Ecosystem Crises Interactions. Merrill Singer
to readers the true and pressing dangers of anthropogenic environmental destruction and motivating them to action. Most desirably, it will be a book of the sort Mary Harris “Mother” Jones (1837–1930), a beloved activist and union organizer who was committed to pushing the world in a certain direction, had in mind when she advised, “Sit down and read. Educate yourself for the coming conflicts” (quoted in Fetherling 2010).
1.3 Three alternative approaches to health and the environment
There is a wealth of evidence connecting ecosystem change with human and nonhuman health impacts. The following discussion of this relationship is organized around the examination of three holistic and interdisciplinary approaches to health: EcoHealth, One Health, and planetary health. All of these, rooted philosophically in wildlife ecologist Aldo Leopold’s (1949) concept of “land health”—the maintenance capacity of organisms and natural systems for internal self‐renewal—reflect an ecological turn that occurred in public health beginning in the 1980s. Deeper roots extend to early thinkers such as Calvin Schwabe (who worked with pastoralists in East Africa and coined the concept of “one medicine,” linking biomedicine and veterinary medicine) and Rudolf Virchow (who pointed to the role of the socioeconomic environment in the origins of infectious and other disease outbreaks), both of whom recognized the close relationship between the health of humans and work done in veterinary medicine (Zinsstag et al. 2010).
Expressing a holistic vision, these approaches seek to break down the historic compartmentalization that separated specialized understandings of the environment and specialized understandings in health. While their points of origin differ, “the relative synchrony of the success of [these] paradigms … did not come about purely by chance: they respond to a growing common perception of the complexity of the linkages between animal and human health and their proximate and distant socio‐ecological environment” (Roger et al. 2016). All three were influenced by the Ottawa Charter of 1986, which highlighted the centrality of ecosystems and sustainable resources for human health. They share: 1) a focus on environmental factors in health; 2) a recognition of the increasing interconnectedness of ecosystems in a globalizing world; and 3) the underlying assumption that humans and other animals face many of the same environmental challenges (e.g., infectious disease, food and nutrition, contention with weather). Roger et al. (2016) note that:
Despite their different origins, One Health and EcoHealth are convergent in their vision and goals to reposition animal and public health within their broader context. Both are motivated by the conviction that health concerns must be addressed at the human–animal interface within their broader natural and social environments (i.e., socio‐ecosystem approach). Both try to integrate scientific disciplines combining multi‐ and cross‐disciplinary approaches. Both aim to mitigate the risks threatening ecosystems and public health, including veterinary public health. Both deal with the complexity of diseases and health … Finally, both struggle to properly define the boundaries of their paradigms despite their apparent similarities regarding principles and objectives.
The Ottawa Charter was a product of the first International Conference on Health Promotion, which took place in Ottawa, Canada in November 1986. Its objective was to expedite the achievement of the U.N. goal of Health For All. A response to the growing expectations for a new public health movement around the world, signatories to the Charter recognized that a key requirement of health is having a supportive environment. While the primary focus was on the built or human‐created environment (e.g., cities and industrial workplaces), there was also a recognition of the need for a stable ecosystem and sustainable natural resources. Subsequent key events in the study of ecology and health included the Rio Declaration of 1992, which was a product of the U.N. Conference on Environment and Development, the launching of the journal EcoHealth in 2004, and the founding of the International Association for Ecology & Health (IAEH) in 2009. These developments have been described as representing a “transdisciplinary imperative for a sustainable future” (Wilcox et al. 2004).
Because of the similarities among them, some have urged a merging of these three alternative approaches to health promotion (Parkes 2012; Zinsstag et al. 2012; Roger et al. 2016). Despite their shared features, however, they are not synonymous. One critical factor that differentiates them is their handling of the human–animal–environment interface (see later). The effort to discuss and compare these approaches is complicated by the various definitions that exist for each of them. Following Lerner & Berg (2017), the focus here is on their respective core values.
1.3.1 EcoHealth
The multidisciplinary EcoHealth approach affirms that humans, animals, and their environment form complex socioecological systems and that destabilization can lead to disease. EcoHealth “examines the complex relationships among humans, animals, and the environment, and how these relationships affect the health of each of these domains” (Listza & Wolbring 2018). It provides a platform to bring together physicians, veterinarians, ecologists, economists, social scientists, health planners, and others to study, understand, and respond to the effects of ecosystem changes on human health. Moreover, it facilitates the integration of different epistemologies, including local, traditional, and indigenous knowledges (Rapport et al. 1998). EcoHealth seeks to build participatory frameworks that include more than conventional expert‐led research toward a richer participatory process that includes relevant community actors in everything from initial problem definition to project design to the interpretation and sharing of findings (Mertens et al. 2005). Underlying all this is the insight that interventions for improving health are more effective if they respond to local realities. In Waltner‐Toews’ (2009, p. 519) assessment, the goal of EcoHealth is “sustainable human and animal health and well‐being, [achieved] through healthier ecosystems.”
The leading journal of the approach, EcoHealth (n.d.), defines it as being:
committed to fostering the health of humans, animals, and ecosystems and to conducting research which recognizes the inextricable linkages between the health of all species and their environments. A basic tenet held is that health and well‐being cannot be sustained in a resource depleted, polluted, and socially unstable planet.
Alternately, Waltner‐Toews (2009, p. 520) states that EcoHealth:
can be defined as systemic, participatory approaches to understanding and promoting health and wellbeing in the context of social and ecological interactions. They reflect not only an understanding of social systems and ecosystems, and how they interact, but also a convergence of applied, organizational ideas from business management, environmental planning, community operations research, participatory action research, critical systems theories and a variety of other fields
Within veterinary medicine, EcoHealth is viewed as an expansion of the scope of the field from a focus on the health of individual animals to a concern about animal populations and herd health. Promoted especially by the International Development Research Centre, Canada (IDRC), the approach appraises “the effective multi‐sectoral collaboration and the engagement of multiple types of stakeholder” (IDRC 2008) through its six integrated principles—namely, system thinking, transdisciplinary research, participation, gender and social equity, knowledge to action, and sustainability—in order to provide a consideration of the human–animal disease interface. A medical perspective on EcoHealth is offered by the International Society of Doctors for the Environment (ISDE), a not‐for‐profit organization based in Switzerland with member groups in 38 countries. The Australian chapter, for example, Doctors for the Environment Australia (DEA), defines its mission as being to publicize “the relationship between the condition of the environment and human health, promote environmentally friendly behaviour amongst physicians, patients, and the public, and [cooperate] at all political levels in the reduction of harmful environmental influences on health” (DEA 2018). In the perspective of the DEA, doctors cannot narrowly focus on the health of individual patients in a world in which a descent into environmental chaos will seriously imperil their ability to use the findings of medical research and advances in patient care to relieve human suffering.
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