Equity in environmental health practice: Findings of a pilot study
Public health inspectors (PHIs) are environmental health professionals who carry out inspections, enforce health protection regulations, and provide environmental health education and training. This qualitative study explored the role of environmental public health practitioners in addressing the social determinants of health (SDH) and health equity related issues that may present as barriers to compliance with public health protection regulations. These barriers align with the social determinants of health (SDH).
National Collaborating Centre for Determinants of Health and the National Collaborating Centre for Environmental Health worked together to conduct focus groups with PHIs in British Columbia and Nova Scotia. Discussions revealed that business or facility operators experience equity issues that affect their ability to comply with environmental health regulations. These equity-related issues include socioeconomic status, differences in practices or knowledge associated with cultural background, limited English language or literacy skills, psychosocial stressors, and geographic isolation.
Participants discussed organizational factors such as limited time or resources, inflexible policies, insufficient managerial support, and departmental silos as compounding issues to PHIs’ challenges in dealing with clients facing inequity-related challenges. Because of these restraints, PHIs used ad hoc strategies to help clients overcome barriers related to SDH, such as borrowing multi-lingual tools, using co-worker or family as translators, and referring clients to social services or external funding sources when possible. They focused on relationship-building and open communication to work with clients who were facing barriers to compliance with public health protection regulations.
The study concludes that support for PHIs’ ability to address health equity in environmental health practice could include:
- training on SDH, health equity, and risk assessment/communication for PHIs
- scaling up ad hoc strategies shown to be effective;
- improving cross-jurisdictional collaboration
- clarifying roles and responsibilities could help support PHIs’ ability to address health equity in environmental health practice
Use this resource to
- deepen your understanding of how SDH and health equity related barriers impact environmental health protection;
- consider strategies that environmental health practitioners can use to support clients facing health equity related barriers with respect to compliance with regulations; and
- contemplate organizational factors that can help public health inspectors respond to these issues.
For more evidence-based resources for public health inspectors and environmental health practitioners, visit National Collaborating Centre for Environmental Health.
Rideout, K. and National Collaborating Centre for Determinants of Health. (2014). Equity in Environmental Health Practice: Findings of a Pilot Study. Vancouver, BC: National Collaborating Centre for Environmental Health, British Columbia Centre for Disease Control; Antigonish, NS: National Collaborating Centre for Determinants of Health, St. Francis Xavier University