Using the socio-economic costs of health and environmental determinants as a decision-making tool to identify priorities

Context . The health system has begun to engage in a transition following the imperatives of reducing greenhouse gas emissions and improving efficiency in order to tackle climate change. It is estimated that more than 70% of non -communicable diseases may be due to environmental health determinants. It has been hypothesised that by acting on environmental health determinants through health prevention and promotion, it may be possible to reduce the burden on the health system imposed by diseases linked with the environment, thus supporting its resilience and transition. Objectives . The goal of this study is to conduct an analysis of health risks linked to the environment by identifying environmental health determinants, and prioritising them in terms of their socioeconomic cost, as a means of supporting the transition of the healthcare system and facilitating policy -making. Methods . The scoping review method was used to define the scope of environmental health and determinants it encompasses. After selecting relevant databases, data on the health and environmental impacts of those determinants were collected in an analysis frame. The standardised socioeconomic translation of those impacts makes it possible to prioritise those determinants. Results . The environmental health determinants which have the greatest burden on society are noise (<euro>147 B/year), outdoor air quality (<euro>130 B/year), and nutrition and physical activity (overweight/obesity: <euro>20.4 B/year and physical inactivity/sedentary lifestyles: <euro>140 B/year). Other environmental challenges with less detail and using other indicators of exposure and mortality are also to be considered, including: - continental flooding as the leading natural risk in terms of exposure and damage; - severe cold and heat episodes as the deadliest climatic events.