Environmental Determinants of Infectious Disease: A Framework for Tracking Causal Links and Guiding Public Health Research

• Type of Material: Article
• Authors: Joseph N.S. Eisenberg, University of Michigan, Ann Arbor; Manish A. Desai, University of California, Berkeley; Karen Levy, Emory University; Sarah J. Bates, University of California, Berkeley; Song Liang, The Ohio State University; Kyra Naumoff, University of California, Berkeley; James C. Scott, University of California, Berkeley
• Language: English
• Date: 2007-05-31
• Publisher: National Institute of Environmental Health Sciences (NIEHS)
• Publication Version: Final Published Version
• Copyright Statement: This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
• Final Published Version (URL): http://ehp.niehs.nih.gov/journal-archive/
• Title of Journal or Parent Work: Environmental Health Perspectives
• ISSN: 0091-6765
• Volume: 115
• Issue: 8
• Start Page: 1216
• End Page: 1223
• Grant/Funding Information: This study was supported by National Institute of Allergy and Infectious Diseases grant RO1-AI050038.
• Keywords: interdisciplinary; system theory; environmental change; infectious disease; transmission dynamics
• Research Categories: Health Sciences, Epidemiology; Environmental Sciences; Health Sciences, Public Health

Abstract

Background Discoveries that emerging and re-emerging pathogens have their origin in environmental change has created an urgent need to understand how these environmental changes impact disease burden. In this article we present a framework that provides a context from which to examine the relationship between environmental changes and disease transmission and a structure from which to unite disparate pieces of information from a variety of disciplines. Methods The framework integrates three interrelated characteristics of environment–disease relationships: a) Environmental change manifests in a complex web of ecologic and social factors that may ultimately impact disease; these factors are represented as those more distally related and those more proximally related to disease. b) Transmission dynamics of infectious pathogens mediate the effects that environmental changes have on disease. c) Disease burden is the outcome of the interplay between environmental change and the transmission cycle of a pathogen. Results To put this framework into operation, we present a matrix formulation as a means to define important elements of this system and to summarize what is known and unknown about the these elements and their relationships. The framework explicitly expresses the problem at a systems level that goes beyond the traditional risk factor analysis used in public health, and the matrix provides a means to explicitly express the coupling of different system components. Conclusion This coupling of environmental and disease transmission processes provides a much-needed construct for furthering our understanding of both specific and general relationships between environmental change and infectious disease.