Safe environments and health

 Whether in the home, the community, or the wider environment, health risks resulting from people’s unsafe living conditions proliferate. Three billion people – 40 per cent of the world’s population – have no facilities at home to wash their hands with water and soap. Nearly half of all schools have no handwashing facilities with water and soap, affecting 900 million school-age children, and 43% of health care settings have no hand hygiene facilities at points of care where patients are treated. Social disadvantage increases the likelihood that someone will be exposed to violence in their family or community, directly or indirectly as a witness. In turn, violence – and the poorer health that results from exposure to it can exacerbate social disadvantage.

 Currently, over 7 million people a year die from exposure to air pollution – 1 in 8 of all deaths. Over 90% of people breathe outdoor air with pollution levels exceeding WHO air quality guideline values. Two-thirds of this exposure to outdoor pollution results from the burning of the same fossil fuels that cause climate change. Meanwhile, around 2.8 billion people rely mainly on polluting fuel and technologies for cooking, resulting in 3.8 million deaths from household air pollution. 

COVID-19, safe environments, and health: Lack of handwashing facilities alone puts an estimated 1 billion people at immediate risk of COVID-19. Chronic exposure to household air pollution increases the vulnerability and susceptibility of household members to COVID19 among other diseases. Furthermore, the economic impacts of COVID-19, particularly in relation to shrinking household incomes, is likely to hinder or even reverse progress in the clean cooking transition due to increased challenges with affordability and availability of clean fuels and technologies. Several countries affected by COVID-19 have seen increases in levels of violence occurring in the home, including violence against children, intimate partner violence and violence against older people. 

Action: While the health sector can directly address certain environmental risks, others are usually managed by other sectors, meaning multisectoral action is essential. 

For example, clean fuels and technologies for cooking reduce acute respiratory infections, chronic respiratory diseases, cardiovascular diseases, stroke, cancer and burns. Multisectoral action is also essential to ensure adequate water and sanitation, and interventions to reduce violence. Urban improvement policies aimed at modifying streets, buildings, sports facilities, and access to alcohol outlets can substantially reduce interpersonal violence.