building health and wellbeing on ecological principles george morris 20 th february 2013
TRANSCRIPT
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Building Health and Wellbeing on Ecological Principles
George Morris
20th February 2013
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• Any modern definition of health and the goals of public health must extend to wellbeing
• Health and wellbeing invariably flow from societies to individuals, not the other way round
• Creating the conditions for health wellbeing is a project for all society
What can we reasonably assert?
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• 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
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For too long we have looked at these issues in our discipline and community silos (whether scientific, policy, professional or stakeholder). The result has
been destruction of the environment, our health and our wellbeing, short and long term – the way forward
has to be the ecological perspective
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Making the case for an Ecological Perspective on Wellbeing
The Principle of Transition
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“A core notion within public health – however defined - is the notion of change ……and the actions of those seeking to improve public health
and wellbeing will vary as circumstances and conditions dictate”
Rayner & Lang (2012)
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In joint interaction, Transitions
- are the Drivers which create and continuously alter the ground on which population health and wellbeing must be built- are the Context which so often translates population level threats into risks for individuals and communities - determine the style of Intervention and the chances of success
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Nutritional
Urban
Demographic
Energy
Economic
Disease
Cultural
Environmental
Nutritional
UrbanDemographic
Energy
Econom
ic
Cultural
Environmental
Epidemiological
Many Transitions are Key for Health and Wellbeing
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Nutritional
Urban
Demographic
Energy
Economic
Disease
Cultural
Environmental
Nutritional
UrbanDemographic
Energy
Econom
ic
Cultural E
nvironmental
Disease
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Making the Case for an Ecological Perspective on Wellbeing
The Environment in Health and Wellbeing
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Policy and action on environment could be much more effectively exploited for better more equal health and wellbeing but only if we developed:
• an enhanced capacity to navigate in complexity
• a recognition in policy of the capacity of good environment to generate good health and wellbeing
• A way to embrace a psychosocial dimension in the relationship between people and their surroundings
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Good Places Better HealthPrototype Phase 2008 -2011(Children’s Health and Environment)Strongly supported by the RERAD–Funded EDPHiS Project,GPBH has produced useful learning around navigating in complexity notably around:
• Evidence• The Science Policy Interface• Stakeholder Engagement
http://www.scotland.gov.uk/Topics/Health/Healthy-Living/Good-Places-Better-Health
http://www.scotland.gov.uk/Topics/Health/Healthy-Living/Good-Places-Better-Health/Approach/Methodology
http://www.edphis.org/
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It has been especially valuable in showing thethe value of Conceptual Models in complex situations as:
1. ‘Tools to think with’
2. ‘Tools to Unify’
3. ‘Tools to Communicate and Engage’
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Supporting
ExperienceExperience
Experience
POLICY and
ACTION
Drivers
Pressures
State of the Environment
Exposure or Experience
Human Health And Wellbeing
Social, economic & environmental etc. context
MODIFIED DPSEEA(Morris et al, 2006)
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Making the Case for an Ecological Perspective on Wellbeing
Planetary Crisis
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A Safe Operating Space for Humanity: Planetary Boundaries
Rockstrom et al (2009)
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Applying an Ecological Perspective in Practice
Developing Ecological Public Health
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HUMAN HEALTH
ECOSYSTEMS HEALTH
“THE DYNAMICS OF ECOLOGICAL PUBLIC HEALTH”
Rayner and Lang (2012)
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Why is Ecological Public Health Different?
• 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”
• EPH is a unifying concept on many levels
Adapted from Rayner and Lang (2012)
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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.
• It does not retreat from complexity … there are no pump handles in this story!
• EPH demands an integration of Environmental Impact Assessment and Health Impact Assessment
Adapted from Rayner and Lang (2012)
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Applying and Ecological Perspective in Practice
Ecosystem Services and Human Wellbeing
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SUPPORTINGNutrient CyclingSoil FormationPrimary Production
PROVISIONINGFoodFreshwaterFuelWoodFibre etc.
REGULATINGClimate Reg.Flood Reg.Water Purif.
CULTURALAestheticSpiritualEducationalCultural
HUMAN SECURITYPersonal SafetySecure Resources etc.Security from Disasters etc
MATERIAL MINIMAAdequate LivelihoodsShelter etc. Fuel, Food, Fibre etc.SOCIAL RELATIONSSocial CohesionMutual Respect Ability to Help others
FREEDOM OF CHOICEOpportunity to achieve what an individual values doing and being
HEALTHStrengthFeeling WellAccess to Clean Air, Water, etc.
Ecosystem Services Link to Wellbeing Through:
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Applying and Ecological Perspective in Practice
Tools To Think With
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POLICY and
ACTION
Human Health and Wellbeing
Through our impact on the
proximal environment
DRIVERS
Though our influenceon ecosystems
TWO PATHWAYS
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Supporting
ExperienceExperience
Experience
POLICY and
ACTION
Drivers
Pressures
State of the Environment
Exposure or Experience
Human Health And Wellbeing
Social, economic & environmental etc. context
DRIVERS TO HEALTH EFFECT VIA THE PROXIMAL ROUTE
MODIFIED DPSEEA(Morris et al, 2006)
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DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTE
Pressures
Ecosystem ServicesRegulating
Provisioning
CulturalSupporting
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)
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Applying and Ecological Perspective in Practice
5 Pillars of Ecological Public Health
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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
AdoptHolistic Issue
Framing
Synthesise a Mixed
Economy of Evidence
Develop an Appropriate
Ethical Framework
Carefully ConsiderInfrastructure
Work to Optimise
Governance
Complexity
Planetary Boundaries
Ecosystem Services
Interconnectivity
etc
Sustainability
Equity
EnvironmentalJustice
Social Justice
etc.
Institutional
Educational
Physical
Transparency
Stakeholder Engagement
Accountability
etc
Qualitative
Quantitative
Experimental
Non-Experimental,
Multiple Sources
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DARWIN’S ENTANGLED BANK
The Entangled Bank