exercise (PRRE) (15 %)
Reflective portfolio (5%)
Quiz/ Test (10%)
Global rating of community experience(15 %)
Assignment and student presentation (15 %)
Written final module exam (40 %)

7. References
1. YemaneBerhane, DamenHailemariam and HelmuKloos. Epidemiology and ecology of
Health and Disease in Ethiopia. 2006
2. EPHTI. Ecology. Lecture note series for health science students. 2007
3. White, P. Biopsychosocial medicine: An integrated approach to understanding illness. 2005
Oxford University Press.
4. Bernice A. Pescosolido, Jack K. Martin, Jane D. McLeod, Anne Rogers (Editors). Handbook of
the Sociology of Health, Illness, and Healing. A Blueprint for the 21st Century. 2011
5. Sobo, E. J. &Loustaunau, M. Cultural context of health, illness, and medicine (2nded.) 2010.
Greenwood
6. WHO. Closing the gap in a generation: health equity through action on the social
determinants of health: final report of the commission on social determinants of health. 2008.
7. Robert H Friis. Essentials of environmental health(2nd edition). The essential public health
series. 2012.
8. Kathryn Hilgenkamp. Environmental Health: Ecological Perspectives. 2006
9. Herman Koren and Michael Bisesi. Handbook of environmental health. 2002

8. 1. Introduction
Environmental Health
Asmamaw
Jan 12,2023

9. 1. Introduction to Environmental health
Learning objectives
At the end this lesson the students will be able to:
•Define health
•Describes determinants of health
•Define sanitation, Environment, Environmental Sanitation/
Health, CD, Public Health, etc
•Illustrate the chain communicable diseases

10. Basic Concepts/definitions
“Healthisastateofcompletephysical,mental,andsocialwell-
beingandnotmerelytheabsenceofdiseaseorinfirmity.”
Determinants of Health
Health/ill health is the combination of different factors---multi-
factorial
➢Income and social status
➢Education
➢Physical environment
➢Social support network
➢Genetic
➢Health service
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11. Environmentis the sum of all external influences and conditions which effect
health, life and growth
Components
Physical:air,water,food,soil,climate,heat,noise,radiation,etc.
Biological:viruses,microbialagents,insects,animalsandplants,etc.
Psychosocial:culturalvalues,customs,beliefs,attitudes,religion,etc.
Sanitation—aprocessofmakingsanitary
➢isestablishmentofenvironmentalconditionsfavorabletohealthby
maintenanceofsanitarycondition
➢ispreventionofdiseasesbyeliminatingorcontrollingtheenvironmental
factorswhichformlinksinthechaintransmission(WHO,1948)
EnvironmentalSanitation-is“thecontrolofallthosefactorsinman’s
physicalenvironmentwhichexercisesormayexerciseadeleteriouseffectonhis
physical,mental,andsocialwell-being.”(WHO,1948)
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12. Environmental Health
is“thetheoryandpracticeofassessing,correcting,controlling,andpreventing
thosefactorsintheenvironmentwhichexercisesormayexerciseadeleterious
effectonthephysical,mental,andsocialwellbeingofpresentandfuture
generation.WHO,2004
or
Environmentalhealthisthescienceandpracticeofpreventinghumaninjuryand
illness,andpromotingwell-beingby:
➢Identifyingandevaluatingenvironmentalsourcesandhazardousagentsand
➢Limitingexposurestohazardousphysical,chemical,andbiologicalagentsin
air,water,soil,food,andotherenvironmentalmediaorsettingsthatmay
adverselyaffecthumanhealth.
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13. Importance of Environmental Health (SDGs)
Goal 2: Zero Hunger
Goal 3: Good Health and Well-Being
Goal 6: Clean Water & Sanitation
Goal 13: ClimateAction
Goal 14: Life Below Water
Goal 15: Life on Land
TheSustainableDevelopmentGoals(SDGs)orGlobalGoalsareacollection
of17interlinkedobjectivesdesignedtoserveasa"sharedblueprintfor
peaceandprosperityforpeopleandtheplanetnowandintothefuture

14. Public Health
isthescienceandartofpreventingdisease,prolonginglife,andpromoting
physicalandmentalhealthandefficiencythroughorganizedcommunity
efforts
Theactivitiesinclude:-sanitationoftheenvironment,earlydiagnosisand
preventivetreatmentofdisease
CommunicableDisease-anillnessduetoaspecificinfectiousagentarises
throughtransmissionofthatagentfromaninfectedreservoirtoasusceptible
host
ChainofCommunicableDiseases
sixrelatedcomponentsmustoccurforinfectionanddisease
isreferredtoasthe“ChainofInfection”
Globally,asof6:24pmCET,11January2023,therehavebeen660,378,145confirmed
casesofCOVID-19
“links” in the chain are:
A. Etiologic agent
B. Reservoir
C. Portal of Exit
D. Mode of Transmission
E. Portal of Entry
F. Susceptible Host

15. Whatistheroleenvironmentalhealthinpublichealth
tostopthespreadofCommunicablediseasethechaincanbebroken
I.Attackingtheagente.g.Sterilization,Disinfection&Chemical(drug)
II.Protectingthehost-fromtheintrusionoftheagent
-strengtheningthenaturaldefensemechanism
III.ChangingtheEnvironment
-themostfeasibleandvulnerablepart
-ismorepracticable
-comparativelymoreeconomical
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16. COVID19-Chain of infection
Etiologic agent
-new decade of the 21st century (2020)
-pandemic caused by a novel coronavirus (SARS-CoV-2) in Wuhan, China
Reservoir –humans, animals, and the environment
Portal of Exit -Respiratory
Mode of Transmission -direct or indirect--Air borne is dominant one
=through droplets of different sizes: when the droplet particles are >5-10 μm in
diameter respiratory droplets, and <5μm in diameter-droplet nuclei
Portal of Entry –mucous membranes of the respiratory tract: eyes, nose or mouth.
Susceptible Host---elder, pregnant women, children and history of respiratory

18. Public Health
Vision:
•Healthy People in Healthy Communities
Mission:
•Promote Physical and Mental Health
•Prevent Disease, Injury, and Disability
Public Health
•Prevents epidemics and the spread of disease
•Protects against environmental hazards
•Prevents injuries
•Promotes and encourages healthy behaviors
•Responds to disasters and assists communities in recovery
•Assures the quality and accessibility of health services

19. Source: National Vital Statistics System, National Center for
Health Statistics
Public Health

20. “…Thedeterminantsofhealtharebeyondthecapacityofanyone
practitionerordisciplinetomanage….Wemustcollaboratetosurvive,as
disciplinesandasprofessionalsattemptingtohelpourcommunitiesand
eachother.”
InstituteofMedicine,1999

21. Top 10 causes of Morbidity
MoH, Ethiopia 2017

22. Top Ten causes of Morbidity for children < 5 years of age
MoH, Ethiopia 2017

23. Global burdens of disease
DALYs--Disabilityadjustedlifeyears:thesumoftheyearsoflifelostdueto
prematuremortality(YLL)inthepopulationandtheyearslostduetodisability
(YLD)forincidentcasesofthehealthcondition.

24. Thank you!!
1212023
Debre Berhan