Chapter 10 – The Physical Environment and its Influence upon Health

Lecturer PowerPoint
Lecturer Lesson Plan
Additional Case Study
3 Papers
3 Websites
3 Media Articles
Learning Tasks Discussion
Issues you may have considered in relation to the Learning Tasks in the book…

Learning Task 1: The Physical environment and health

You will have considered a range of factors in relation to this learning task. Here are some examples of the types of things you might have listed. These are not exhaustive.

Agriculture and food production: Distribution and availability of food; Types of food; Cost of food; Process of food production; Fortification.
Education: The link between education and earning potential; The link between education and better health outcomes.
Different working environments: Risk to physical health from manual labour; Health effects of shift-work; Risk to mental health from workplace bullying/work-related stress.
Water and sanitation: Effects of polluted water sources on health; Access to clean water; Access to sanitation facilities.
Healthcare services: In the USA. issues of unequal access due to the way in which healthcare is funded and managed (lack of national health service; privatization of healthcare; In Bangladesh, issues more typical of a low-income country such as lack of resources and personnel, infrastructure deficits impacting on access to healthcare services, the role of international aid in healthcare provision.
Housing: Impact of poor housing on health; Impact of being homeless on health.

Learning Task 2: Food scares and health

The information you have gathered for this exercise will depend on which issue you selected. Here are some examples of the different factors which you may have listed:
– Issues to do with demand for the food product
– Issues to do with food production/manufacture
– Issues to do with food marketing/distribution
– Issues to do with food storage/regulation

Learning Task 3: Community-led total sanitation (CLTS)

Community-led total sanitation is a community-based method aimed at eradicating open defecation. You may have listed different ways in which open defecation impacts on health – here are some examples:
– Contaminates local water sources
– Attracts and encourages vermin
– Increases diarrhoeal diseases in children

Here are some examples of the key features of the CLTS approach:
– Community participation
– Community-led approach
– Sustainability/long-term solutions
– Local solutions to local concerns

Learning Task 4: The influence of the working environment on health

Some additional answers to this are as follows (again these are not exhaustive):
– Impact of unemployment on mental health
– Exposure to hazards (e.g. chemical, biological)
– Work-related injury or illness
All of these factors may relate to the issues you have listed in some way or other.

Multiple Choice Quiz

1. Which of the following would NOT be described as an environmental influence on health?
a. Housing
b. Water and sanitation
c. Agriculture and food production
d. Genetics


The correct answer is d. According to Dahlgren and Whitehead’s model of determinants of health, genetics would be described as an ‘individual’ influence on health, not as an environmental influence.

2. Which of the following is NOT an explanation for health inequalities outlined within Busfield’s typology?
a. Individual behaviour
b. Societal behaviour
c. Material environment
d. Social relationships


The correct answer is b. Busfield’s four explanations are as follows: Type 1– Explanations to do with individual behaviour; Type 2 – Explanations to do with individual attributes and circumstances;Type 3 – Explanations to do with the material environment and allocation of resources; Type 4 – Explanations to do with social relationships and human subjectivity.

3. Lalonde proposed a model outlining factors which he saw as being central to health improvement. What is this model called?
a. The Health Field Concept
b. The Health Improvement Model
c. The Health Improvement Concept
d. Influences on Health Improvement


The correct answer is a. The other answers have been made up for the purposes of this question.

4. Which of the following is NOT a component of Lalonde’s model?
a. Environmental influences
b. Social influences
c. Individual lifestyles
d. Health services


The correct answer is b. Lalonde’s Health Field Concept does not explicitly include social influences as a factor. The other three are factors within the model which are taken into account. The fourth factor, which is missing from this list, is human biology/genetics.

5. What does the term ‘food security’ refer to?
a. Protecting and preserving food stocks
b. Keeping food safe from contamination
c. Access to, and availability, of food
d. Making sure that there is enough food for everyone


The correct answer is c. Although there are many ways in which to define the term ‘Food Security’, the central idea is that it is concerned with access to food and availability of food.

6. What does the term ‘obesogenic environment’ refer to?
a. The increase of overweight and obese people in developed countries
b. The role that environmental factors play in nutrition and physical activity
c. The number of fast-food outlets available in a neighbourhood
d. The role of genetics in the development of obesity


The correct answer is b. The increase of overweight and obese people in many parts of the globe is, in part, viewed as being a result of obesogenic environments. The number of fast-food outlets is a factor which may contribute to an obesogenic environment. Genetics would not be considered an ‘environmental’ factor.

7. What is ‘Sick Building Syndrome’?
a. A building which needs to be destroyed
b. A psychological problem
c. An excuse for not working hard enough
d. A range of symptoms related to working in a specific building


The correct answer is d. The other answers are either a consequence or a value judgement (matter of opinion).

8. Which of the following do NOT appear to be linked to lower levels of reported health in employees?
a. Repetitive tasks
b. High job insecurity
c. Low levels of social support
d. High levels of control


The correct answer is d. Research shows that this is the odd one out. People will higher perceived levels of control in the workplace tend to report higher levels of health and wellbeing than people with low perceived control in the workplace.

9. According to research, which of the following does NOT appear to be an outcome of unemployment in terms of its effect on health?
a. Higher death rates in the unemployed
b. Lower death rates in the unemployed
c. Increased vulnerability to other life events
d. Adverse effects on mental health


The correct answer is b. All the other answers relate to the negative effects of unemployment on health outcomes as demonstrated by studies into this.

10. In terms of health outcomes for whole communities, who is it generally most important to educate?
a. Older men
b. Mothers
c. Young girls/women
d. Young men


The correct answer is c. Investing in education for girls and young women impacts not only on their health but on the health of their future children and families. This means that they have the potential to be the most influential on the health of whole communities in comparison to the other people in the list.

Additional Case Study: Deprived neighbourhoods in the UK

This case study considers the different aspects of living and working conditions discussed within this chapter in relation to a specific context. This particular context is fictional yet represents many deprived and disadvantaged inner-city areas of the UK. The context is a council estate (social housing). Note that, for the purposes of this case study, broad generalizations are made.

Several factors may influence the health of people in this type of context:

Healthcare services: For a number of reasons access to healthcare services may be limited – for example, due to lack of money to pay for transport. Lower levels of literacy may mean that health information is less accessible.

Agriculture and food production: In terms of the availability of food there may be a lack of choice in the local area and fresh fruit and vegetables may be comparatively expensive. Communities may lack the skills and knowledge required to prepare and cook healthier options. Fast food may be readily available.

Working environment: Rates of unemployment are likely to be higher than average with the associated effects that this brings.

Housing: The quality of housing may vary for a number of reasons. The relatively high cost of fuel may lead to cold and damp housing conditions. Issues of personal safety may also be of some concern and have an impact on mental and emotional health.

3 Papers

Audate, P.P., Fernandez, M.A., Cloutier, G., and Lebel, A. (2019) Scoping review of the impacts of urban agriculture on the determinants of health. BMC Public Health. LINK
This paper reports on a systematic review designed to explore the impact of urban agriculture on health-related outcomes.

Cundiff, J.M., Smith, T.W., Baron, C.E. and Uchino, B.N. (2016) Hierarchy and Health: Physiological Effects of Interpersonal Experiences Associated with Socioeconomic position. Health Psychology, 35 (4): 356-365. LINK
This paper explores the links between socio-economic position and health, specifically cardiovascular disease.

Norström, F., Waenerlund, A., Lindholm, L., Nygren, R., Sahlén and Brydsten, A. (2019) Does unemployment contribute to poorer health-related quality of life among Swedish adults? BMC Public Health, 19: 457. LINK
This paper investigates the effect of unemployment on health-related quality of life and concludes that health deterioration form unemployment is likely to be substantial.

3 Websites

1. Archive
Contains a range of information related to housing and health specifically within the context of what is called ‘vulnerable environments’.

2. International Food Policy Research Institute
A range of information available on this website looks at the relationship between agriculture, food production, nutrition and health.

3. World Health Organization’s Water Sanitation Health programme
Showcases a range of work which the WHO does in relation to water and sanitation. The contents illustrate the numerous ways in which these impact on health and health experience.

3 Media Articles

1. The Health Impacts of Cold Homes and Fuel Poverty
This is a link to a 2011 report by the Marmot Review Team which outlines how cold homes impact on health in a number of direct and indirect ways.

2. The Effects of Workplace Bullying
This is one of many similar articles within the media about workplace bullying which illustrate the impact of this on employee health.

3. Barriers and Solutions to Accessing Healthcare
This is a link to part of the Children Society’s website which focuses specifically on the barriers to accessing healthcare faced by refugees.