The increasing population and industrialisation of the modern world has led to a vast increase in production of wastes which has drawn much public health attention. Waste management involves collection, transportation and disposal of wastes, which according to UNEP are substances or objects that are disposed of, are intended to be disposed of or are required to be disposed of by the provisions of national law. There are many types of waste but the most important ones are the municipal wastes which include house-hold and commercial wastes, biomedical wastes from health care centres and hazardous waste including electronic, explosive and radioactive wastes. Waste collection generally involves use of collection bins and bags- which are sometimes colour coded depending on the region or country, and are then transported with trucks to the disposal site. They are then burnt in an incinerator to reduce waste volume, or are buried in landfills which are typically distant from residential areas.

Aside the aesthetic importance of proper waste management, there are several important health and environmental consequences. Wastes dumped close to residential areas such as along the streets, roadsides, farm lands and in rivers could easily lead to all forms of pollution, which is another grave problem. Water pollution poisons the water we drink and harms aquatic life while Air pollution results in other environmental health problems like global warming and climate change. Land pollution from wastes and other hazardous wastes can lead to long term devastating effects on the population. Poor waste disposal can also increase vector-borne disease burden. Although nobody still thinks that wastes can suddenly turn into organisms like the 18th century man once thought, improper waste management could still lead to accumulation of disease causing organisms or vectors like mosquitoes, houseflies etc. Health care wastes can harbour potentially lethal infectious organisms like HIV, hepatitis viruses etc. Exposure to radioactive wastes could lead to birth defects, cancer and even death.

Given the vast amount of wastes churned out on a daily basis, the task of waste management is quite a challenging one. This seemingly challenging problem has actually given rise to a fast growing industry- the waste management industry which creates employment for a large number of people. Armed with principles of proper waste management- reduce, reuse and recycle, and seen in policies such as: “don’t waste your waste” and “zero waste campaigns”, these industries focus on recycling and conversion of wastes to energy. Unfortunately, this is not existent in developing countries and is not very effective in some developed nations; indeed only few countries like Sweden have waste industries so effective that they even import wastes. This Swedish success is partly due to government policies like progressive payment with more wastes that discourage waste generation.

Government can help by providing more waste storage and transport facilities to remove wastes from residential areas. Also, placing huge fines and setting up laws against improper waste disposal could help dissuade the public from dumping wastes carelessly. Public health officials can also help to educate the general public on the importance of waste management. If the health risks are effectively communicated and that everyone in their own little way can help, it becomes an easier task. Research into the long term environmental effects of current waste management methods has favoured reduction and recycling to be the most appropriate ways to handle wastes. International bodies like the EU should raise the minimum recycle targets to nudge member states towards this direction.

The effects of vector borne diseases have been strongly felt throughout the course of human history even though the relationship between vectors and diseases was not established until 1890s. Ever since then, they have been recognized as important global disease burden accounting for about 17% of all infectious diseases. Vector borne diseases are diseases that are transmitted by vectors- insects that harbour infectious agents. Vectors can harbour virtually any infectious agent including bacteria, viruses, protozoa and can transmit more than one infectious agent e.g. mosquito which transmits malaria and filariasis. Vectors also tend to be distributed based on the environmental parameters leading to unequal disease distribution, for e.g. mosquitoes in tropics and sand flies in Asia. However, the drastic effects of climate change coupled with advances in human transportation and industrialisation is blurring this line.

Despite being public health threats, vectors are also part of our ecosystem and help to create balance. Environmental parameters like climate change are perhaps the most significant causes of imbalance which accounts for the increased incidence of diseases. Also, pollution can serve as a breeding ground as seen in mosquitos or housefly in improperly disposed sewage. This reason coupled with weak public health response is why poorer communities, especially in Africa, tend to have more vector burden compared to the developed world. Another factor is seen in the late 20th century when the war over vectors was thought to be almost over. A shocking incidence followed- mosquitoes suddenly developed resistance over insecticides like DDT which was effectively used to control them. This is even worsened by the infectious agents that can also become resistant to drugs, and can even mutate to more pathogenic strains as seen in influenza. There seems to be really no way around these mechanisms of microbial adaptation, mutation and evolution.

Whether it’s the vectors or the organisms themselves, it takes time for these survival mechanisms to develop and it is within this time lag that public health responses and efforts can be useful to control the spread of these diseases. This is illustrated by the significant reduction of these diseases during the widespread public health campaigns in early 1900s. Generally vector borne diseases are controlled by educating the public on the importance of the environment on health; reducing pollution, better housing and sanitation could reduce disease spread. In addition, removing the source of these organisms like stagnant water and providing materials like nets to prevent their contact with people would go a long way in reducing spread. There should be increased provision and availability of vaccines for better coverage against infection as well as research into newer vaccines to include newer types of organisms. Funding of public health services in remote areas with higher prevalence is essential to educate people on the lifecycle of vectors and where we can intervene to limit their spread. Research into more efficient ways of vector control has led to novel approaches involving biological control like use nanotechnology such as nanoparticles and genetic engineering as well as the Oxitec friendly mosquitoes.

Human history is littered with horrors of disease outbreaks ranging from as far back as the Justinian plague to the recent Ebola outbreaks. These outbreaks could be global- known as pandemics like the 1918 influenza pandemic; or localized involving a large part of a continent-known as epidemics  like the 14th century bubonic plague that almost wiped out half of Europe. Most of these outbreaks are caused by viruses but some are also caused by bacteria and parasites. These infectious agents are mostly communicable, spreading quickly by air like influenza; localizing in body fluids like blood and saliva e.g. HIV or travel via vectors like mosquitoes as in the case of Zika virus and malaria parasite. Given the death toll from these outbreaks as evidenced by the fact that the bubonic plague claimed more lives than the First World War, it is important to understand why they happen and how to prevent, control or manage their occurrence.

There are several reasons that account for outbreaks. Firstly, infectious agents can become resistant to already available treatments and vaccines, something known as antimicrobial resistance. They do this by several forms of genetic adaptations like the antigenic shifts and drifts seen in influenza virus. Also, some infectious agents can create conditions for spread of other agents as exemplified in the resurgence of TB due to HIV. Secondly, environmental modification such as climate change can cause spread of pathogens via vectors from a resistant human population to a vulnerable population like the increasing incidence of dengue fever in the United States. Additionally, increased population pressure could lead to movement to uninhabited areas which results in exposure to newer pathogens and vectors. Improper waste disposal and sanitation practices could also lead to increased spread of these agents. There are also cases of biological warfare like the US anthrax attack in 2001. Finally, the higher rate of globalization and human travel can lead to a faster spread of these diseases before they can be controlled.

Most outbreaks are caused by novel agents or known agents which are resistant to already available modes of treatment. Consequently, they often constitute a public health emergency. With threats to health care givers and patients In hospitals, hospitalized care is paralyzed leaving public health prevention practices as the only safe and reliable method of control and prevention. Widespread education and awareness programs about disease symptoms, route of spread and vectors- if any, are important for identification and prevention of disease outbreaks. As stated in SDG goal 4, the importance of the environment to heath should be stressed to reduce the rate of climate change. More so, better sanitation practices would reduce the rate of spread. Government must also place strict restrictions to immigration, especially people from known affected areas and also quarantine if needed until effective treatments are discovered. There is really nothing to do about genetic adaptations but to keep on researching and providing drugs and vaccines to cover resistant organisms. Sadly, outbreaks will keep occurring probably because it is an evolutionary and survival mechanism for these organisms but we must also fight for our survival by being prepared and ready to control them.

Birth defects, also known as congenital anomalies, are growing public health problems which cause structural and functional disorders that result in malformations, malfunctions or syndromes that may present in-utero or after birth. Birth defects cause significant morbidity and mortality with increase in health care expenditure and psychosocial problems for the child and family throughout life. It is the leading cause of infant mortality and occurs worldwide with about 3% live births. In general, different birth defects are existent in different rates in different parts of the world probably due to differences in distribution of risk factors.

In the early 1940s, scientists thought that genetic factors, which are out of the control of health workers, were the only predisposing factors to birth defects. However, the discovery that German measles affecting pregnant mothers led to birth defect showed that relevant public health measures could be put in place to reduce these disorders and defects. Shortly afterwards, it was also observed that the use of the sedative drug- thalidomide, by pregnant women led to increase in Amelia in embryos while the anti-acne drug, isotretinoin commonly known by its trade name Accutane causes oro-facial clefts. These findings showed that drugs could also lead to birth defects. Subsequently, the number of agents that cause birth defects- known as teratogens, continued to increase due to widespread surveillance, monitoring and observation. Other infectious causes include protozoans e.g. toxoplasmosis; bacteria e.g. syphilis; and viruses e.g. HIV. Besides drugs and infectious agents, birth defects can also be caused by exposure to environmental teratogens such as radiation and heavy metals or issues with maternal health such as obesity, diabetes, pregnancy before 18 years or after 35 years, smoking and substance abuse especially alcohol which causes foetal alcohol syndrome.

Although many birth defects, especially those of genetic origin, are difficult to treat or prevent, public health has focussed more on educating the public through awareness programmes on those that can be prevented. Several research studies worldwide have unequivocally demonstrated that increased folic acid intake (above the given FDA range) reduces the risk of neural tube defects. Public health officers also partner and work with the FDA to ensure that there is a black box warning against use of potential teratogens. More so, awareness is continuously created for other causes of birth defects such as radiation and poor hygiene or sanitation practices. Most awareness campaigns are targeted towards the prevention of infection and have proven to be effective in addressing some causes of birth defects. Screening and advanced testing such as karyotyping or PCR are essential to the diagnosis of genetic defects like Down syndrome as well as to counsel parents on what to expect. Stem cell research and gene therapy, on the other hand, continues to give hope to families of children with genetic disorders.

Family planning is a significant part of healthcare, and is important to not just the family unit but also the community, state, and nation. Generally, it presents far reaching effects that cut across social, financial and political dimensions of the society. Family planning is particularly a problem in poorer families, low income groups and developing parts of the world. It is also an integral part of maternal health, basic human right to choose and women empowerment in general. According to WHO, family planning allows individuals and couples to anticipate and attain their desired number of children as well as the spacing and timing of their births. This is achieved by the use of contraceptives, whether traditional ones like withdrawal and rhythm methods or modern contraceptive methods which may involve birth control pills, condoms, insertion of a diaphragm or an IUD and castration or vasectomy. Even though these methods are aimed at avoiding pregnancy, post conception ways and acts of terminating pregnancy such as abortion are not part of family planning. Despite being legal in many countries, including Canada, the 1994 United Nations summit in Cairo still rules out abortion as part of family planning.

As an important public health issue, it is pertinent that doctors, nurses, midwives and other health care workers educate the public and provide necessary expert advice on the contraceptive options available. The importance of family planning cannot be overemphasized because the right to choose birth times allows women to be free to pursue their career or academic goals which in turn improves their feeling of wellbeing, empowers them to make better choices about how to plan and live their lives as well as increases their economic significance to the society. Families may also choose to have a particular number of children or even temporarily delay childbirth if there are important financial stressors which would actually improve the quality of life. Also, contraceptives like condoms are an integral part of safe sex practices which have helped reduce the incidence of AIDS and STIs among sexually active people like teenagers or extramarital affairs that are not considered to be planning a family.

Evaluations have revealed a decline in infant mortality and adolescent pregnancies in areas with better family planning access, awareness and education. On a larger scale, some governments mandate family planning for national planning and population control like China’s One Child Rule policy. Family planning, despite all its merits has met some stubborn challenges. Several issues influenced by maternal age and health such as the risk of down syndrome and other chromosomal disorders, tumours, gestational diabetes and even emergency life threatening conditions like eclampsia have been identified. Additional issues reported include deficiencies with the method of contraception such as irregular periods and infections from implant. There are also cultural and religious hindrances to virtually all forms of modern contraceptive use especially in communities with more cultural and religious influence on individuals. Perhaps the most modifiable limitation of family planning is coverage and accessibility which healthcare providers and governments can tackle by creating more awareness through outreach and educational programmes to promote, emphasize and nail in its importance.

Children like every human have basic human rights and child maltreatment in all its forms violates this right. Child maltreatment involves child abuse, child neglect, manipulation or trafficking by the supposed care giver .Child abuse could be physical like inflicting wounds or sexual like oral sex, fondling of genitals, voyeurism and other sexual acts or emotional use words to hurt a child feeling. Child neglect is physical- when a caregiver fails take care of the child; medical- when medical needs are not taken care of; and emotional- when the emotional needs of the child are not met. Children who are particularly at increased risk of maltreatment include: children born into broken homes or those born to mentally ill parents. The fact remains, child maltreatment is a global and public health problem given that one in every four adults report experiencing some kind of abuse or maltreatment as a child.

The consequences of child maltreatment may be immediate death of the child during the process or injury.  Long term results such as psychological issues like depression, anxiety, schizophrenia, suicide or emotional brokenness are equally devastating to both the child and the society. There could be physical deformations in cases of physical abuse or extreme sexual behaviors, abnormal sexual cravings and other psycho-sexual disorders in cases of sexual abuse. Medical neglect may lead to complication of an otherwise benign disease while physical and emotional neglect could result in poor emotional understanding and awkward responses even in adulthood. Abused children may grow up to become involved in crimes, substance abuse, violence to cope with their past, and may even abuse other children setting up a vicious cycle that worsens the problem in the society

The public health sector has perhaps the most important role in tackling this problem. There are already education and awareness programs where children are taught, for example, to understand sexual cues like good touch and bad touch, rights as individuals over their bodies. Awareness programs also help train health workers and the general public on ways to recognize physically abused children like children with multiple bruises, especially bruises in unusual areas of the body like the cheeks, ears and back. Physically neglected children may be generally untidy and wear dirty clothes to school while medically neglected ones have an obvious medical condition that’s not attended to. Victimized children tend to be distrustful and withdrawn so it is especially challenging to reach out to them however, their fears should be addressed and they should be assured that they would be properly taken care of. Public officers should be sent more to areas with higher reports of abuse and there should be reliable access to public health services through a phone. They should work with the judiciary to take control of the child as quickly as possible as the child runs the risk of further abuse or even death. Children with psychological problems from abuse should be referred to psychiatrists to assess and help them to find coping mechanisms. Government also has important roles like instituting laws such as serious jail terms for children abusers and proper funding of social and health care services that help fight child maltreatment.

Child maltreatment is not just a problem for public health and the government, it is every ones problem and we must do what we can to protect, guide and save these innocent creatures for posterity sake.

Air quality can be defined as the state of the air within our surrounding environment in relation to its appearance and composition. Air quality is measured by the extent to which air is clean, clear and free from impurities such as smoke, chemicals, particles, mists, dust and smog. The quality of air can be determined by measuring and assessing a series of quality indicators such as amount of impurities, rate at which these impurities are released into the atmosphere and how long they are trapped in air. The WHO Air Quality Global Guidelines, which was published in 2005, provides an assessment of the health effects of poor air quality as well as thresholds values for harmful impurities.

Good air quality is important to balance and sustain the existence of human, plant and animal life, and to preserve natural resources and the environment at large. Consequently, all life and resources are threatened when impurities and chemicals exceed threshold concentrations in the atmosphere. Air quality can be depraved through either natural or man-made means- natural processes that depreciate air quality are volcanic eruption and windstorm dust while man-made processes include contamination by vehicles exhausts, toxic gases from industries, coal powered plants, landfills and burning wood or other material in open air. Both natural and manmade causes of poor air quality can significantly affect overall air quality resulting in severely negative health problems for humans, animals, plants and the environment as a whole.

Human activities emit a wide range of contaminants which depreciate air quality on a daily basis. These contaminants are classified into different categories that include Sulfur Dioxide, particulate matter, Hydrocarbons, volatile organic compounds, Lead, Carbon Dioxide, Carbon Monoxide, Nitrogen Oxides and Smog. In most parts of the globe, substances that visible reduce air quality include smoke, dust, particles, some gases, soot and smog from factories, power plants, automobiles, and smelters particularly in urban and industrial areas. In general poor environmental air quality also affects indoor air quality. Specific indoor air contaminants include cigarette smoke, mould, dust mites, pet dander, formaldehyde, volatile organic compounds and radon gas. Certain conditions like light winds and high mountains that tend to constrain air movement may preserve and increase contaminants and perpetuate poor air quality in an area.

Despite many efforts by various organizations, including WHO, to improve air quality, the situation has worsened. Many people across the world die annually due to the damage done to their bodies by the gradual, yet daily and consistent inhalation of toxic gases present in the atmosphere. Health consequences of poor air quality are difficulty breathing, irritation of lungs and airways and aggravation of already existing chronic diseases such as heart disease, chronic bronchitis, emphysema and asthma.

Certain ways to promote and improve air quality for this, and the coming generations include: reducing traffic and vehicle emissions by encouraging public transports; managing industrial waste and emissions; and establishing effective policies that embrace clean air action plans. However, these require collaborative effort and long-term team work, partnerships and commitment from individuals, businesses, companies, facilities, national governments and international organizations.

Significant changes in the earth’s climate system which result in new weather patterns that may last tens to millions of years is referred to as Climate Change. The climate system receives energy from the sun as well as dissipates energy to the outer space in order to maintain the balance of incoming and outgoing energy. This balance of incoming and outgoing energy, and the passage of the energy through the climate system, determines earth’s energy budget. When the incoming energy is greater than the outgoing energy, earth’s energy budget is positive and the climate system is warming.  On the other hand, if more energy goes out of the climate system compared to that which comes in, then the energy budget becomes deficit or negative and earth experiences a cooling effect.

The climate system is made up of five interacting parts which include:

• Atmosphere (air)
• Hydrosphere (water)
• Cryosphere (ice and permafrost)
• Biosphere (living things)
• Lithosphere (earth’s crust and upper mantle)

Climate change is widely recognized as one of the most urgent problems currently facing humanity, and the world at large. Fortunately, humans have the knowledge, technologies, and resources to solve this problem, in ways that support the most vulnerable nations and communities. We must take care of the earth’s atmosphere which is part of a global system that keeps the temperature of the universe within a habitable range. Sadly, we have not kept up with this mandate due to industrialization.

Since the advent of the industrial revolution, humans and their activities have continued to alter the composition of the atmosphere by burning fossil fuels such as coal, oil and gas. The resulting carbon dioxide (CO2) builds up in the atmosphere, creating the greenhouse effect. The greenhouse effect then traps energy from the sun and raises the temperature of the earth causing a positive change in the climate. An example of greenhouse gases is methane released mainly by natural gas production and nitrous oxide from nitrogen-based fertilizers. Greenhouse gases occur naturally and are essential to the survival of living things because they keep some of the sun’s warmth from reflecting back into space making the earth habitable. However, human activities including industrialization, deforestation and large scale agriculture, have increased the quantities of these atmospheric greenhouse gases to record levels not seen in three million years and which threaten the existence of life. As populations, economies and standards of living grow the cumulative level of greenhouse gas emissions increases.

Currently, the wide-ranging impacts of climate change are felt globally: various studies have reported an increase in annual temperature worldwide which is predicted to further increase by the year 2050. The ecosystem is changing and if nothing is done, many species may go extinct because their habitats are changing faster than they can adapt.

We can choose a future that prevents the worst impacts of climate change, by controlling our population as well as making a rapid transition from fossil to renewable energy sources which is very affordable.

Global warming is the continuing rise in the average temperature of the Earth’s climate system. It is a consequence of climate change and is reflected by temperature measurements and its numerous resulting effects. Global warming has been happening for a long time, however, increased intensity of its effects was observed in the 1900s. Therefore, the term is used mainly to describe the observed and ongoing increase in average air and ocean temperatures since 1900 caused predominantly by the emissions of greenhouse gases (GHGs) in the modern industrial economy. Although global warming and climate change are sometimes used interchangeably, they are not exactly the same. Global warming is a result of climate change, it is one of the many effect of changes in the climate system. On the other hand, climate change is much broader and encompasses both global warming and its effects including changes to precipitation and other environmental impacts that differ by geographic region. The effects and impacts of global warming are broad and include the following

• Rising sea levels
• Regional changes in precipitation
• Frequent extreme weather events such as heat waves and wild fires
• Expansion of deserts
• Destruction of infrastructure and food insecurity
• Water pollution
• Reduced water quality
• Extinction of some ecosystems and species

As the climate becomes warmer, the nature of global rainfall, evaporation, snow, stream flow and other factors that affect water supply and quality change. Surface temperature increases are highest in the Arctic, with the continuous retreat of glaciers, permafrost, and sea ice. Generally, increase in temperature results in more rain and snowfall for some regions while it causes droughts and wildfires in other regions.

Resulting effects of global warming such as increased variability in weather patterns, heat waves, heavy precipitation events, flooding, droughts, intense storms, sea level rise, and air pollution negatively affect public and global health. The specific health effects vary across geographic regions, age, economic resources and populations. More so, global warming may intensify already existing health problems in addition to causing new health issues.

In general, extreme heat events remain a cause of preventable disease and death worldwide. Public health is affected by disruptions of physical, biological, and ecological systems. The health effects of these disruptions may include increased respiratory, kidney and cardiovascular disease, injuries and premature deaths related to extreme weather events such as heat waves and heat stroke, changes in the prevalence and geographical distribution of food- and water-borne illnesses and other infectious diseases, and threats to mental health.

A balanced diet is a healthy diet that contains all the necessary food nutrients in their right proportions or recommended quantities. Eating a healthy diet daily and throughout one’s life helps prevent different forms of malnutrition as well as a wide range of non-communicable diseases (NCDs) and conditions. The exact composition of a balanced and healthy diet varies based on specific individual characteristics such as age, gender, lifestyle, level of physical activity, cultural context, locally available foods and dietary customs; however, the basic principles of what constitutes a healthy diet remain the same. Basically, a balanced diet includes the six classes of food: carbohydrates, protein, fats and oil, fruits and vegetables, minerals, vitamins and water.

The benefits of a balanced diet are broad and far reaching. Eating a healthy, balanced diet is one of the most important things that protect health. In fact, up to 80% of premature heart disease and stroke can be prevented through healthy diet and physically activity. A healthy diet helps lower the risk of heart disease and stroke by:

• Improving cholesterol levels
• Reducing blood pressure
• Maintaining body weight
• Controlling blood sugar
• Helping the body function properly

For infants and young children, a balanced diet provides optimal nutrition which fosters healthy growth and improves cognitive development especially in the first two years of life. It also reduces the risk of becoming overweight or obese and developing NCDs later in life. For adults, eating a balanced diet which contains most or all of the classes of food is essential to remaining healthy. Specifically, eating at least 400g or five portions of fruits and vegetables daily reduces the risk of NCDs and helps to ensure an adequate daily intake of dietary fiber. Additionally, reducing the amount of total fat intake helps to prevent unhealthy weight gain in the adult population while limiting salt intake to the recommended level of less than 5g per day could prevent up to 1.7 million deaths annually. More so, minimizing the intake of free sugars in both adults and children also provide additional health benefits by preventing dental caries (tooth decay), cardiovascular diseases and obesity.

Despite the benefits and established guidelines of healthy eating as well as the negative health effects associated with not eating balanced diets, many people still consume foods high in energy, fats, free sugars and sodium. This is as a result of increased production and availability of processed foods, rapid urbanization and changing lifestyles which have resulted in a shift in dietary patterns. People no longer eat enough foods beneficial to health including fruits, vegetables and other dietary fiber such as whole grains.

Diet is influenced by personal, social and economic factors that interact in a complex fashion. These factors include income, cost, availability, palatability, individual preferences, personal beliefs, culture and geographical aspects including climate change. As a consequence, promoting a healthy and balanced diet or food environment requires multiple sectors and stakeholders, including government, private sectors and the public in general.