Environmental Health

Introduction

Recognise : Making the invisible, visible

The Sensory Gap Problem: 

• Humans evolved to respond to immediate, visible threats (predators, fire, contaminated food) 

• Environmental health threats operate below sensory thresholds 

• E.g. Research from Bangladesh shows citizens' perception of air quality correlates poorly with actual measurements 

Theories:

Risk Perception Theory: 

• Risk perception requires both cognitive understanding AND emotional salience 

• The "risk perception paradox": High awareness ≠ protective action without perceptual availability 

Availability Heuristic: 

• People judge probability by ease of recall/imagination

 • Invisible threats are cognitively "unavailable" → systematically underestimated 

Protection Motivation Theory: 

• Threat appraisal requires perceived severity AND vulnerability 

• Without sensory detection, both remain abstract concepts

Sensory Detection 

• Direct sensing: Using human senses when possible
• Proxy indicators: Observable signs that correlate with invisible threats
• Technology aids: Monitors, apps, and measurement tools
• Biological markers: Health symptoms that indicate exposure

Engage: Motivating knowledge

The Awareness-Action Gap 

• Information alone rarely changes behaviour 

• Environmental health competes with immediate survival needs 

• Emotional connection drives prioritization 

Theories 

Value-Belief-Norm Theory (Stern, 2000) 

• Personal values → beliefs about consequences → moral obligation → action 

• Environmental concern correlates only modestly with behaviour 

• Need emotional activation of existing values 

Risk-as-Feelings Theory (Loewenstein et al., 2001) 

• Emotional reactions to risk often diverge from cognitive assessments 

• Affect heuristic: Feelings guide judgments more than analysis 

• Vividness, proximity, and similarity trigger stronger emotional response 

Construal Level Theory (Trope & Liberman, 2010) 

• Psychological distance affects prioritization (temporal, social, spatial) 

• Distant/abstract threats = low priority; Near/concrete = high priority 

• Reducing psychological distance increases engagemen

Act: Taking action

The Intention-Action Gap 

• 70% of motivated people fail to sustain new behaviours 

• Knowledge + motivation ≠ action without capability 

• Skills, confidence, and support systems essential 

Theories 

COM-B Model (Michie et al., 2011) 

• Capability (physical/psychological) + Opportunity + Motivation = Behavior 

• COM-B based cookstove intervention in Uganda resulted in 72,535 improved cookstoves sold, achieving 36% reduction in fuel consumption 

• Application: Address all three components systematically 

Protection Motivation Theory (PMT) 

• Response efficacy: Belief that the action will work 

• Self-efficacy: Confidence in ability to perform the action 

• Response costs: Barriers to performing the action 

Protective Action Decision Model (PADM) (Lindell & Perry, 2004) 

• Covers the full decision-to-implementation pathway 

• Protective action search: Finding feasible options 

• Protective action assessment: Evaluating options 

• Protective action implementation: Actually doing it

Context: Structural Conditions

The Structure -Agency Gap 

• Individual agency operates within structural constraints 

• Protective behaviours require enabling conditions 

• Knowledge + motivation ≠ action without supportive context 

Theories 

Social Ecological Model (Bronfenbrenner) 

• Individual behaviour nested within multiple system levels 

• Environmental factors shape behavioural possibilities 

• Structural interventions have cascade effects across levels 

Capability Approach (Sen, 1999) 

• Distinction between capabilities and functions • Resources + conversion factors = real opportunities 

• Context determines what behaviours are actually possible

Habit: Creating lasting change 

Action Over Time and interacting with structure 

• Conscious decision-making is cognitively taxing 

• Competing priorities erode initial motivation 

• Protection behaviours require constant willpower without habit 

Theories 

Dual Process Theory (Kahneman, 2011) 

• System 1 (automatic) vs System 2 (deliberative) thinking 

• Habits shift behaviour from effortful System 2 to automatic System 1 

• Environmental cues trigger responses without conscious decision 

Habit Loop Model (Duhigg, 2012) 

• Cue → Routine → Reward creates neurological patterns 

• Habits formed in stable, consistent environments are more likely to become automatic Repetition in consistent contexts builds automaticity

3 Communication Guide have been developped based on the REACH Framework. 

• Lead Poisoning Prevention Message Guide
• Air Pollution Prevention Message Guide
• Extreme Heat Prevention Message Guide