Environmental health: what changed since the industrial revolution (19th century)?

Abstract

Why do we still wrestle with the same basic environmental health issues in the 21st century, as determinants of health, which was the stimulus to the origin of environmental health during the industrial revolution (19th century?

The quadruple burden of disease in South Africa and the continued community protests , viewed as a 'rebellion of the poor', signals a concern about the lack of sustainable 'basic municipal services' at local government level, that informs some determinants of health and impacts negatively on viable preventive health outcomes.

What challenges are prohibiting the effective implementation of preventive Environmental Health Services? Is it the 'Psychological distance between the decision maker and the issues?, or / and; Politics; Policies of sectors responsible for negative health outcomes not based on health criteria and / or; Health outcomes not part of local government performance assessment of its powers and functions?