Place and Well-Being (AQA A Level Geography)

Environmental Variables of Health

• The environment can have a significant impact on health and the incidence of disease
• An estimated 70-90% of disease risk comes from environmental factors; the rest comes from genetic factors
• Climate and topography are two notable factors 

Environmental Factors Influencing Disease

 Air Quality and Health

• World Health Organisation (WHO) provides safe guideline limits for air pollution 
• Their data reveals 99% of global population breathe air that exceeds these limits
• Common sources of air pollution are:
• Household combustion devices such as open fires for heating and cooking stoves
• Motor vehicles
• Industrial facilities burning fossil fuels
• Forest fires 
• Pollutants include:
• Particulate matter
• Carbon monoxide
• Ozone
• Nitrogen dioxide 
• Sulfur dioxide
• Outdoor and indoor air pollution cause respiratory and other diseases and are important sources of morbidity and mortality
• Pollution of the air can be both outdoor (ambient) and indoor (household)
• Ambient air pollution in both cities and rural areas is causing fine particulate matter 
• This increases the risk of strokes, heart diseases, lung cancer, acute and chronic respiratory diseases
• Household air pollution, while using polluting open fires or ovens fuelled by kerosene, biomass (wood, animal dung and crop waste) and coal
• Household pollutants result in approximately 2.4 billion people being exposed to dangerous levels
• Evidence also links air pollution to increased risk of:
• Adverse pregnancy outcomes (low weight and small  size at birth)
• Cancers
• Diabetes
• Cognitive impairment 
• Neurological diseases
• Children, elderly and pregnant women are the most susceptible to air pollution-related diseases
• Diet and socio-economic factors also impact a person’s susceptibility to air pollution which means that low- and middle-income countries suffer from the highest exposures and greatest disease risks
• WHO data suggests the combined effects of ambient and household air pollution leads to 7 million premature deaths annually around the world

Share of deaths attributed to air pollution 2019

Water Quality and Health

• Safe drinking water and clean water for hygiene and sanitation is essential to good health
• The World Health Organisation (WHO) collects data on water quality around the globe
• Over 2 billion people live in regions suffering from water-stress. This is getting worse due to climate change and population growth.
• More than 2 billion people use a drinking water source contaminated with faeces
• Microbiologically contaminated drinking water is estimated to cause 485,000 deaths from diarrhoea each year
• Diarrhoea is the second leading cause of death globally in children under 5
• Other water borne diseases include cholera, dysentery, hepatitis A, typhoid and polio
• Industrial and agricultural waste discharges pollutants into water sources
• This can lead to drinking water containing arsenic, fluoride or nitrate, as well as pesticides and microplastics
• Poor quality of water for drinking, sanitation and hygiene also makes it difficult to prevent and manage other diseases prevalent in developing countries 
• Including malnutrition, cholera and other neglected tropical diseases (NTDs) 

Role of External Agencies

• The leading global agency promoting good health is the World Health Organisation (WHO)
  • Some felt it was too bureaucratic and lacked leadership on the front-line
  • Failed to act decisively over China’s handling of the disease during the early days of the outbreak
• Set up by the United Nations (UN)  in 1948
• Original aims were to help combat malaria, women’s health, children’s health, tuberculosis (TB), venereal disease and sanitation conditions in the developing world
• Other major diseases added to its agenda since, including Ebola and HIV/AIDS
• 147 countries and their governments are members and WHO advises them on vaccines, research, instruction and assistance with clean water programmes, and treatment of communicable and non-communicable diseases
• WHO works with other UN agencies and NGOs to manage international health issues and pandemics
• Notable successes of WHO have been the complete eradication of smallpox in the 1970s and the Global Polio Eradication Initiative which, since 1988 has reduced cases of polio by 99%
• WHO was criticised during the Covid-19 pandemic 
• Other UN bodies also involved in supporting global health include UNICEF (United Nations Children’s Fund), and UNAIDS (a joint United Nations Programme on HIV/AIDS
• Non-Governmental Organisations (NGOs) are non-profit bodies working separately and independently from any governments
• Many are involved in the promotion of health and health care
• NGOs sometimes lack the resources of larger international organisations and governments and they rely on donations and aid from richer countries
• This can limit the impact they make on the global healthcare system
• NGOs mostly have charitable status such as Oxfam and Médecins Sans Frontières

• The Bill and Melinda Gates Foundation is an NGO founded by the co-founder of Microsoft and his wife in 2000

• Bill Gates started the foundation with $1 billion of his own money and he and his wife have since donated more than $36 billion
• Its focus is on increasing health and reducing extreme poverty across the world
• The foundation funds food security and healthcare programmes around the world
• In 2010 it donated $19.9 million to the International Rice Research Institute to support the increasing world demand for rice
• It has partnered with the Rockefeller Foundation, donating $100 million to enhance agricultural science and small-farm productivity in Africa to support the green revolution
• In 2005 it launched the Water, Sanitation and Hygiene program which now focuses on sanitation and education around water hygiene in sub-Saharan Africa and South Asia
• Amongst the hundreds of grants to healthcare programmes one of the biggest has been $1.75 billion to accelerate development and distribution of COVID-19 tests, treatments, and vaccines since 2020
• Deaths caused by AIDS, TB and malaria each year have been reduced by nearly 50% since 2002 in countries where the foundation invests