8GHPC HELSINKIEurope Day13.6.2013Revisiting Health in All Policies inTimes of Environmental Crisis:Building Public Health ...
Four public health realities1. So-called socio-ecological complexity has definedthe public health challenge in the develop...
NutritionalUrbanDemographicEnergyEconomicDiseaseCulturalEnvironmentalIn Joint Interaction, Transitions Define and Redefine...
SupportingExperienceExperienceExperienceState of the EnvironmentExposureDiminished Human HealthThe “Classical”Environment:...
SupportingExperienceExperienceExperienceEnvironmental HazardorEnvironmental “Good”Exposure or ExperienceModified Health an...
SupportingExperienceExperienceExperienceEnvironmental HazardorEnvironmental “Good”Exposure or ExperienceModified Health an...
SupportingExperienceExperienceExperienceState of the EnvironmentExposure or ExperienceHuman Health And WellbeingSocial, ec...
SupportingExperienceExperienceExperiencePOLICYandACTIONDriversPressuresState of the EnvironmentExposure or ExperienceHuman...
• The state of the environment, and how it will change inthe future, is intimately connected to our health andwellbeing• C...
A Safe Operating Space for Humanity:Planetary BoundariesRockstrom et al (2009)
Why is Ecological Public Health Different?• EHP reminds those who might think we canplunder, destroy and ignore environmen...
HUMANHEALTHECOSYSTEMSHEALTH“THE DYNAMICS OF ECOLOGICAL PUBLIC HEALTH”Rayner and Lang (2012)
SUPPORTINGNutrient CyclingSoil FormationPrimaryProductionPROVISIONINGFoodFreshwaterFuelWoodFibre etc.REGULATINGClimate Reg...
POLICYandACTIONHuman Health and WellbeingThrough ourimpact on theproximalenvironmentDRIVERSThough ourinfluenceon ecosystem...
SupportingExperienceExperienceExperiencePOLICYandACTIONDriversPressuresState of the EnvironmentExposure or ExperienceHuman...
DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTEPressuresEcosystem ServicesRegulatingProvisioningCulturalSupportin...
A Suggested Goal: A Society in whichhealth, wellbeing, inclusiveness, equity etc. are pursued in a waywhich respects plane...
DARWIN’S ENTANGLED BANKThe Entangled Bank
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George Morris, NHS Health Scotland, United Kingdom

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13.6.2013, Parallel session, Veranda 2

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  • As we speak, Ecosystem Services is not part of the lingua franca of public health. It has power and utility for public health
  • George Morris, NHS Health Scotland, United Kingdom

    1. 1. 8GHPC HELSINKIEurope Day13.6.2013Revisiting Health in All Policies inTimes of Environmental Crisis:Building Public Health on Ecological PrinciplesGeorge Morris
    2. 2. Four public health realities1. So-called socio-ecological complexity has definedthe public health challenge in the developedworld, arguably since the 1970s, and is here tostay2. The aspiration for Health in All Policies has itsroots in this realisation3. A core notion within public health, howeverdefined, is the notion of change4. The art and the science of public health is aboutbuilding population health on shiftingfoundations
    3. 3. NutritionalUrbanDemographicEnergyEconomicDiseaseCulturalEnvironmentalIn Joint Interaction, Transitions Define and Redefine thePublic Health Challenge and How it Can be AddressedDeveloped from Rayner and Lang (2012)
    4. 4. SupportingExperienceExperienceExperienceState of the EnvironmentExposureDiminished Human HealthThe “Classical”Environment: HealthInterface in PublicHealth
    5. 5. SupportingExperienceExperienceExperienceEnvironmental HazardorEnvironmental “Good”Exposure or ExperienceModified Health andWellbeingA more realisticrepresentation?
    6. 6. SupportingExperienceExperienceExperienceEnvironmental HazardorEnvironmental “Good”Exposure or ExperienceModified Health andWellbeingSocial, economic & environmental etc. contextMore realistic still!
    7. 7. SupportingExperienceExperienceExperienceState of the EnvironmentExposure or ExperienceHuman Health And WellbeingSocial, economic & environmental etc. contextState of the Environment
    8. 8. SupportingExperienceExperienceExperiencePOLICYandACTIONDriversPressuresState of the EnvironmentExposure or ExperienceHuman Health AndWellbeingSocial, economic & environmental etc. contextMODIFIED DPSEEA(Morris et al, 2006)More Realisticand Policy Relevant
    9. 9. • The state of the environment, and how it will change inthe future, is intimately connected to our health andwellbeing• Climate change, biodiversity loss, pollution, waterissues and food security are already undermininghealth and wellbeing nationally and globally• in terms of "re-thinking" things as a society, we can nolonger consider health, wellbeing and health serviceswithout thinking about the environmentThe New Environmental Public Health Imperative
    10. 10. A Safe Operating Space for Humanity:Planetary BoundariesRockstrom et al (2009)
    11. 11. Why is Ecological Public Health Different?• EHP reminds those who might think we canplunder, destroy and ignore environment thatecological forces underpin all life.• EPH posits that human (social) ecology is inextricablelinked to natural ecology and in dynamic interactionwith it• Unlike previous expressions of the environmentalcontribution to health and wellbeing, environment isno longer an “out there”Adapted from Rayner and Lang (2012)
    12. 12. HUMANHEALTHECOSYSTEMSHEALTH“THE DYNAMICS OF ECOLOGICAL PUBLIC HEALTH”Rayner and Lang (2012)
    13. 13. SUPPORTINGNutrient CyclingSoil FormationPrimaryProductionPROVISIONINGFoodFreshwaterFuelWoodFibre etc.REGULATINGClimate Reg.Flood Reg.Water Purif.CULTURALAestheticSpiritualEducationalCulturalHUMAN SECURITYPersonal SafetySecure Resources etc.Security from Disasters etcMATERIAL MINIMAAdequate LivelihoodsShelter etc.Fuel, Food, Fibre etc.SOCIAL RELATIONSSocial CohesionMutual RespectAbility to Help othersFREEDOM OF CHOICEOpportunity to achieve whatan individual values doingand beingHEALTHStrengthFeeling WellAccess to Clean Air, Water, etc.Ecosystem Services Link to Wellbeing Through:
    14. 14. POLICYandACTIONHuman Health and WellbeingThrough ourimpact on theproximalenvironmentDRIVERSThough ourinfluenceon ecosystemsTWO PATHWAYS
    15. 15. SupportingExperienceExperienceExperiencePOLICYandACTIONDriversPressuresState of the EnvironmentExposure or ExperienceHuman Health AndWellbeingSocial, economic & environmental etc. contextDRIVERS TO HEALTH EFFECT VIA THE PROXIMAL ROUTEMODIFIED DPSEEA(Morris et al, 2006)Morris et al ( 2006)
    16. 16. DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTEPressuresEcosystem ServicesRegulatingProvisioningCulturalSupportingExperienceDeterminants of healthand wellbeingSupportingDriversPOLICYandACTIONHuman Health AndWellbeingFreedom of ChoiceSocial RelationsSecurityMaterial MinimaExperienceSocial, economic & environmental etc. contextECOSYSTEMS ENRICHEDDPSEEA(Reis, S., Morris, G et al, 2013 in press)
    17. 17. A Suggested Goal: A Society in whichhealth, wellbeing, inclusiveness, equity etc. are pursued in a waywhich respects planetary boundaries and creates and protects a safean operating space for humanity and the species with which we sharethe planet5 PILLARS OF ECOLOGICAL PUBLIC HEALTHAdoptHolistic IssueFramingSynthesise aMixedEconomyof EvidenceDevelop anAppropriateEthicalFrameworkCarefully ConsiderInfrastructureWork toOptimiseGovernanceComplexityPlanetaryBoundariesEcosystemServicesInterconnectivityetcSustainabilityEquityEnvironmentalJusticeSocial Justiceetc.InstitutionalEducationalPhysicalTransparencyStakeholderEngagementAccountabilityetcQualitativeQuantitativeExperimentalNon-Experimental,Multiple Sources
    18. 18. DARWIN’S ENTANGLED BANKThe Entangled Bank

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