WHO
Disadvantaged population subgroups may be exposed to or affected by environmental factors 5 times more than other
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Environmental health inequalities

18 July 2023

Key facts

  • Environmental health inequalities occur in all countries, irrespective of the level of development and the environmental or economic status. A recent WHO assessment showed that environmental health inequalities have even increased in many countries, indicating that the improvement of environmental conditions observed in most countries in the WHO European Region is not shared equally across societies.
  • In some countries, disadvantaged population subgroups may be exposed to or affected by environmental factors 5 times more than others and, in extreme cases, 10 times more and beyond (for example, with access to essential services such as water and sanitation).
  • Higher environmental exposure levels are most often associated with – and partly explained by – socioeconomic deprivation (notably poverty and low income). Other forms of disadvantage, such as demographic or spatial determinants, also play a significant role in environmental inequalities.
  • Differences in our daily environment and living conditions explain 29% of the self-reported inequalities in health in European Union countries (controlling for age and sex). Of this gap, over 90% is explained by differences in housing conditions, fuel poverty, lack of green space, crowding and air pollution, showing the influence of material and environmental deprivation on health and equity.
  • Academic evidence shows that environmental deprivation levels have an independent effect on health. Regions of the United Kingdom with the poorest physical environments have 18% more deaths than expected than other regions across the country.

Overview

Inequalities in health are an increasing concern in the European Region, and one of the reasons is that environmental risks (accounting for at least 15% of the disease burden in the region are not evenly distributed within countries and their populations. In addition, different population groups have other means of coping with these risks.  

A compelling body of evidence documents how environmental health issues such as environmental pollution, poor water supply and sanitation, lack of access to clean energy sources, and unsafe homes and workplaces have disproportionately negative consequences for disadvantaged groups in the European Region and elsewhere, hampering the progress of the global agenda on “leaving no one behind” and the implementation of Sustainable Development Goal (SDG) 10 on equity.

WHO Response 

Countries in the European Region have defined equity as a crucial cross-cutting element of environmental health interventions and policies to ensure environmental justice. WHO, through the European Centre for Environment and Health (WHO ECEH), supports national governments and stakeholders with technical information and strategic advice in addressing national inequality challenges. This includes:

  • compilation of country data and equity assessments to enable the identification of national environmental health inequalities as a prerequisite for targeted action through environmental and/or social policies;
  • provision of methodological guidance and technical resources on assessing inequalities and interpreting inequality findings to support policy priorities and decision-making;
  • country support and technical assistance on environmental equity issues and suitable interventions, and the development of national environmental health inequality assessments;
  • review of the integration of equity considerations in national SDG implementation and national policies;
  • integration of equity considerations in WHO ECEH programmes and projects and collaboration with WHO units on social determinants of health and health equity.