September 2015, the United Nations promulgated the “Sustainable Development Goals” (or SDGs), which reflect how the concept of sustainability has evolved to embrace overlapping environmental, economic and social dimensions. SDG 3 focuses specifically on health and health equity – “to ensure healthy lives and promote well-being for all at all ages,” SDG 10 on reducing inequalities, and the SDG agenda for 2030 overall explicitly recognizes and describes the inter-dependency among and across all 17 of its goals. The World Health Organization’s strategic plan for 2019 to 2023, and the work of the United Nations more generally, focus in particular on two related SDG themes: achieving universal health coverage and “leaving no one behind.” Each of these requires attention not only to the environmental and economic determinants of health, but the social and political factors that fuel the interplays between power and poverty, and ultimately drive mobility and the sustainability of positive change.
Poor people already pay the highest price for environmental degradation, as they are far more likely to live in less resilient regions and neighborhoods and have fewer resources to cope with the impacts of short- and long-term changes to their environment. In addition to creating financial and geographic barriers to accessing health services, poverty undermines nutrition, exacerbates stress, increases exposure to toxins and unsafe work environments, and increases the likelihood of inadequate shelter and poor sanitation. In turn, poor health exacerbates poverty, most directly by increasing out of pocket expenditures on health care, increasing the burden of care within poor households and reducing the ability to work, and indirectly by fueling migration, which can undermine health, for example, by increasing exposure to health hazards, as well as mental health concerns including those resulting from reduced access to health services due to discrimination on arrival in a new destination.
USC IIGH has already sponsored foundational research and teaching at the intersection of these important issues, including attention to the health impacts of access to justice and racial and ethnic polarization.
Over the next five years, the Institute will prioritize work that is focused on the intersection of these issues with one another, including the relative roles of both domestic and foreign policy in mitigating health risks from climate change and poverty related migration; how to reduce both exposure to and health consequences of racism, xenophobia and legacies of racial and ethnic inequality; as well as drawing on its extensive methodological expertise to evaluate the health and social impacts of different community and institutional approaches to building resilience.