State of the environment: health, people and the environment research This report by the Environment Agency focuses on the relationship between human health and people’s access to and connection with a clean, high quality natural environment. It presents information on England’s environment, and people’s exposure to environmental pollutants, flooding and climate change in relation to human health. It highlights environmental inequalities that contribute to differences in health outcomes for people in England. Case studies throughout the report demonstrate the role played by the Environment Agency in protecting and enhancing the environment, and how this benefits people’s health. Main findings Air pollution is the single biggest environmental threat to health in the UK, shortening tens of thousands of lives each year. After air pollution, noise causes the second highest pollution-related burden of disease in Europe, and is responsible for more life years lost than lead, ozone or dioxins. There is emerging evidence of health effects from lower levels of pollution, although these are not currently well understood. Antimicrobial resistant microbes are becoming more common in the environment due to contamination, meaning infectious illnesses may become harder to treat. Mental health conditions are increasing - they are the largest single cause of disability in the UK, and can be caused or affected by pollution, flooding and climate change. There is substantial and growing evidence for the physical and mental health benefits of spending time in the natural environment, but children are engaging less with nature. Exposure to pollution, and access to the natural environment are not equally distributed across society - people living in deprived areas often have poorer quality environments with less accessible green space. Equality of access to, and connection with, a healthy natural environment would save billions of pounds in healthcare costs and reduced economic activity every year. There are opportunities to improve health through the choices government, regulators, businesses and individuals make in creating and contributing to healthier, greener and more accessible environments.