Physical environment: introduction

Environment has been recognised as a key determinant of health throughout history, and is described as a determinant in many of the current models of health. The important advances in public health in the 19th century were based on controlling the built and natural environment, in particular improvements in water supplies and sewerage systems, while in the 20th century improvements in housing reduced overcrowding and its associated diseases (e.g. tuberculosis); similarly, the clean air acts in the latter part of the century significantly reduced the levels of respiratory disease in the population.

The environment in which people live and work can influence health both directly (through toxic, allergenic, or infectious agents) and indirectly through influencing behaviours (e.g. availability of a local environment in which to walk or cycle) and through affecting mental health and wellbeing (which in turn may affect physical health). Its influence therefore covers both traditional environmental issues (such as air, water, pollution) and those related to the social sphere (housing, neighbourhoods, safe areas etc.).