Environments and Health: overview
Intersectoral Prevention Research
Introduction
The environments in which we live, work, learn and play affect our health and well-being over the life-course.
Trends demonstrate that Canada ranks low amongst peer countries on the environment and risks falling further behind. The 2013 Conference Board of Canada Report Card on the Environment showed that Canada ranked 15th (among 17 peer countries) on fourteen indicators including air quality; water quality and quantity; biodiversity and conservation; climate change and natural resource management.
Furthermore, despite growing concerns and the recognized need for intersectoral solutions on environmental health issues that can lead to population health improvements, Canada could do more to fulfill its research potential in this field.
Research funded through this initiative will helped us to:
- Bring together information and understand how the environment contributes to health and disease across the life course;
- Identify new methods to measure the environment and its effects and new ways to prevent or to treat diseases caused by harmful environmental exposures; and
- Improve overall health, health equity, and quality of life.
Background
In spring 2013, CIHR organized the Environments and Health National Forum academic and government-based researchers and government agencies to identify opportunities for interdisciplinary environments and health research. In response to feedback received at this forum, as well as feedback from the Measuring Environmental Exposures Workshop in November 2011 and the Environments, Genes and Chronic Disease Workshop in February 2012, CIHR took a nexus approach to signal the importance of the interconnections between human health and environmental exposures, and to examine the complexity of these interconnections and interactions in both etiological and prevention studies. The nexus areas were:
- Agri-food: food production, food security, food safety, nutrition and the microbiome
- Resource development: production and/or extraction of natural resources
- Urban form: design of communities and cities
The initiative included three interlinked components that each directly addressed the priority nexus areas:
- Data platform enhancements and measurement
- Etiological research on environment-gene-microbiome interactions
- Intersectoral prevention research
What is the nexus approach?
The CIHR Signature Initiative on Environments and Health was grounded in a nexus approach to signal the importance of interacting environmental exposures, and the need to examine cumulative exposures across the life course. This was a key recommendation from the May 2013 CIHR national forum on environments and health.
A nexus approach highlighted the interdependence of actions taken by multiple sectors and the necessity of cross-sector collaboration in tackling environmental problems. The approach could lead to "improved overall resource use efficiency, sustainable resource management and equitable benefit sharing" (Stockholm Institute, 2011).
Features of the nexus approach for the Environments and Health Signature Initiative
- Addressed interacting environmental exposures
- Examined cumulative environmental exposures across life course
- Required the involvement of multiple sectors and disciplines
Nexus areas
Agri-food: Food production, for domestic use and export, is an important pillar of the Canadian economy. Many emerging public health issues arise at the animal-human-ecosystem interface and are related to the intensification and integration of food production. This nexus area also includes a focus on food security, food safety, nutrition and the microbiome (the ecological community of microorganisms that share our body space, soil and water).
Resource development: Resource production influences the social, physical (built and natural) and economic environments, thereby impacting on health in both direct and indirect ways. While development of natural resources is an important part of building a healthy economy, the balance of influences is often distributed unevenly and/or inequitably across social classes and geographic regions.
Urban form: In Canada, the proportion of Canadians living in urban areas has grown steadily over time. Citizens' perceptions are affected by the design of communities which in turn affects healthy behaviours – for example, walkability of neighbourhoods with high traffic exposure. Research can contribute to the development of evidence-based policies and by-laws that promote increased levels of land-use mix, street connectivity and residential density. These policy and regulatory interventions can have lasting public health and health equity effects for population sub-groups of all ages.
Goals of core research components
Etiological research on environment-microbiome-gene-interactions: to advance our understanding of how environment-microbiome-gene interactions affect disease patterns and human health across the life course. This component supported interdisciplinary studies to examine how complex interactions between an individual's genes, the microbiome and environmental influences cause chronic diseases. Research addressed a variety of environmental factors, such as diet, physical activity levels, home and work environments, as well as the microbiome (the microorganisms that share our body space).
Data platform enhancements and measurement: to support data enhancements and improved environmental measures and facilitate interoperability of existing data platforms in order to strengthen etiology, and intersectoral prevention research in priority nexus areas. This component built on, utilized and enhanced existing cohorts and data platforms that capture environmental measures and/or health outcomes, including longitudinal cohort studies, health administrative databases, monitoring and surveillance systems in health and other sectors, and policy repositories.
Intersectoral prevention research: to advance our understanding of how to prevent and mitigate environmental threats and promote healthful environments within Canada and globally. This component supported research on the impacts of intersectoral strategies, and how these strategies can enhance healthful environments and contribute to long-term improvements in population health and health equity. This research also examined strategies that prevent, mitigate, reduce and/or enhance resilience to harmful environmental exposures in priority nexus areas.
Research supported by the Environments and Health Signature Initiative took into account the complex ethical, legal and social (ELS) dimensions as well as sex and gender considerations related to environments and health research. Through partnership engagement and collaboration with the public and private sectors, and an integrated approach to the translation of knowledge into action, research results were expected to directly inform decision-making both in Canada and internationally.
Impacts
By working with various partners on this initiative, we could:
- Align our investments on environmental health research to address real-world complex issues
- Engage various sectors such as health, agriculture, transportation, housing, and environment in defining research agenda and desired outcomes
- Improve sets of well-validated environmental measures that are being used in a variety of scientific fields (e.g., epigenetics, environmental etiological studies, longitudinal cohort studies) and in national and provincial programs (e.g., monitoring and surveillance of environmental health programs in health and other sectors)
- Improve our understanding of the etiology of chronic disease and potentially develop new methods to measure the environment and its effects on human health across the life course
- Gain knowledge of more effective prevention strategies and prevention systems that are being used to inform policies on environmental threats in health and other sectors
- Work towards integration of novel and effective processes for community engagement in decision-making about environmental threats
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