Better Health For All

• by Bayad Nozad, FFPH
• Co-chair, FPH’s Global Violence Prevention SIG

Air pollution is a serious public health issue and high on the agenda now. Last year, the Department for Environment, Food and Rural Affairs (Defra) and Public Health England (PHE) collaboratively produced guidance to ensure evidence based actions are taken nationally and locally to improve air quality.

The WHO guidelines states that that there are no safe levels of the main pollutant of concern, Particulate Matter (PM), and impacts on air pollution are observed below levels permitted by EU and UK limits (1). The guidance also states that for long term exposure (over months or years) the levels should not exceed annual average concentrations of PM of 10 μg/m3 of PM2.5 and 20 μg/m3 of PM10 (2):

There is now mounting evidence that long term exposure to air pollutants contributes to the development of lung cancer, cardiovascular disease and respiratory illness. The Department of Health’s (DH) Committee on the Medical Effects of Air Pollutants (COMEAP) estimated the burden of PM air pollution in the UK to be equivalent to nearly 29,000 deaths and an associated loss of population life of 340,000 life years lost (3).

It is not disputed that military conflicts are associated with massive release of pollutants into the environment including air. The war in Iraq associated with hundred thousand tonnes of pollutants from military vehicles and weaponry that continue to adversely affect the public’s health.

A great legislation that contributed to limit the environmental damages from industry is the Polluter Pays Principle (PPP). The PPP is a well-established National, European and International code through which the costs of pollution prevention and control measures should be paid by polluter.

The preventive function of the PPP which is based on the assumption that the polluter will reduce pollution as soon as the costs which he or she has to bear are higher than the benefits anticipated from continuing pollution. The control measures should be decided by public authorities to ensure that the environment is in an acceptable state (4).

In applying the above principle to the war in Iraq, it would be useful to know how much consideration had been given to the air quality and the PPP in the decision making process to invade Iraq. It is less likely that this was an issue for the decision makers but would they now face the consequences and take responsibility to clean up the mess, in particularly following the publication of the Chilcot report?

Further, the health impacts from air pollution are not limited to the residents of the affected area but also to serving military personnel. This should be highlighted to new army recruits as occupational hazard and measures should be taken to reduce the adverse effects.

Future generations in Iraq and conflict zones need access to clean water

More research is needed to quantify the war-related environmental pollution as a considerable potential contributor to Iraq’s poor health conditions and high rates of mortality from CVD and cancer.

For the sake of future generations of Iraqis and others growing up in former conflict zones, we cannot let winning the peace be at the expense of access to clean water as well as good air quality and health.

References
(1) Review of evidence on Health Aspects of Air Pollution – REVIHAAP: final Technical Report, World Health Organization Office for Europe, 2013
(2) WHO air quality guidelines global update 2005, World Health Organisation, 2005
(3)  The Mortality Effects of Long-Term Exposure to Particulate Air Pollution in the United Kingdom A report by the Committee on the Medical Effects of Air Pollutants, 2010
(4)  ORGANISATION FOR ECONOMIC CO-OPERATION AND DEVELOPMENT (OECD), THE POLLUTER-PAYS PRINCIPLE Analyses and Recommendations, ENVIRONMENT DIRECTORATE, Paris 1992

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• by Marguerite Regan
• Policy Manager, Mental Health Foundation

One in four of us will experience a mental health problem each year, representing the largest single cause of disability in the UK. As it stands, the economic and social costs of poor mental health (estimated at £105 billion a year) are too great for our health and social care systems to handle.

We need to invest in upstream interventions in the places where people live, learn, work and play. It is imperative that a public health perspective is taken within mental health to change the current crisis and reactive service model.

The mind-body division has historically mean that public mental health has been a neglected field and perceived to be outside the remit of public health.  The Faculty of Public Health chose to focus on the mental health agenda, making it the core theme of their annual conference this year and collaborating with the Mental Health Foundation to combine expertise and produce some key resource aimed at supporting the development of knowledge and skills in public mental health.

Better Mental Health For All report

The resources include a report, three videos and a Public Mental Health Award. Over 600 copies were distributed to delegates at the Brighton-held conference.

The report examines what can be done individually and collectively to enhance the mental health of individuals, families and communities by using a public health approach and looks to support the development of knowledge and skills in public mental health. The report is an evidence based resource for people who want to create real change in local communities.

It outlines the critical role that public health professionals, commissioners and elected representatives play in leading the necessary reforms. The report gives clarity to the fact that we know how much can be done to promote mental health and wellbeing across all age groups, prevent mental health problems from occurring and to support people to recover their mental health.

Throughout the report, case studies showcase examples of innovative public mental health programmes and projects being run across the UK. These were selected from the thirty entries submitted to the Faculty of Public Health inaugural 2016 Public Mental Health Awards and celebrate the public health professionals who are pioneering role models for public mental health.

Three of these case studies were then chosen to have their work presented in short videos, which were launched at the conference. These three varied examples illustrate clear advocacy for public mental health by public health practitioners, exploring; A mens mental health/suicide prevention project in Torbay;  a project addressing mental wellbeing as part of flood response in Somerset;  and social prescribing in Lanarkshire.

The public health professionals involved in these, and several of the other case studies, were invited to share best practice at two sessions held during the conference. It should be noted that these particular sessions were hugely popular with delegates, illustrated by the room being well over capacity.

FPH’s focus on highlighting public mental health this year was largely driven by outgoing President, Professor John R Ashton CBE. He spoke at length about mental health during the conference and awarded the Faculty’s inaugural Public Mental Health award to Gerry Cadogan, Public Health Principal at Torbay Council, for the Torbay men’s mental health/suicide prevention project. Mental health ran through the whole conference, with the keynote given by Dr Stan Kutcher on increasing mental health literacy of young people.

Collaboration is central to the pursuit of good mental health across society. It is vital that both public health practitioners and mental health professionals become advocates for public mental health to prevent mental health problems and promote mental wellbeing.

This isn’t to say that full responsibility lies with them, and governmental-level action and support is also required. It is our hope that this partnership between the Mental Health Foundation and the Faculty of Public Health will encourage more leadership and advocates for public mental health across the UK.

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