Environmental Risk Factors Related to Sanitation, Water, and Hygiene

CBHS
Global Health

Copyright 20122014 National Academy Foundation. All rights reserved.

Sanitation, water, and hygiene are linked to disease

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Inadequate
access to safe
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Poor hygiene
practices, like not
washing hands
after using the
toilet or before
preparing food

Lack of improved
sanitation, like not
having access to
clean toilets that work
Diarrheal diseaseth leading cause
(7th
of death in low
and mid income
countries) and
other major health
problems

Can you name some effective hygiene practices?

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People in sub-Saharan Africa and Oceania have less

access to improved sources of drinking water

Children are more vulnerable to diarrheal disease and death

from diarrheal disease why?

Water is an essential resource

Global health issues can occur when there is:
A physical scarcity of water (44% of
people in sub-Sahara Africa do not
have reasonable access to water)
Improper management of the
conservation, use, and distribution
of water
Unsafe drinking water
Not enough water for cleaning
Improper methods for storing water
Safety

Guinea Worm: The Need for Safe Drinking Water

Guinea Worm: Safe Drinking Water

https://www.youtube.com/watch?v=IH9nB4ztjZM

Guinea Worm: Safe Drinking Water

Inadequate sanitation is a health concern and an attack on human dignity

2.6 billion people dont have

access to basic sanitation.
Many communities in the world
lack even a basic toilet.
People are forced to defecate in
the open, increasing the risk for
disease.

Why do you think human dignity is an

important topic in global health?

Many people lack access to a

basic toilet, like this one built
in Haiti.

The Ganges River is one of the most polluted rivers in the

world

- The Ganges River is used

by millions of people every
day, but it contains toxins
that are more than 100
times the limits set by
Indias government.
Used for bathing, washing
clothes and dishes,
drinking water
Major health threat to
humans, animals and fish.

Hand washing is the most important hygiene practice

Good hygiene involves
knowing when it is critical to
wash hands:
After defecating and
urinating
Before eating
Before and after preparing
food
Reduces # diarrhea bouts
be .

For effective hand washing,

people need access to both water
and soap. Disinfectant gel can
also be used to remove germs
from hands.

Use what you know about the chain of infection to explain why there are
critical hand-washing times.
If people have limited access to water, they cant practice good hygiene.
In what other ways is hygiene linked to water or sanitation?

Diarrhea is the most important global health issue

related to water, sanitation, and hygiene

Cause:
Microorganisms
in excreta, or
waste, enter a
persons system

Effect:
Person with
diarrhea loses
water and
electrolytes
4 billion cases of
diarrhea each
year

Effect:
Dehydration,
possible death
1.8 million
deaths/yr; over
90% are in
children

Have you ever been dehydrated? How did it feel? What were
your symptoms? What did you do?

Specific diseases are related to sanitation, water, and

hygiene
Cause

Effect

Arsenicosis Arsenic in drinking

water

Skin lesions, cancer

Cholera

Contaminated food or
water

Severe diarrhea,
dehydration, death

Worms

Soil contaminated
with human waste

Malnutrition, anemia,
retarded growth

Trachoma

Contact with eye or

nose discharge of
contaminated person

Eye pain, blurred vision,

eyelid scarring;
blindness

Typhoid

Contaminated food or
water

Severe diarrhea,
dehydration, fever

Poor sanitation, water, and hygiene have other

repercussions
Women are forced to spend a lot of time getting
water. Womens safety and health may be
compromised by going long distances to get water.
If wage earners are ill, they are less productive and
the economy suffers over time.
Health systems are overwhelmed.
Children dont get a complete education.(stop
attending due to lack of hygiene or privacy in
bathrooms, or frequent or severe illnesses)

CBHS
Global Health

Risky Behaviors and Health Outcomes

Copyright 20122014 National Academy Foundation. All rights reserved.

A risky behavior is an action that threatens health

Category

Examples of Risky Behaviors

What high-risk behaviors do you think are most common

in your community? Are there any risky behaviors that you
think, in part, define your community?

A risky behavior is an action that threatens health

Category

Examples of Risky Behaviors

Alcohol, tobacco,
drug use

Smoking cigarettes; abuse of pain medication

Diet and exercise

habits

Eating foods high in sugar, salt, and fat;

spending too much time watching television

Sexual practices

Sexual activity before youre ready; having

more than one partner; not using
contraception when having sex

Food-handling
practices

Not washing produce before eating it; not

washing knives after cutting raw meat

Driving behaviors

Texting while driving; not wearing a bicycle or

motorcycle helmet

What high-risk behaviors do you think are most common

in your community? Are there any risky behaviors that you
think, in part, define your community?

Changing personal behavior can be difficult

What influences
personal behavior?

People often find it easier to change a

behavior, like physical activity, when their
family supports them or their friends join in.
What do you think are the reasons
that a prevalent risky behavior in your
community continues to be a
problem?

Changing personal behavior can be difficult

What influences
personal behavior?
Family and friends
Societal norms
Personal knowledge
about health outcomes
Attitudes
Beliefs and religion
Rules and laws that
regulate or support
healthy actions

What do you think are the reasons

that a prevalent risky behavior in your
community continues to be a
problem?

For young people, having sex without being fully

prepared to face the outcomes is risky behavior
Unplanned pregnancies can cause severe emotional
stress, put educational goals on hold, and trigger
family problems over who will raise the child.
Babies born to teen mothers face greater health
risks.
Sexually transmitted diseases (STDs) can be
painful and harmful. There are some sexually
transmitted infections (STIs) that never really go
away, even with treatment.
What are other potential health outcomes related to teen sexual
behavior? How do the emotional, physical, and social outcomes
for male and female teens differ? How are they the same?

Unsafe sex is a risky behavior that can result in HIV/AIDS

Global health workers try to address these issues:
A refusal to believe the risk for HIV/AIDS
Religious beliefs forbidding the use of contraception
Opposition from a sexual partner
Lack of information about where to get condoms
Condoms being expensive or unavailable
In some societies, women dont feel that they have a choice
about whether or not their partner uses protection. What might
be some characteristics of such a society?

Not having access to condoms is one reason that

people have unsafe sex
In South Africa, many
poor people mistrust
the government-issued
free condoms.
They also cant afford to
buy other condoms or
are worried about being
seen buying them.
These people are at risk
for HIV/AIDS.

This child is an AIDS orphan in South Africa.

Safe road behavior can help protect people from

injury and death
Wearing motorcycle helmets
Not texting or talking on the
phone while driving
Wearing seat belts
Controlling speed in urban
areas

Pedestrians, rickshaws, motorbikes,

and cars attempt to share the road in
Delhi, India.

As the worlds cities grow, road safety becomes even more

important. Why do you think cities are expanding? What
cities do you know of that are growing rapidly?

Road-safety behavior is changing in Rwanda

Problem: High number of injuries and deaths related
to risky road-safety behavior
Solutions

Road-safety behavior is changing in Rwanda

Problem: High number of injuries and deaths related
to risky road-safety behavior
Solutions
Enforce speed limit
Enforce seat belt laws
Build speed bumps
Use alcohol tests
Limit the number of passengers on minibuses
Provide education for children about road safety

There are different approaches to changing behavior

Approach

How It Works

Community
mobilization

Engages an entire community to make a

change

Mass media

Uses radio or TV to entertain and educate

about risky behaviors

Social marketing

Designs healthy products to be attractive to

buyers

Health education

Provides education through school, the news,

or the Internet

Conditional cashtransfer programs

Gives money in exchange for participating in

healthy behavior

Can you think of a specific example youve learned

about that shows how one of the approaches above
made a difference in changing behavior?

Physical inactivity and eating foods high in fat, sugar,

and salt are risky behaviors
Physical inactivity and
unhealthy diet can lead
to diabetes. There has
been a dramatic spike in
the number of diabetes
cases in China, where
people are riding bikes
less and eating food with
more fat.
Fast-food restaurants in Shenzhen, China

Some people see the adoption of Western culture

in other countries as a threat to peoples health.
Do you agree? Why or why not?

Alcohol abuse is a risky behavior

Health outcomes of alcohol abuse include:
Addiction and other mental health issues
Some cancers
Liver disease
Risks to babies born to mothers who drink during
pregnancy
Motor vehicle accidents
Homicide and other intentional injuries
Why do you think changing peoples behavior
about alcohol is so difficult?

This map shows patterns of risky drinking around the world

Why do you think some countries have more

risky drinking patterns than others?

Governments can take actions to reduce alcohol

consumption
Increase the taxation of alcohol
Limit the timeframe during which alcohol can be
sold each day and each week
Ban alcohol advertising
Provide alcohol counseling in health care settings
Ban the sale of alcohol and drinking in public places
Take actions to reduce drunk driving
What other actions can you think of that could
change peoples behavior?

Smoking is one of the biggest threats to global health

As of 2012, nearly 80% of the worlds smokers lived in low- and middleincome countries. On this map, these countries are in purple and red .

If people are unaware of the dangers of smoking, who is

responsible? Is it up to the government to warn the public? Or
is it up to the companies who manufacture and sell cigarettes?

Poland has taken steps to reduce risky behavior

The problem: Highest smoking rate in the world
The solutions:
Health warnings on cigarette packs
Ban on smoking in certain places
Ban on advertisements
Ban on selling to minors
The result: 10,000 fewer deaths and a decline in
lung cancer and cardiovascular disease

Risky behaviors are linked to serious health outcomes

Behavior

Example of Possible Outcome

Unsafe sex

HIV/AIDS

Unsafe driving

Major injuries

Unhealthy eating and

lack of physical activity

Diabetes

Alcohol abuse

Liver disease

Smoking cigarettes

Emphysema

Can you name another risky behavior that wasnt

discussed in this presentation? What health
outcomes are associated with the behavior?

Success comes from tackling all three issues:

sanitation, water, hygiene
Where:
Rural region in Vietnam

Problem:
Inadequate access to clean water
Inadequate sanitation systems

Solution:
New latrines and sanitation systems in schools
Educational programs about hand washing
Purifying water facility that pumps water into
peoples homes

Better clean water sources improve sanitation and

hygiene

Improved
access to safe
water sources

Improved sanitation
facilities
Improved hygienic
practices