American Public Health Association. Confirming need for protective national health-based air quality standards

Health system outcomes and determinants amenable to public health in industrialized countries: a pooled, cross-sectional time series analysis

BACKGROUND

Few studies have tried to assess the combined cross-sectional and temporal contributions of a more comprehensive set of amenable factors to population health outcomes for wealthy countries during the last 30 years of the 20th century. We assessed the overall ecological associations between mortality and factors amenable to public health. These amenable factors included addictive and nutritional lifestyle, air quality, public health spending, healthcare coverage, and immunizations.

METHODS

We used a pooled cross-sectional, time series analysis with corrected fixed effects regression models in an ecological design involving eighteen member countries of the Organisation for Economic Cooperation and Development during the period 1970 to 1999.

RESULTS

Alcohol, tobacco, and fat consumption, and sometimes, air pollution were significantly associated with higher all-cause mortality and premature death. Immunizations, health care coverage, fruit/vegetable and protein consumption, and collective health expenditure had negative effects on mortality and premature death, even after controlling for the elderly, density of practicing physicians, doctor visits and per capita GDP. However, tobacco, air pollution, and fruit/vegetable intake were sometimes sensitive to adjustments.

CONCLUSION

Mortality and premature deaths could be improved by focusing on factors that are amenable to public health policies. Tackling these issues should be reflected in the ongoing assessments of health system performance.

Kids need clean air: air pollution and children's health

Air pollution affects children's health in many ways, including reduced lung function, increased morbidity, increased use of health care services, and infant mortality. Information on the relationship of air pollution and children's health is discussed, with a focus on the diversity of research methods used to understand this relationship. Decisions affecting air quality ultimately are made through political and social processes. Health care and health promotion practitioners who are concerned about the health of children should provide leadership for advocacy to promote environmental health in our communities.