Conference Papers Year : 2025

Environmental health challenges: prioritisation by socioeconomic cost as a tool to decision making

Abstract

Context: The health system is taking care of health outcomes, including 70% of non-communicable diseases that might be due to environmental factors , and contributes to environmental pollution and global warming . Health prevention and promotion on environmental health determinants should help reduce the burden of environmentally linked diseases on society and health system, therefore supporting its resilience and transition. Objective: The goal of this study is to conduct an analysis of environmental health risks through “environmental health determinants”, and prioritize them in regard of their socioeconomic cost, as a support to policymaking and health care system ecological transition. Method: The scoping review method – composed of 5 steps – was used to: (1) define the perimeter of environmental health and the included determinants, (2,3) identify and select relevant databases, (4,5) gather and synthesize data on environmental impacts, sanitary burden (mortality, morbidity, years of life lost (YLLs)) and socioeconomic costs in an analysis frame. Those costs were aggregated: added when methodologically possible if the costs linked to the health or material outcomes are independent (ex: asbestos and noise exposure). Costs cannot be added if some components of the environmental health determinant are intertwined and their contribution to similar outcome overlap. For example: each of the cost of premature deaths respectively attributable to PM10, PM2.5 and NOx cannot be added. The cost of mortality attributable to PM2.5 exposure is kept as representative of the cost of the overall outdoor air pollution in France. Results: In France, the environmental health determinants weighing the most on society are the noise exposure (147 billion euros per year (B€/yr)), nutrition and physical activity (overweight/ obesity: 20.4 B€/yr ; physical inactivity/ sedentary lifestyle: 140 B€/yr), outdoor air quality (130 B€/yr) . The interconnected understanding of environmental health means the socioeconomic indicator cannot be used on its own and must be implemented with studies using other indicators (population exposure, environmental risk factors, etc.). Thus, the following environmental events are to be addressed as major risk: • Continental flooding as the first natural risk in terms of population exposure and potential damages, • Severe cold and heat waves episodes as the deadliest climatic events. Lastly, climate change could cost up to 1.100 B$ in stranded assets in 2050, and there is no exhaustive quantitative health and economic evaluation on biodiversity loss beyond its ecosystemic services (80B€/yr). Discussion: First, those results are dependent on the available data. Noise and air pollution are regulated and easy to monitor, whereas for many determinants, their health and economic impacts might be emergent or incomplete and their associated annual cost very probably underestimated (chemicals multi-exposures, biodiversity, etc.). Increasing knowledge could lead to a revision of determinant’s weight and priority order. However, this study offers an overview of environmental health issues, most of the time studied in a fragmented or sectorized way. Conducing public policies on noise, air pollution, nutrition and physical activity could be synergistic (transportation, healthy urban planning, bicycle development, etc.) and have positive impacts on health, environment, climate and economy. On a long term, it should reduce the weight of those factors on health and the health sector hence contributing to its transition and resilience.

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Dates and versions

hal-05574530 , version 1 (31-03-2026)

Identifiers

  • HAL Id : hal-05574530 , version 1

Cite

Raphaël Kermaïdic, Cyrille Harpet, Laurie Marrauld. Environmental health challenges: prioritisation by socioeconomic cost as a tool to decision making. European Health Management Conference 2025 (EHMA), European Health Management Association (EHMA), Jun 2025, Rennes, France. pp.148 / ID 213. ⟨hal-05574530⟩
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