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INTRODUCTION
The 30th anniversary of Ciência e Saúde Coletiva brings the challenge of tracing the paths taken and pointing to the future. Among the many distinguished associate editors invited to discuss these issues in the several Collective Health fields, as associate editor, I was called in to discuss the relationship between Health and Environment within this important scientific journal.
Upon its 20th anniversary in 2015, the journal published an article by its editors Maria Cecília de Souza Minayo and Romeu Gomes, in which they discussed the role of Ciência e Saúde Coletiva in disseminating knowledge in Brazil and abroad, the new challenges faced at the time, and the Journal’s task to consolidate Collective Health. At the time, they considered that the issue that had arisen when the Journal was created in 1996 regarding why ABRASCO (Brazilian Collective Health Association) should have a scientific journal had been overcome. They emphasized that, in 2015, the challenges were two points of promising tension: the commitment to the Unified Health System (SUS) and the scaled-up internationalization of the knowledge that the journal disseminated. There was an apparent concern among the editors with health as a public good, in this case, still primarily focused on the provision of health services to the Brazilian population at different care levels, given that the SUS is a Brazilian health system. Internationalization was instead related to the “national movement of internationalization and adherence to advances in theories, technologies, and practices of scientific dissemination and their challenges in the short term, which includes everything from the simplest standardization processes to the heated discussion of the parameters for measuring the impact of the texts published in it” [1] (p. 2015).
Minayo and Gomes [1] comment that when the journal was created, authors were invited to participate in its construction with the publication of articles. They highlighted its focus:
“Without leaving out the contribution of the hard core of thought in the field, which traditionally gathers epidemiology, planning, and social sciences, it has since integrated the multiple perspectives from other disciplines, such as oral health, history, demography, nursing, physical education, physiotherapy, speech therapy, social psychology, and psychiatry, as long as they are oriented towards the analysis and evaluation of health problems and quality of life of the Brazilian population.” [1](p. 2015).
This quote shows the Journal’s primary focus on health sciences and the lack of concern for environmental issues or even global health; in other words, for all peoples of the world. The editors did not mention environmental health and global health.
However, when surveying the topics published in articles in the first 20 years of the Journal’s existence, Minayo and Gomes [1] (p. 2017) state that the fourth-most published topic was Health and Environment, with 7% of the articles (67 articles). They recalled the intense and effervescent debate on environmental issues in the world and Brazil since the late 1980s and early 1990s, when Rio de Janeiro hosted the United Nations Conference on Development and Environment, ECO 92, popularly known as Rio 92, in 1992. Apparently, environmental issues have been slowly, without fanfare or a defined editorial policy, inserted into the thematic and academic content of Ciência e Saúde Coletiva. The distance between public health researchers and environmental issues was almost universal in the country and is reflected in other published statistics [1].
“Approximately 21% of the 70 articles on Public Health and the Environment available in SciELO on March 19, 2015, were published by Ciência e Saúde Coletiva, which then ranked first among the main Public Health journals” [1] (p. 2017).
In 2020, when Ciência e Saúde Coletiva celebrated its 25th anniversary, a special issue of the event featured the article Health and Environment in the 25 years of Ciência e Saúde Coletiva, led by physician and researcher Nelson Gouveia [2], co-authored with several other authors, with prominent performance on the subject. In this article, the authors surveyed all previous issues of the Journal and identified 248 articles in the Health and Environment interface, which represented 5% of production over 25 years. Although they highlighted the growing relevance of the topic within ABRASCO, noteworthy is the declining interest in other topics, with a drop from 7% to 5%.
Environmental Health is a relatively recent field of Public Health, dating back to the second half of the 20th century. However, as a field of knowledge, its origins date back more than 2,000 years, when Hippocrates, in Ancient Greece, wrote the work Air, Water, and Places. The definition of Environmental Health has evolved, even within the World Health Organization, reflecting the concerns of societies and the scientific community. The concept also depends on the institution that uses it and the objectives it aims to achieve. Among the definitions, the following stand out:
• From the World Health Organization, 1972: Environmental Health concerns the control of all physical, chemical, and biological processes, influences, and factors which exert or may exert, directly or indirectly, a significant effect on the physical, mental, or social well-being of man and his society;
• From the World Health Organization, 1989: Environmental Health comprises those aspects of human health and disease that are determined by environmental factors. It also refers to the theory and practice of assessing and controlling environmental factors which may potentially affect health;
• From the World Health Organization, 1993, in the Sofia Letter: Environmental Health is all those aspects of human health, including the quality of life, which are determined by physical, chemical, biological, social, and psychological factors of the environment. It also refers to the theory and practice of assessing, correcting, controlling, and avoiding environmental factors that may potentially harm the health of present and future generations.
These three definitions from the same institution allow us to see how the concept evolved. In the 1970s, concerns focused on the physical, chemical, and biological processes that could affect the well-being of man and society. The definition was limited to the diagnosis of situations. There was still no reference to the role of this science in preventing environmental factors that caused harm to health. In the 1980s, there was a focus on establishing theory and practice to assess and control environmental factors that were harmful to health, following scientific and technological advances in pollution control in several elements of the environment. Finally, in the early 1990s, an apparent influence was seen from the 1992 United Nations Conference on Environment and Development, when the term sustainable development, coined in the Brundtland Report, became popular as that which meets the needs of present generations without harming future generations. Other important points of the 1993 definition are the inclusion of psychological aspects of the environment and the term quality of life, thus expanding the scope of Environmental Health and the reference to prevention (avoidance). Thus, we observe a higher complexity of the term and the areas of action that contribute to environmental health [3], besides its commitment to the present and the future. Another point to highlight is that the disease is no longer the primary focus, although it is still very present in more current definitions.

The American Public Health Association website defines it as follows: Environmental health is the branch of public health that focuses on the relationship between people and their environment. It promotes human health and well-being and aims for healthy and safe communities. According to the association, environmental health is a key component of any comprehensive public health system, ensuring that everyone has a safe place to live, learn, work, and play.
However, Black, Indigenous, people of color and low-income communities are disproportionately burdened by environmental health risks, systemic and structural racism, and disinvestment, negatively impacting their health and well-being. The field of Environmental Health promotes policies and programs that reduce exposure to chemicals and other environmental products in air, water, soil, and food [4].
In Brazil, ABRASCO only recognized the importance of organizing a thematic “Health and Environment” WG at the Fifth Brazilian Congress of Epidemiology in 2002, six years after the creation of the journal Ciência e Saúde Coletiva. The WG’s objective was “to participate in a more organized way in the fight for sustainable development, through political action in Collective Health, in search of healthy environments and the promotion of health” [5]. The group recognized two principal axes for the development of health and environmental policies: Development/sustainability focused on intersectoral and interdisciplinary actions and actions in health and environment of a more sectoral nature [6].
Production in Health and Environment in the journal Ciência e Saúde Coletiva in the last 10 years
The Journal’s Editorial Board computed the production of articles in the Health and Environment axis based on the Total Report of Articles by Area of Knowledge from March 2014 to 2024. During this period, the total number of articles received by the Journal that were not discarded by the Editors-in-Chief in an initial evaluation and forwarded to associate editors of the Journal’s different thematic areas totaled 14,923 manuscripts.
Of these, 540 articles were sent to associate editors in the Health and Environment, representing 3% of the production received. Apparently, despite a greater production, there was a proportional drop/decline in articles submitted in the Health and Environment knowledge field, from 7% between 1996 and 2015 to 3% in the last decade. This situation occurred in deteriorated environmental issues, with accelerated climate change, natural and man-made disasters, and enormous impacts on public health. Only 81 of the articles submitted were approved for publication, including articles authored by associate editors at the time in thematic issues.
The question is, then, why is there such a distance from the theme of Health and Environment in one of the most relevant Brazilian Collective Health journals or Brazilian Collective Health, represented by ABRASCO and the CAPES (Higher Education Support Coordination) area of the Ministry of Education? Or why do Environmental Health researchers not direct their publications to the Journal?
Studies published in the middle of the last decade have shown that 23% of all deaths worldwide and 26% of deaths among children under five are due to preventable environmental factors. The leading causes of death related to these environmental factors are stroke, ischemic heart disease, cancer, diarrhea, and respiratory infections. People in low-income countries bear the most significant burden of these diseases [7].
These data supported decisions by heads of state who, in 2015, adopted the Sustainable Development Goals – SDGs as the main policy of the United Nations for 2030. These SDGs are based on intense intersectoral action to create healthier environments and improve the lives of millions of people around the world. The following section analyzes the articles published annually in the journal Ciência e Saúde Coletiva in the Health and Environment thematic axis to identify the evolution of the themes addressed in the Journal by Collective/Public Health researchers.
Health and Environment topics covered in articles published in Ciência e Saúde Coletiva
In May 2025, the author of this manuscript searched the Journal’s website to retrieve articles published in the Health and Environment thematic axis. The search was conducted by reading the titles of articles published in all issues of the Journal since 2015. A total of 99 articles were identified in the Health and Environment thematic axis over 10 and a half years. This number is slightly higher than that found by the Journal’s editorial team, as some may have been forwarded to another associate editor, other than the Health and Environment editor, since this is a cross-cutting theme.
In 2015, 10 articles were published under the Health and Environment editorial section, with a greater focus on socioenvironmental aspects, such as homicides, transport accidents, alcohol use and unprotected sex, home care, participatory diagnosis in the vicinity of a petrochemical complex, fires in the Amazon (one of the few recurring themes), Aedes aegypti strains, and one in a more technological aspect on the use of fuzzy models to assess length of hospital stay for cardiovascular diseases.
In 2016, a special issue was published on environmental issues related to water and health and environmental education, including the availability of phosphorus in water due to the use of detergents, the potability of recreational water use, fluoridation in water supplies, and underwater sewage outfalls to reduce health risks.
In 2017, a thematic issue on Surveillance published two articles on pesticides: one on genetically modified organisms and one on social knowledge regarding drinking water preferences.
In 2016 and 2017, 11 articles were published, with some new free themes, such as the environmental influence on physical disability, the burden of mild mental retardation attributed to prenatal exposure to methyl mercury in the Amazon, the struggle of Indigenous peoples for health in environmental conflicts, the influence of socio-environmental conditions on high blood pressure in riverside communities in the Amazon, and climate variables in the prevention of acute respiratory infections. The most theoretical article is the FPSEEA model in the management of health services.
Nine articles were published in 2018, and most were on the health effects of chemical contaminants: mercury in riverside communities in the Amazon, fluoride in children in the semiarid region, NO2 in children in Rio de Janeiro, pesticides in students and their families in Friburgo (RJ), and phosphorus in water. In addition, one article addresses disposal in an area of Rio de Janeiro, one discusses socioenvironmental influences on high blood pressure among riverside residents, and two discuss conceptual aspects, especially the 2030 Agenda.
In 2019, 11 articles were published in Health and Environment. Three addressed the health effects of air pollution, four addressed the effects of pesticides on water and rural workers, two addressed urban solid waste as a risk factor for dengue fever and as a risk to workers in recycling warehouses, and two focused on managerial aspects, such as social control and the action of municipal councils in sanitation policies.
In 2020, 12 articles were published on Health and Environment. One, already mentioned, takes stock of the Journal’s production of articles on the subject. Others address a variety of subjects: three on sanitation and its relationship with arboviruses, leishmaniasis, and Indigenous health, four on chemical pollution, one on natural disasters, one on snakebite, one on the effects of noise, and one on the influence of climate on asthma. Two of these articles address locations other than Brazil (India and Mexico).
In 2021, vol. 26, no. 10, had as its special theme: Science in the face of contemporary global health issues. The featured article was “Global health and planetary health: perspectives for a transition to a more sustainable world post COVID-19”, which provides a global view of the topic, unlike the articles frequently published in the Journal, which address local and territorialized issues. In total, 14 articles focused on Environmental Health. In addition to this, we had articles on emergencies and disasters, climate change and production changes, floods, two on the effects of pesticides, one on suicidal ideation, exposure to metals, and oil spills, and some have a more qualitative focus on community participation and behaviors.
In 2022, 10 articles were published on the axis. Of these, five addressed climate change, or aspects of the climate that affect health, two addressed the effects of pesticides, one addressed the effects of mercury on children and adolescents in the Amazon, one analyzed the coverage and quality of the water supply in different regions of the country, and one highlighted conflicts and socioenvironmental vulnerability in sugarcane areas.
In 2023, 10 articles were published emphasizing the topic of sanitation (five articles), possibly motivated by the process of granting sanitation companies to the private sector in the country. The remaining articles addressed the risks of pesticides, urban agriculture, food systems in Brazil, Colombia, and Panama, waste from discarded medicines, and widespread surveillance.
The year 2024 surprisingly saw only three articles on the subject, a year with catastrophic environmental disasters in Brazil: the historic floods in Rio Grande do Sul, the unprecedented drought, and the low level of rivers in the Amazon, with incalculable impacts on health and health services. The articles published addressed biodiversity and health, one on access to drinking water in the Amazon and one on the effects of pesticides on indigenous communities. There is a lack of readiness on the part of researchers and the Journal to address quickly huge Public Health and environmental crises.
In 2025 (vol. 30, n. 1), we had a thematic issue on Health and Sustainability, with five articles. The topics covered were water population, health and environment in the lower Amazon, impacts of municipal policies and plans on fundamental sanitation indicators, the relationship between temperature and environment in hospitalizations due to respiratory diseases in Cuiabá, socio-environmental determination of health in sugarcane-producing territories in Pernambuco, and the association between occupational exposure to pesticides and ototoxicity in Pontal do Paranapanema, São Paulo.
Current and future challenges
In the last 10 years, no year reached the total number of articles published in 2012, when 31 articles on the subject were published by the Journal, reflecting the 20th anniversary of the Rio+20 Conference on Environment and Development, held in Rio de Janeiro, with significant celebrations. However, in 2013, we observed a decline in the interest of the Journal’s authors in environmental health issues, as only five articles were published on the health and environment interface. Also, in 2014, only one special issue, on natural disasters and their impacts on the health sector, with 12 articles, was dedicated to this health and environment interface.
Almost every year, there are fewer articles on Environmental Health than the number of volumes of the journal (12 per year). The topic has still been very timidly included in the Journal. The editors’ efforts, with thematic calls and special issues, have attracted a more significant number of studies, but the momentum soon runs out due to free demand.
Somehow, the thematic analysis revealed an evolution of the themes and a greater broadening of their understanding, with greater weight given to social aspects, as is the Journal’s tradition, an expanded inter- and multidisciplinarity, but still far from the potential and the current need. The current environmental emergency that is outlined in the future has not yet resonated in the scientific production of this field. The relevant aspect of Environmental Health of showing solutions was also lukewarm in comparison to diagnoses and criticisms.
One of the most prominent themes in recent years has been chemical pollution, which is very much in the North American tradition, especially the impact of pesticides on health. Concerns about pesticides are very aligned with ABRASCO’s position on questioning the intensive use of pesticides in Brazil, the world’s largest consumer of the product. We have also seen recurrent studies on the impacts of mercury and poor water quality on riverside populations in the Amazon. Large-scale and long-term research groups may have chosen to publish their research results in the Journal, hence the recurrence of some themes and the absence of others.
Given the magnitude of air pollution as a global environmental health problem, the issue is addressed rather timidly in the Journal, with no significant concern for vehicle traffic and urban mobility, the leading causes of this pollution. The relationship between climate and health itself has only recently and belatedly appeared as a subject of research in the Journal, bearing in mind that the Paris Climate Agreement dates back to 2015. Few articles address the important issue of climate and health in climate change.
In the field of internationalization, despite advances in international indexing, the increased classification to A1, the maximum grade received by CAPES, and the publication of several articles in other languages, the published research still primarily refers to locations, cities, states, regions and, when broader, Brazil.
The production of scientific evidence portrayed in Ciência e Saúde Coletiva is to be celebrated and praised, as it supports more effective policies and programs and contributes to reducing health inequity in the country. However, from the perspective of Planetary Health and Global Health, a look at the search for sustainability of the planet and health equity in the world also requires a glance at major global issues and the learning and exchange of experiences with other places and populations worldwide.






REFERENCES
1. Minayo, M.C.S; Gomes, R. Ciência e Saúde Coletiva no contexto nacional e internacional da divulgação científica. Ciência e Saúde Coletiva, vol. 20 (7): 2013-2022, 2015.
2.Gouveia, N.; Augusto, L.G.S; Carneiro, F. F.; Franco Neto, G.; Kuhn, M.; Miranda, A.C.; Castro, H.A.; Câmara, V.M.; Tambellini, A.M. A Saúde e Ambiente nos 25 anos da Ciência e Saúde Coletiva. Ciência e Saúde Coletiva, vol. 25, n. 12, dez. 2020.
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4. APHA – American Public Health Association. www.apha.org/topics-and-issues/environmental-health. Acesso em: 23 de maio de 2025.
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7. WHO- World Health Organization. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. Environmental Health. Acesso em: 12 de Abril de 2017.