Health Protection Inequalities: Tackling Disparities in Infectious Disease and Environmental Hazards

Inequalities in the burden of infectious disease, and in exposure and vulnerability to environmental hazards, are unfair and largely avoidable. Infectious and environmental hazards are closely connected: social, economic and environmental conditions shape exposure, vulnerability and the ability of individuals and communities to prevent and recover from their effects. We take an all-hazards approach to health protection, considering infectious and environmental hazards within one conceptual framework, as this can clarify how overlapping risks contribute to health protection inequalities across populations and over time.Disparities may affect people based on age, sex, ethnicity, disability or sexual orientation. They may also result from the accumulation of social, economic and environmental circumstances across the life-course, influencing exposure to hazards, vulnerability to their effects and access to effective preventive and protective interventions. Inclusion health groups, such as people seeking asylum, people in prison, people experiencing homelessness and people who inject drugs, are often disproportionately affected by infectious diseases. For example, over 70% of people in the United Kingdom diagnosed with tuberculosis disease are from minority ethnic groups who migrated from a high TB prevalence country. Environmental hazards are similarly patterned: the health effects of poor outdoor air quality disproportionately affect people living in the most socially deprived areas. Repeated or cumulative exposures may further increase vulnerability across the life-course.Health inequalities are not always apparent in public health surveillance data. Protected characteristics such as ethnicity are often poorly recorded in clinical systems, while surveillance reports may not include analyses that support monitoring of health inequalities. Surveillance evaluations also rarely examine how social, economic and environmental circumstances across the life-course shape exposure, vulnerability and access to protection, across both communicable disease and environmental hazards.Whilst we often know where inequalities exist, interventions to reduce them are less frequently described. Vaccination programs may be highly effective, but uptake is often poorest in deprived or ethnically diverse communities. Elimination efforts for HIV, tuberculosis and viral hepatitis are hampered by their concentration in marginalized groups. Environmental policies and interventions may also fail to benefit all communities equally or address cumulative exposure over time. Policy makers and town planners should consider the impact of locating polluting industries in vulnerable communities, as well as how the built environment and living conditions influence exposure and access to protection.We welcome articles that advance this topic, taking an all-hazards view of health protection inequalities. We are particularly interested in studies examining how social, economic and environmental circumstances over the life-course shape health protection inequalities, including differences in exposure to infectious and environmental hazards, vulnerability to their effects and access to preventive and protective interventions. Themes include:· Describing and quantifying inequalities in communicable disease and environmental health outcomes· Social, behavioral and commercial determinants across the life-course· Links between infectious and environmental hazards within a shared health protection framework· Methods for measuring health protection inequalities and incorporating them into public health surveillance· Health inequalities in emergency planning and preparedness, including for pandemics· Exposure to infections and environmental hazards in health inclusion groups· Interventions to reduce health protection inequalities, including those focused on the built environment· Evaluating actions to reduce inequalities across life stages and populations· Policy and guidance for reducing health protection inequality Topic editors: Daniel Rhys Thomas, Roland Salmon, George Karani, Tom Fowler Source: https://www.frontiersin.org/research-topics/85749/health-protection-inequalities-tackling-disparities-in-infectious-disease-and-environmental-hazards