Challenges for public health around meaningful engagement in environmental matters: Conceptual, historical and ethical issues

It remains challenging for those working in public health in the UK, and elsewhere, to meaningfully engage in issues of environmental health. This presentation draws on two recent publications (the author's own book Air, the Environment and Public Health and UNESCO's report Environmental Ethics and International Policy) to think through some of the barriers to meaningful engagement. These are presented in three areas.

First, there is discussion of the definition of the terms ‘public health' and ‘environmental health'. Lack of conceptual clarity around such terms reflects important, and differing, perceptions of their meaning. The reasons underpinning these differences in perception are relevant to barriers to engagement between public health and the environment.

Next is consideration of historical developments in the UK. When professional public health emerged in the middle of the nineteenth century, the environment was central to relevant, inter-linked debates about infectious disease causation and evolutionary change. However, developments in professional public health through the twentieth century have seen a gradual separation from environmental matters.

Third, recent insights from environmental ethics have shed light on some of the difficulties experienced by public health practitioners today. Ethicists have argued that the environment should be considered as having inherent value rather than instrumental value. Public health treats the environment as having instrumental vale, and the significance of this position is explored.

Finally, the different strands of the presentation are brought together, including generic relevance to public health in the USA, and suggestions are made for the way forwards.