Environmental risk factors cause about one quarter of deaths world-wide, amounting to 13 million deaths each year. Ambient and household air pollution together cause 7 million deaths per year. 829,000 annual deaths still results from easily preventable risks linked to poor water, sanitation and hygiene. A large fraction of malaria, dengue and other vector diseases are closely linked to aquatic environments. Adverse health impacts from chemicals are continuously identified. Over half of the world population live in urban areas, which will increase to over 70% by 2050. The threats of climate change to health are multi-faceted and rapidly increasing in intensity. A transformative approach is needed to address environmental risks to health at their root, at the level of policy setting, in an integrated way. Sectors which define policies highly impacting on population health include the energy, transport, land use planning, housing, water and sanitation, labour and industry. Accumulating evidence on impacts and solutions and the Sustainable Development Goal (SDG) Agenda are creating the opportunity for change. Evidence on notable successes from solutions to critically reduce this burden has increased, and is showing high returns from investments in safer environments. Our vision is an overarching framework and set of governance mechanisms and leadership for health, and stepped up, broad intersectoral stakeholder engagement and action to implement health-supportive policies. Such actions are to be based on a solid evidence base of health impacts and solutions, and informed by regular monitoring and tracking. New research connected to interventions in health-relevant areas, implementation science and participatory policies are necessary to accelerate the attainment of the SDGs. Research, together with strengthened advocacy, communication and awareness raising around the co-benefits from actions on health, environment and climate change is essential to trigger for long-term sustainable solutions.
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