1) Public health realities are increasingly complex due to socio-ecological factors like nutrition, urbanization, demographics, energy, economics, disease, and culture interacting with the environment.
2) The document discusses how the environment is intimately connected to human health and wellbeing, and climate change, pollution and other environmental issues are undermining health.
3) It proposes that public health must consider the environment and that human and ecosystem health are interlinked, in that human activities impact ecosystems and the services they provide that determine wellbeing.
2. Four public health realities
1. So-called socio-ecological complexity has defined
the public health challenge in the developed
world, arguably since the 1970s, and is here to
stay
2. The aspiration for Health in All Policies has its
roots in this realisation
3. A core notion within public health, however
defined, is the notion of change
4. The art and the science of public health is about
building population health on shifting
foundations
9. • The state of the environment, and how it will change in
the future, is intimately connected to our health and
wellbeing
• Climate change, biodiversity loss, pollution, water
issues and food security are already undermining
health and wellbeing nationally and globally
• in terms of "re-thinking" things as a society, we can no
longer consider health, wellbeing and health services
without thinking about the environment
The New Environmental Public Health Imperative
10. A Safe Operating Space for Humanity:
Planetary Boundaries
Rockstrom et al (2009)
11. Why is Ecological Public Health Different?
• EHP reminds those who might think we can
plunder, destroy and ignore environment that
ecological forces underpin all life.
• EPH posits that human (social) ecology is inextricable
linked to natural ecology and in dynamic interaction
with it
• Unlike previous expressions of the environmental
contribution to health and wellbeing, environment is
no longer an “out there”
Adapted from Rayner and Lang (2012)
13. SUPPORTING
Nutrient Cycling
Soil Formation
Primary
Production
PROVISIONING
Food
Freshwater
Fuel
Wood
Fibre etc.
REGULATING
Climate Reg.
Flood Reg.
Water Purif.
CULTURAL
Aesthetic
Spiritual
Educational
Cultural
HUMAN SECURITY
Personal Safety
Secure Resources etc.
Security from Disasters etc
MATERIAL MINIMA
Adequate Livelihoods
Shelter etc.
Fuel, Food, Fibre etc.
SOCIAL RELATIONS
Social Cohesion
Mutual Respect
Ability to Help others
FREEDOM OF CHOICE
Opportunity to achieve what
an individual values doing
and being
HEALTH
Strength
Feeling Well
Access to Clean Air, Water, etc.
Ecosystem Services Link to Wellbeing Through:
14. POLICY
and
ACTION
Human Health and Wellbeing
Through our
impact on the
proximal
environment
DRIVERS
Though our
influence
on ecosystems
TWO PATHWAYS
16. DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTE
Pressures
Ecosystem Services
Regulating
Provisioning
Cultural
Supporting
Experience
Determinants of health
and wellbeing
Supporting
Drivers
POLICY
and
ACTION
Human Health And
Wellbeing
Freedom of Choice
Social Relations
Security
Material Minima
Experience
Social, economic & environmental etc. context
ECOSYSTEMS ENRICHED
DPSEEA
(Reis, S., Morris, G et al, 2013 in press)
17. A Suggested Goal: A Society in which
health, wellbeing, inclusiveness, equity etc. are pursued in a way
which respects planetary boundaries and creates and protects a safe
an operating space for humanity and the species with which we share
the planet
5 PILLARS OF ECOLOGICAL PUBLIC HEALTH
Adopt
Holistic Issue
Framing
Synthesise a
Mixed
Economy
of Evidence
Develop an
Appropriate
Ethical
Framework
Carefully Consider
Infrastructure
Work to
Optimise
Governance
Complexity
Planetary
Boundaries
Ecosystem
Services
Interconnectivity
etc
Sustainability
Equity
Environmental
Justice
Social Justice
etc.
Institutional
Educational
Physical
Transparency
Stakeholder
Engagement
Accountability
etc
Qualitative
Quantitative
Experimental
Non-
Experimental,
Multiple Sources