Environmental determinants

Abstract

Environmental factors contribute in direct and indirect ways to the causes, consequences, and overall burden of injury. In this chapter, we review a range of ways in which the physical and social environments that influence injuries can be conceptualized, from the Haddon matrix through to the social determinants of health, and ecological and life course approaches. Physical characteristics of home, occupational settings, transport infrastructure, and urban and rural environments can constitute hazards and sources of risk to varying levels, interacting with human vulnerabilities exacerbated by ineffectual policies or injury prevention efforts. Globally, as well as within countries, these factors often result in substantial inequities in the incidence and impact of injuries, with more impoverished socially disadvantaged communities bearing a disproportionately high burden. We conclude with examples from the research field that illustrate how environmental influences on injury can be explored and quantified to inform efforts that reduce both the overall burden and inherent disparities.