This document summarizes the work of the HEAL (Health and Ecosystems: Analysis of Linkages) program. It discusses how environmental change can impact human health through changes in wildlife populations, food supply, and nutrient intake. Specifically, it presents a case study on how wildlife declines in Madagascar are linked to increased malnutrition. It outlines the HEAL methodology which involves collecting dietary, health, and biological data. The results indicate strong reliance on wild foods and associations between consumption of bushmeat and improved nutrition. The document emphasizes the importance of ecosystems for nutrition and highlights mortality risks from malnutrition.

1. Christopher Golden PhD, MPH
Director of HEAL, Wildlife Conservation Society
Harvard School of Public Health
ATBC 7-13-2015
Ecosystem Change and Human Health:
An Overview of the HEAL Program

2. Environmental Change as
Public Health Risk

3. • Wildlife population collapse
Environmental
Change
• Reduced access to
animal-source foods
Changes in Food
Supply
• Micronutrient and vitamin
intake decreases
Changes in Nutrient
Intake
• Increased incidence of
nutritional deficienciesHealth Impacts

4. Makira Region, NE Madagascar

5. 0%
10%
20%
30%
40%
50%
60%
70%
Stuntingprevalence(%)
An Environment of Chronic Malnutrition

6. Global Prevalence of Anemia

7. Forest Foods

8. Wildlife Consumption

9. 0
0.2
0.4
0.6
0.8
1
1.2
0 1 2 3 4 5 6 7 8 9 10
PredictedIncreasein
HemoglobinConcentrations
(g/dL)
Annual Individual Wildlife Consumption (kg)
Median Consumption
75th Percentile

10. Reliance on Wild Foods
• More than 280 different food items consumed over 1 year (142 hh)
• 8 items purchased from stores
• 24 mammalian bushmeat species, 22 wild bird species
• Mean household bushmeat consumption is 7.4kg per year
• A quarter of households consume 200g of bushmeat per week
• Some households are consuming nearly 70kg of busmeat in a year,
the equivalent of a single household receiving 12 quarter-pounder
burgers per week from the forest
• Mean proportion of bushmeat to total meat consumption is 13%
while in some households it comprises 75% of all meat consumption

11. Health Methodology
1
• Dietary calendars
• Socio-economic surveys
• Pharmaceutical use records
2
• Current health status
• Anthropometry
• Fingernail samples
3
• Blood samples (fasted)
4
• Fecal samples
• Breast milk samples (fasted)
CONTINUOUS
NIGHT BEFORE
CLINICAL VISIT
FIRST / LAST

12. Clinical Diagnostics

13. Biological Samples

14. Ultimate risk factors of mortality

15. Effects of malnutrition on
brain development and cognition
Source: Cordero E et al, 1985 (Adapted from Figure 2 & Figure 4), Benıtez-Bribiesca et al. 1999 (Adapted
NormalMalnourished
Normal
brain cells
Extensive
branching
Impaired
brain cells
Limited
branching

16. Mortality attributed to malnutrition
0%
10%
20%
30%
40%
50%
60%
70%
Diarrhea
deaths
Pneumonia
deaths
Measles
deaths
Malaria
deaths

17. Outline
1. Methodological Framework
2. Case Study:
Wildlife Declines and Food Security
3. Ongoing Research
Fishery Declines and Food Security
Roadmap

18. Eco-Epidemiology Ecosystem Services Nutritional Epidemiology
Climate Ocean Fisheries Catch Human Development
Science Health Ecology Histories Geography Economics

19. Importance of Marine Fisheries to Nutrition
0
10
20
30
40
50
60
70
80
90
100 Omega-3 Vitamin B12 Vitamin A Protein Iron Zinc Calories
Contributionofwildcapturefish
tototalnutrientintake(%)

20. Thank You!
• Sam Myers, Walter Willett, Anu Shankar, Steve Osofsky
• Ben Rice, Danny Milner, Sarah Volkman, Dan Hartl
• Lia Fernald, Claire Kremen, Justin Brashares
• Evelin Jean Gasta Anjaranirina and Luciano Tantely
• Herlyne Ramihantaniarivo