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Tomorrow’s healthy environments: 30 years later

Publication: Environmental Health Review
23 April 2021


Dr. Trevor Hancock published an article in the Summer 1990 issue of the Environmental Health Review where he used his substantial environmental health knowledge and experience to provide a prospective look at the important environmental issues facing Canadians and their health (see Supplementary Material1 for the original article). Dr. Hancock began his article by highlighting the importance of healthy environments, which had been overlooked for decades. He indicated this is a mistake and put together his thoughts on what the Canadian Institute of Public Health Inspectors (CIPHI) and the environmental public health profession should be doing to promote healthy environments and human health in the future. He quoted a British futurist James Robertson to highlight the importance of this type of work—“Thinking about the future is only useful and interesting if it affects what we do and how we live today.” It is appropriate that we review Dr. Hancock’s work using a present-day lens. The authors encourage everyone to read the original article, which contains many insights and perspectives that are still relevant today.
Dr. Hancock reminded us that much of our population’s health improvements over the decades can be directly attributed to public health. He continued that it is not just public health interventions, but local public health ideology and politics that help improve our communities. The Commission on Conservation was developed in 1909 and concluded its work in 1921 (Armstrong, 1959) which had an aim to not only build “the city beautiful” but also to ensure that we build “the city healthy” (Commission of Conservation, 1915). Dr. Hancock continued to provide a summary of the state of environmental health in 1990, touching on the fact that we were performing well within a historical context, but we are facing “serious threats to our long-term health into the health of future generations.” He specifically focused on sustainable development and provided much support for the erosion of our natural environment and its impacts on human health.

The 1990 view on future environmental health prospects and issues

Dr. Hancock identified four major environmental health challenges that communities face and outlined what CIPHI could do to support action in those areas. These included occupational health, ecotoxicity, urban planning and healthy environments, and sustainable development.
There have been advancements in occupational health, for example smoke-free workplace policies that have been significantly strengthened in Canada since 1990 (Canadian Centre for Occupational Health and Safety, 2021). Environmental public health professionals (including public health inspectors and environmental health officers) may be involved in investigating these issues during their routine inspections of workplaces such as food premises and long-term care homes. However, this integration between environmental and occupational health has not been substantial. Further, the coronavirus disease 2019 (COVID-19) pandemic has highlighted additional gaps in occupational health with notable outbreaks in manufacturing plants, meat plants, and among migrant farm workers (Detsky & Bogach, 2020). These events, occurring at the intersection of occupational and environmental public health, are examples of areas where environmental public health professionals could have a more proactive prevention and response role in occupational health issues.
The persistence of chemicals in our environment remains an ongoing ecotoxicity challenge. There has been some positive movement in this area, such as the removal of the cosmetic use of herbicides in many Canadian jurisdictions (Statistics Canada, 2015). However, much work and future challenges still remain in this area. For example, microplastic pollution (Katyal et al., 2020) has emerged as a possible threat to ecosystem and human health, and there is a need to consider the role of environmental public health professionals to address and respond to such emerging issues.
There has been a push in recent years toward environmental public health professionals being more involved in urban planning and healthy environments (healthy built environments), such as access to healthy foods, air quality, and traffic-related injuries. However, there remains many areas of the built environment where public health professionals have not been able to provide substantial input. Environmental public health professionals have had inconsistent involvement in policies related to land use patterns and community design that have led to urban sprawl, resulting in poor air quality, physical inactivity, and impacts on mental health (Bray et al., 2005). There is a need for a more consistent and unified approach to including public health in the early stages of built environment planning.
Sustainable development can be an overarching term. At times it is difficult for environmental public health professionals and CIPHI to understand their roles and how to provide meaningful input ensuring the health and well-being of our current and future generations. Sustainable development and climate change are inextricably linked, and environmental public health professionals may play an important role in responding to climate change. Environmental public health professionals observe the direct impacts of climate change in their daily work, including the northern expansion of ticks carrying Lyme disease and more frequent extreme weather events. Many communities have already undertaken climate change health vulnerability assessments, but these are only the first step in recognizing the implications of climate change on health. The next steps will be more challenging as we determine how to further implement mitigation and adaptation measures (United Nations, n.d.).

The 2021 view on future environmental health challenges and issues

Environmental public health professionals and CIPHI have a significant role to play in creating and adapting environments to support public health. The concept of sustainable development was born in the report of the World Commission on Environment and Development in 1987 titled “Our Common Future” (Cassen, 1987). We believe sustainable development is an overarching principle that should guide environmental public health professionals’ future work and advocacy.
In 2015, all member nations of the United Nations adopted the 2030 Agenda for Sustainable Development (United Nations, 2015). Urgent action by everyone within the global community focusing on the 17 Sustainable Development Goals can help to create a future that provides optimal health and prosperity to all communities. The Public Health Agency of Canada began work in this area in 2007 (Public Health Agency of Canada, 2006) recognizing the importance of sustainable development to the health of Canadians. It would be a misrepresentation to state that environmental public health professionals alone can change our societies’ actions and values toward ones that are focused on sustainable development, but we can be a valuable contributor.
Sustainable development is often viewed as an initiative that concentrates on the environment. That is one pillar. There are two others that are important to note: economic sustainability and community sustainability. A quick review of the 17 Sustainable Development Goals will identify many areas where environmental public health professionals can provide input. Building resilience is a central theme throughout sustainable development.
The most obvious and direct of these is Goal 6: Clean Water and Sanitation. Environmental public health professionals have a central role in this particular goal, for example in small drinking water system and septic system inspections, safe water surveillance (e.g. lead, fluoride), water-borne illness and outbreak response, and operator and community education and awareness. Our continued work in these areas is critical; however, expanding our roles in source water protection and water conservation can also be very helpful in achieving the outcomes of this goal.
With great foresight, the National Collaborating Centre for Environmental Health and the National Collaborating Centre for Determinants of Health have worked together to discuss health equity within the environmental public health profession (BC Centre for Disease Control, 2021). That important concept can be found as an underpinning in all of the 17 Sustainable Development Goals. Continuing our daily work with an eye toward health equity regardless of our activities will ensure the safety net of our social programs promotes health and well-being among all community members, and not just those that are advantaged.
The current and hopeful expanded work on healthy built environments can help meet the needs of Goal 12: Healthy Cities in Communities. Working with urban planners and others on creating physical environments that support and promote community health will be critical to our future. Providing input on walkability, appropriate and necessary shade, green space, noise reduction, energy efficiency, and other beneficial components to a healthy community should be necessary and critical contributions that environmental public health professionals can make.
Much of our health promotion and education work can be found in Goal 3: Health and Well-being for All. We are currently involved in education, training, and outreach with the public and other stakeholders to promote food safety (e.g., food handler training courses), water quality (e.g., messaging for private well owners and small drinking water system operators), and recreational facilities (e.g., swimming pool operators). It is suggested that a more proactive approach be taken and we engage in broader advocacy to improve environmental public health policy. We have demonstrated success in this activity in areas such as smoke-free policies. Identifying future opportunities to reduce the impact of both communicable and non-communicable disease will increase the sustainability of our communities substantially. Effective collaboration and partnerships with other stakeholders will be critical to achieve these goals, as many of the environmental public health challenges facing the profession are complex, multifaceted problems that require coordinated efforts and solutions.
An enhanced focus on sustainable development is one that looks toward the future and has the ability to improve our present as well. The United Nations recently released the UN Research Roadmap for the COVID-19 recovery which is focused on the 17 Sustainable Development Goals (United Nations, n.d.). The focus of this document is to provide a research agenda that will result in more equitable, resilient, and sustainable communities as we recover from the COVID-19 pandemic. Economic recovery packages will provide opportunities to focus efforts on sustainable development. This will be an opportunity to invest in choices that will support the health of the population (Watts et al., 2020) such as renewable energy, community infrastructure, and active transportation.
To ensure environmental public health professionals across Canada are fully equipped to be able to actively engage in sustainable development activities, post-secondary institutions and departments that offer degree programs in environmental public health must adapt their curriculum to incorporate the necessary skills and knowledge working professionals will require. Some of these components are outside of the fundamentals of sustainable development and include effective advocacy, working with community partners, understanding policy, and being able to negotiate and work within complex environments.


Thirty years ago, Dr. Trevor Hancock identified key areas where the field of environmental public health can focus to improve population health through healthy and sustainable environments. His foresight in focusing on sustainable development as an overarching concept was accurate. While public health improvements have been made in several areas over the past few decades, many environmental health challenges remain, and new threats have emerged such as COVID-19 and climate change that require a sustainable development lens and approach in the profession moving forward. Environmental public health professionals will need the necessary educational support as well as collaboration with key groups such as CIPHI and other public health and nonprofit associations, such as the Canadian Public Health Association, to ensure that we continue to be central in maintaining healthy communities across Canada.


The authors would like to thank Dr. Trevor Hancock for his original article and foresight in the field of environmental public health. Further, we would like to thank the Environmental Health Review for continuing to provide an avenue for the exchange of research and other evidence-based information in the field.


Supplementary marerial are available on the journal website at


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Information & Authors


Published In

cover image Environmental Health Review
Environmental Health Review
Volume 64Number 1April 2021
Pages: 11 - 13


Version of record online: 23 April 2021



Andrew Papadopoulos [email protected]
Department of Population Medicine, University of Guelph, Guelph, Ontario
Wendy Pons
Bachelor of Environmental Public Health, Conestoga College Institute of Technology and Advanced Learning, Kitchener, Ontario
Ian Young
School of Occupational and Public Health, Ryerson University, Toronto, Ontario


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