Environment and health risks: 
           of social inequalities
                                                                  
            
            
            
            
                                       
                                       
                                       
                                       
                    Environment and health risks:  
                     a review of the influence and  
                     effects of social inequalities 
                                       
            
                                       
                                       
                                       
            
            
            
                                       
                                                                                                  ABSTRACT 
                                
                                 This report serves as a background document for the policy brief on social and gender inequalities in 
                                 environment and health that was prepared for the Fifth Ministerial Conference on Environment and 
                                 Health (Parma, Italy, 10–12 March 2010). It provides an overview of the currently available evidence 
                                 on the influences and effects of social and gender inequalities on environmental health risks.  
                                 The evidence has been compiled for six environmental health challenges (air quality, housing and 
                                 residential location, unintentional injuries in children, work-related health risks, waste management 
                                 and climate change) as well as for gender-related inequalities and children’s exposure. Additional 
                                 chapters present interventions on child-related environmental inequalities and social inequalities in 
                                 environmental health risks in the Russian Federation.  
                                 Although the evidence base on social inequalities and environmental risk is fragmented and data are 
                                 often available for few countries only, it indicates that inequalities are a major challenge for 
                                 environmental health policies. The review confirms that people living in adverse socioeconomic 
                                 conditions in Europe can suffer twice as much from multiple and cumulative environmental exposures 
                                 as their wealthier neighbours, or even more. Similarly, inequalities in exposure to environmental 
                                 threats have been identified for vulnerable groups such as children and elderly people, low-education 
                                 households, unemployed persons, and migrants and ethnic groups. Only little evidence is available 
                                 indicating that in some circumstances, well-off and advantaged social groups are more at risk. 
                                 Irrespective of developmental status, environmental inequalities can be found in any country for which 
                                 data are available. Despite lack of data from many Member States of the WHO European Region, 
                                 social inequalities in environmental risk must therefore be considered a public health issue for each 
                                 country and the whole Region.   
                                                                                               Keywords 
                              
                                                                                           ENVIRONMENTAL HEALTH 
                                                                                         ENVIRONMENTAL EXPOSURE 
                                                                                          SOCIOECONOMIC FACTORS 
                                                                                                   RISK FACTORS 
                                                                                                GENDER IDENTITY 
                                                                                                        EUROPE 
                              
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                                                           page iii 
                                                               
                                                               
                                                               
                                      
                                      
                                      
                                      
                                CONTENTS 
                                      
                                                           Page 
           Acknowledgements .....................................................................................iv 
           Introduction................................................................................................ 1 
           1. Social inequalities in health risk related to ambient air quality ..................... 5 
           2. Social inequalities in environmental risks associated with housing and 
           residential location .....................................................................................33 
           3. The social inequalities in health risks related to unintentional injuries  
           among children..........................................................................................76 
           4. Social inequities in working environment and work-related health risks.....105 
           5. Inequalities, inequities, environmental justice in waste management  
           and health...............................................................................................127 
           6. Social inequalities in environmental risks associated with global  
           climate change.........................................................................................149 
           7. Environmental inequalities among children and adolescents. A review  
           of the evidence and its policy implications in Europe ...................................159 
           8. Summary report on interventions and actions to tackle inequities in  
           physical activity in children........................................................................199 
           9. Abstracts of country case studies on interventions and actions to  
           tackle inequities in physical activity in children............................................205 
           10. Gender inequities in environment and health ........................................217 
           11. Social inequality and environmental health in the Russian Federation......238