CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

The environment plays an irreplaceable role in human life and ensuring friendly environments has often been in the top agenda for over centuries now. The world at large is battling with global climate change, which is as a result of constantly degrading environments cause by both human activities and some natural occurrences.  The last virtual world leaders summit on climate change took place on the 22^nd   and 23^rd of April 2021, which brought together 40 world leaders in a virtual Summit on Climate to rally the world in tackling the climate crisis and meeting the demands of science. The United States and other countries announced ambitious new climate targets ensuring that nations accounting for half of the world’s economy have now committed to the emission reductions needed globally to keep the goal of limiting global warming to 1.5-degrees C within reach. Many leaders underscored the urgency of other major economies strengthening their ambition as well on the road to the United Nations Climate Change Conference (COP 26) in November 2021 in Glasgow (US Department of state 2021). The Summit, which was the largest virtual gathering of world leaders, convened the world’s 17 largest economies and greenhouse gas emitters and included the leaders of other countries especially vulnerable to climate impacts or charting innovative pathways to a net-zero economy. President Biden was joined at the Summit by Vice President Harris, members of the President’s Cabinet, Special Presidential Envoy for Climate John Kerry, and National Climate Advisor Gina McCarthy, as well as senior representatives of other countries and leaders from business and civil society. This summit just like other that have come are gone and the one that are still to come are focusing on ways of limiting the rate at which the environment is degrading before causing climate change (US Department of state 2021).

Environmental degradation is an umbrella concept which covers a variety of issues including pollution, biodiversity loss & animal extinction, deforestation & desertification, global warming, and a lot more. Environmental degradation is the deterioration of the environment through depletion of resources such as air, water and soil; the destruction of ecosystems and the extinction of wildlife. It is defined as any change or disturbance to the environment perceived to be deleterious or undesirable and Warford (2003). Environmental degradation is one of the ten threats officially cautioned by the High-level Panel on Threats, Challenges and Change of the United Nations. The United Nations International Strategy for Disaster Reduction defines environmental degradation as “The reduction of the capacity of the environment to meet social and ecological objectives, and needs”. Environmental degradation is of many types. When natural habitats are destroyed or natural resources are depleted, the environment is degraded. Efforts to counteract this problem include environmental protection and environmental resources management. 

 Human health is essential before everything else,  “We recognize that a growing number of diseases in humans have been linked to environmental exposures . . . that environmental exposures are increasing in many countries . . . that new emerging risks are being identified, and that more and more humans are being exposed to unsafe environments.” (the Bangkok Statement; WHO 2002b).

Environmental threats to the health of children are myriad, and include the classic infectious disease hazards: pneumonia, dysentery, measles, AIDS, and tuberculosis (Wegman 1999). Moreover, as industrial development proceeds and nations pass through the epidemiologic transition (Orman 1971), children are confronted by a rapidly multiplying array of new threats to health posed by exposures to toxic.

The impact of environmental degradation on human health has gained increased attention in recent years. Environmental pollution and the threat posed to human health is most pressing in developing countries, particularly access to potable water, adequate sanitation, and the impact of indoor and outdoor air pollution. In a seminal text on the role of the environment in economic and social well-being, Pearce and Warford (2003) argued that “the most important and immediate consequence of environmental degradation in the developing world takes the form of damage to human health”. The importance of environmental quality in determining people’s survival has received significant attention in both the developed and developing literature (Briggs 2003, Suk et al. 2003, Kyle et al. 2006). Ensuring environmental quality and therefore health is essential to achieving the World Health Organization’s (WHO) Millennium Development Goals (MDGs) in reducing child mortality around the world (WHO, 2002; Briggs 2003). Particularly in the poorest countries, less attention has been paid to the economic costs of poor health and morbidity associated with environmental damage. One reason for this is that exposure is not readily measured and levels of environmental pollution can vary significantly within a small geographic area, thus making detection of the link between pollution and health imprecise. In countries where conventional economic development dominates environmental concerns, the link between well-being and environmental quality does not receive adequate attention (Corvalan and Kjellstrom 1996). Furthermore, economic interests often drive environmental pollution, thus competing with interests to reduce exposure and improve health outcomes (Dasgupta, 2004)

Variation in health outcomes is prevalent within and between countries, with the poorest populations usually at a greater risk of poor health. Such variation can be due to myriad factors, including unaffordable medical care, poor access to facilities, low education levels and greater exposure to high risk activities such as agriculture, an d the negative externalities associated with agro -chemical applications, poor water quality, soil and access to quality food stuffs (Musgrove 1993). Inequality in health has been noted in the developed and developing
literature alike; there is significant debate as to how health inequalities should be measured (Wagstaff, et al., 1991; Le Grand and Phillips 1996).

Many government policies and international efforts at decreasing rates of mortality and thus improving overall health focus on pro-poor public spending as a “catch-all” approach to improving health (Gupta et al., 2003). Such a blunt tool, however, has not necessarily shown to improve health outcomes. In China, for example, advances in mortality reduction over the past 50 years were not significantly correlated with improvement in health resource availability (Prescott and Jamison 1985). Especially in developing and transition economies, poor data on the distribution of health outcomes makes understanding the impact of spending on the poor difficult to differentiate in aggregate -level analysis (Bidani and Ravallion 1997) There is evidence that basic improvements in social services and primary health care can reduce maternal and infant mortality in Central Asia, however, due to the significant variations in completeness, validity and reliability of health data across the region, the effectiveness of policies varies significantly between countries (WB, 2004) The role of health care in explaining differentials in rates of morbidity and mortality at the international, regional and even national level are confounded by many other socioeconomic factors that may exacerbate health inequalities, such as education, religion, geographic location and spatial factors, such as population density (Sachs et al. 2001, Balk et al., 2004).

Environmental protection and its importance in policies designed to improve health outcomes and equality is recognised (Marmot 1998; Marmot, 2002). Environmental health plays a particularly acute role in the health of poor rural communities where dependence upon the natural environment is much greater; the survival prospects of poorer members of a society have been cited as a function not only of inequality, but inequity (Kirigia 1997; Wildman 2001; Goesling and Firebaugh 2004) The environment and quality of the environment determined by anthropogenic activities is a primary example of inequity that may ultimately lead to inequality in health outcomes.

Multiple factors impact on the poor to affect health outcomes linked to the environment. For example, less money means a household is less able to afford water, non-polluting heating, access to quality and sufficient food, thereby increasing susceptibility to disease and illness (Victoria et al., 2003). Changes in health outcomes and variation across a particular area are broadly effected by not only economic factors but also changes in the epidemiological environment (Kirigia 1997; Sieswerda et al., 2001). The environmental impacts on human health; also known as the epidemiological environment are defined by a broad set of variables that are ultimately shaped by development (and global change), including geography, nutrition, land conversion, biodiversity, agricultural intensification and climate change (Daily and Ehrlich, 1996). Potential health hazards posed by different environmental pollutants are of significant concern, although many factors are unobserved, under reported, and/or immeasurable (Best et al.,2000) Furthermore, many health outcomes do not show “smooth” trends across space and over time or within and between populations, thus confounding causal links (Kelsall and Diggle 1998). It is the limitation of data availability and quality that largely prevents much understanding of what determines health differentials within a given geographic, social and economic area. There is a distinct need to pool information across disciplines to understand those factors which ultimately determine health outcomes, combined with ongoing development of methods of measurement to link economic, social and environmental factors impacting on health (Green et al., 2000)

Environmental health addresses the relationship between the natural environment and human health outcomes. Exposure to environmental pollution and the impact on human health is well established and human exposure to pollutants, whether through air, water, soil and food, is a main contributor to increased morbidity and mortality around the world (Corvalan and Kjellstrom 1996). Briggs (1999) has defined environmental health as “the presence in the environment of an agent which is potentially damaging to either the environment or human health”. Factors which reduce environmental health are those “stressors” that impact on human health through normal pathways such as ingestion, inhalation and absorption. Environmental health studies therefore, concerned with negative externalities arising from household and/or activities external to the home that reduce health outcomes at the individual, community or national level (Smith et al., 1999).  

Environmental health, which encompasses all aspects of the natural and man-made/designed environment that may affect human health, remains a major concern in Cameroon, like elsewhere in sub-Saharan Africa. Industrial chemical spills and disposal of industrial debris into water or open fields have harmful effects on the environment, causing particularly water, air and soil pollution. The direct consequences of these bad practices are reflected through common diseases, and food intoxication and climate change. Enormous efforts towards addressing the diversified and multi-factorial environmental health issues in Cameroon (e.g., through the Inter-Ministerial Commission for Municipal Waste Management in Cameroon in charge of formulating and developing appropriate policy for the management of municipal wastes) has been made with observable impacts. Notwithstanding, the challenges of (i) environmental waste management, (ii) pollution, and (iii) associated health implications remain major concerns. For example, industrial and market waste management and poor town planning (poorly constructed houses and poor drainage systems which contribute to the spread of diseases) remain major concerns, resulting in unhealthy environment. Furthermore, environmental pollution e.g., the poor-handling of industrial chemicals/waste, likewise, gas emissions by imported vehicles, as well as natural factors such as volcanoes and the release of poisonous gas, represent serious environmental concerns for land, water and air pollution. Also, the poor handling of pesticides and non-degradable plastics have negative impact on soil quality and thus reducing farm land and agricultural production. Human exposures to harmful chemicals, pesticides, pathogens that may be present in our environment (e.g. in foods, water, air, untreated wastes) either at workplace or at home, are possible causes of many environmental diseases. This in most cases has increase infant mortality especially in areas which are prone to more environmental health hazards.

Environmental health studies are concerned with the “many-to-many” relationships that is, many potential risks and outcomes that are not easily identifiable, making the causal chain of environmental pollutants to human health imprecise. Due to variation in detecting the impact of environmental pollution on health and the significant variability in exposure and human resistance, Briggs (2003) highlights that in general, too little is known either about the causal links between environmental quality and health, or about the levels of exposure across the population to make reliable assessments of the proportion of disease or mortality attributable to pollution.

The Alma Ata Declaration of 1978 noted that protecting human health is essential for human welfare (quality of life and peace), social and economic development. Health is the vital policy objective at both national and international level. That is national and international policy anchors on ensuring that people lives a long quality life. This has been demonstrated by the setting out of the Millennium Development Goals (MDGs) which are all related to health in their totality as well as effort and resources attributed to their fulfillment.

1.2 Statement of the Problem

Environmental degradation has been locally, nationally and internationally recognized as the main driver of global warming. Global warming on its part has been found to have serious negative effects on human and animal health. Given that the health of a nation serves both as an important means and a basic end in efforts aimed at improving human welfare (Fayissa et al., 2005), there is need to address environmental degradation as a means of limiting global warming and its consequences. Healthy people are able to positively contribute to economic development by active involvement in the productive sectors of the economy such as agriculture, manufacturing, mining and informal activities. This also improves their own incomes thereby reducing poverty and inequality. After recognizing that health is wealth, and that poor health is a deprivation that is part of poverty, WHO (2002) noted that governments should promote the way of life people live and freedoms they enjoy, especially freedom from escapable mortality and avoidable illnesses.

Cameroon striving to achieve high rates of economic development, though with agriculture as it back bone is at the moment witnessing increased urbanization, Population growth, intensification of agriculture, Increase in energy use and Increase in transportation. All these activities are at the core of environmental changes which results to degradation. Carbon dioxide and other greenhouse gases released into the atmosphere through Fossil fuel burning, combustion in cars and from heavy industry equipment trap more heat in the lower atmosphere and affect the global climate. Intense agriculture and population growth leads to deforestation which destroys the habitat of plants and animals leading to certain specie disappearance. Also intense agriculture paves the way for agricultural runoffs which is a deadly source of pollutants that erode soils and degrades environments. All these activities lead to Air pollution, water pollution and land pollution which are the common types of environmental degradation.  Scientific research has proven that rising global temperatures are increasing the possibility of ice melting and the rise of sea levels. If current trends in Cameroon in particular and the world at large continues, increase in temperature and in the frequency of extreme weather events may lead to severe consequences to the environment as a whole and human health in particular (Leal Filho et al. 2016). Vora et al. (2008) stated that human-driven ecological changes might be contributing to the spread of vector-borne diseases. Following the line, Patz et al. (2000) argue that deforestation may create ecological niches favoring the proliferation of vectors and parasites. Also, Uneke (2008) stated that deforestation had been shown to increase the risk of malaria transmission. Harrus and Baneth (2005) also stated that water puddles in deforested areas tend to have lower salinity and acidity than puddles in forests. Such deforested water puddles may be more conducive for the larval development of certain Anopheles mosquito species (the vectors of malaria), particularly the most effective vector of malaria in the Amazon.

Beside the human activities that contribute to environmental degradation in Cameroon, natural causes also aggravate the rate at which environment are degradation. The environments are also constantly changing over time with or without the impact of human activities; some ecosystems degrade over time to the point where they cannot support the life that is “meant” to live there. Things like landslides, earthquakes, tsunamis, hurricanes, and wildfires (some of which are very common in Cameroon) completely destroy local plant and animal communities to the point where they can no longer function. This in Cameroon comes through physical destruction, natural disaster or by the long-term degradation of resources by the introduction of an invasive alien species to a new habitat. The latter often occurs after hurricanes, when lizards and insects are washed across small stretches of water to foreign environments. Sometimes, the environment cannot keep up with the new species, leading to degradation.

Over the years, health outcomes in Cameroon have improved though the country continues to face a heavy burden of both communicable and non-communicable diseases such as malaria, HIV/AIDS, Tuberculosis.  Crude Death rates Rate (DR) among other health outcome indicators though has been declining remained relatively high in Cameroon. Evidence from the World Development Indicators (WDI) of the World Bank is the fact that by 2019, crude death rates were 9.06 per thousand deaths showing a remarkable drop from the 20.5 per thousand deaths in 1966. Also, life expectancy at birth increased from about 50 years in the year 2000 to about 57.6 years in the year 2015 and percentage of population with access to improved sanitation facilities only increased by about 3.6% (from 42.2% in 2000 to 45.8% in 2015) (WDI, 2017). All these improvements are far below the desired levels spelt out in Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs).

Environmental degradation has been found to be a key contributor of some major health problems in Cameroon. Given it major contribution to global warming and the resulting consequences of such climatic changes to human health, such as illnesses, death in children and adults, there is need to empirically investigate the effect of environmental degradation on health outcome in Cameroon. This study on the basis of the various types of environmental degradation such as water and air pollution and on it major consequence climate change, provide the magnitude and direction of their effect on death rates in Cameroon, a case study which may help in developing environmental policies that can complement the existing healthcare policy strategies.

1.3 Research Questions

1.3.1 Main Question

The main question this study intends to answer is “what is the effect of environmental degradation on the death rate as a determinant of health outcome in Cameroon? “Holding other factors like animal extinction and floods constant.

1.3.2 Specific Questions

• How does water pollution affect death rate in Cameroon?
• What effect do air pollution has on death rate in Cameroon?

1.4 Objectives of the Study

1.4.1 Main Objective

The main objective of the study is to examine the effect of environmental degradation on the mortality rate in Cameroon.

1.4.2 Specific objectives

• To examine the effect of water pollution on the death rate in Cameroon.
• To investigate the effect of air pollution on death rate in Cameroon.