Abstract
Until the 20th century, west European health status was primarily determined by environmental factors, especially hygienic conditions and housing standards. Since the public health transition unfavourable social and life-style factors have gradually become the most significant causes of avoidable health loss. This paper identifies the principal determinants of health, and reviews the changing relative importance of environmental and societal forces for health status. It is concluded that the current situation calls for new definitions of health and well being, as well as for a new demarcation of the field of environmental quality. Environmental health should be part of an integrated, multi-disciplinary, multi-sectoral approach towards deprived urban areas, incorporating policies on socio-economic, spatial and environmental aspects of neighbourhoods. As a consequence, environmental health science should also widen its scope, integrating urban planning, architecture, social psychology, epidemiology, public health and environmental sciences.
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