MOJ ISSN: 2379-6383MOJPH

Public Health
Volume 4 Issue 6 - 2016
Building an Understanding of Environmental Health
Surili Sutaria Patel*
Department of Environmental Health, American Public Health Association, USA
Received: August 10, 2016 | Published: September 22, 2016
*Corresponding author: Surili Sutaria Patel, Senior program manager of Environmental Health, American Public Health Association, USA; Email:
Citation: Patel SS (2016) Building an Understanding of Environmental Health. MOJ Public Health 4(6): 00102. DOI: 10.15406/mojph.2016.04.00102


What does environmental health mean? Is it recycling? Does it involve physical activity and making good food choices? And who works in environmental health?

The field of environmental health encompasses the primary branch of the public heath that protects the health and increases the safety of our communities comprised of our homes, food, water, soil and air. It incorporates the aspects of an equitable natural and built environments that affects everyone’s health. As such, the field it is a very broad definition with a multitude of players, and boiling it down to one description is no simple task. At least that is what the Center for Public Health Policy at the American Public Health Association learned when beginning the quest to define environmental health. APHA, in partnership with the Association of Public Health Laboratories and the Association of State and Territorial Health Officials, and with support from the National Center of Environmental Health at the Centers for Disease Control and Prevention, commissioned the Frame Works Institute to conduct research to answer these questions. To map the gaps between how the public and experts think about the field of environmental health, the Frameworks Institute conducted key informant interviews of environmental health professionals, and on-the-street interviews with members of the general public. Then they tested explanatory metaphors – memorable comparison that quickly and effectively explains a concept - that could direct the understanding of the field through the use of focus groups.

Notably, members of the general public think environmental health is about the health of the environment, or contaminants only, or about making good individual choices. And while experts in the field understood environmental health well, they explained it differently based on which area of environmental health they practiced. This vast disconnect in the thinking of these two groups uncovered five problem areas:

  1. A lack of understanding of environmental health.
  2. Limited awareness of who does environmental health work.
  3. A dominant contaminant model, which helps many people understand some of what environmental health means, but not the breadth of environmental health issues.
  4. A misunderstanding that individual choice, like recycling, can remedy environmental health concerns.
  5. A deep lack of attention to health promotion strategies that environmental health services can accomplish to prevent poor health outcomes.

These five problematic patterns tend to eclipse or obscure the importance of environmental health work.

To help readjust the public’s understanding of environmental health and the importance of the environmental health sector and its work, the Frameworks Institute created two powerful explanatory metaphors. One is “upstream/downstream.” This metaphor illustrates that there are upstream factors that shape human health downstream. While this is a simple model to follow, it offers multiple messaging opportunities, including the need to act upstream and earlier in order to lessen harmful health impacts downstream. This metaphor supports the role of health promotion and that there is something that can be done to prevent poor health outcomes. It also implies that there are actors who will take measures upstream.

The other explanatory metaphor is “airport ground crew.” By comparing the environmental health workforce to an airport ground crew, the public had a better understanding of the work of environmental health. For instance, a ground crew ensures safe air travel. They practice prevention to evade crashes or dangerous situation and minimize the risk of life-threatening events. There is also a sense of reliance on the ground crew for safety; the same goes for environmental health workers. Above all, it recognizes a team effort to get a passenger from departure to destination, from baggage handlers to flight attendants to pilots and more. Similarly, there are many diverse yet interconnected environmental health professionals ensuring the safety of where Americans live, work and play. By employing this metaphor, participants of the on-the-street interviews were better able to map the role of the environmental health workforce and the importance of the field.

The Frameworks Institute also explored American values. Through this part of the study, researchers discovered the idea of “fairness across places” to embody the notion that everyone deserves to live in a healthy environment, regardless of where they live. This concept or value resonated with the general public and mobilized thinking around concepts of health equity and environmental justice. By applying these metaphors and values during a conversation, researchers observed that the general public began to understand the field of environmental health and the role of the diverse workforce. By employing these frames, environmental health professionals can unmask pertinent environmental health issues in a way that the general public or policymakers will begin to understand concepts of environmental health and who protects our communities. This research is meant for all to use. The Building an Understanding of Environmental Health webpage is filled with a variety of resources, including archived webinars that delve deeper into this research, access to trainings, and a toolkit with materials you can use today. When communicating with the public or policymakers, users are encouraged to borrow toolkit language verbatim if desired, or adapt it to their needs-no citation or special permissions are needed.

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