Building Health and Wellbeing on
Ecological Principles
George Morris
20th February 2013
What can we reasonably assert?
• 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
• 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
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
Making the case for an Ecological Perspective on Wellbeing
The Principle of Transition
“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)
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
Many Transitions are Key for Health and Wellbeing
Nutritional
Urban
Demographic
Energy
Economic
Disease
Cultural
Environmental
Nutritional
Urban
Demographic
Energy
Economic
Disease
Cultural
Environmental
Making the Case for an Ecological
Perspective on Wellbeing
The Environment in Health and
Wellbeing
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
Good Places Better Health
Prototype 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-BetterHealth/Approach/Methodology
http://www.scotland.gov.uk/Topics/Health/Healthy-Living/Good-Places-Better-Health
http://www.edphis.org/
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’
MODIFIED DPSEEA
(Morris et al, 2006)
Drivers
Pressures
Experience
Experience
State of the Environment
Exposure or Experience
Supporting
Experience
Human Health And
Wellbeing
Social, economic & environmental etc. context
POLICY
and
ACTION
Making the Case for an Ecological
Perspective on Wellbeing
Planetary Crisis
A Safe Operating Space for Humanity:
Planetary Boundaries
Rockstrom et al (2009)
Applying an Ecological Perspective
in Practice
Developing Ecological Public Health
“THE DYNAMICS OF ECOLOGICAL PUBLIC HEALTH”
HUMAN
HEALTH
ECOSYSTEMS
HEALTH
Rayner and Lang (2012)
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)
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)
Applying and Ecological Perspective
in Practice
Ecosystem Services and Human
Wellbeing
Ecosystem Services
PROVISIONING
SUPPORTING
Nutrient Cycling
Soil Formation
Primary
Production
Link to Wellbeing Through:
HUMAN SECURITY
Food
Freshwater
Fuel
Wood
Fibre etc.
Personal Safety
Secure Resources etc.
Security from Disasters etc
REGULATING
SOCIAL RELATIONS
Climate Reg.
Flood Reg.
Water Purif.
Social Cohesion
Mutual Respect
Ability to Help others
MATERIAL MINIMA
Adequate Livelihoods
Shelter etc.
Fuel, Food, Fibre etc.
FREEDOM OF CHOICE
CULTURAL
Aesthetic
Spiritual
Educational
Cultural
Opportunity to achieve what
an individual values doing
and being
HEALTH
Strength
Feeling Well
Access to Clean Air, Water, etc.
Applying and Ecological Perspective
in Practice
Tools To Think With
TWO PATHWAYS
DRIVERS
Through our
impact on the
proximal
environment
POLICY
and
ACTION
Human Health and Wellbeing
Though our
influence
on ecosystems
DRIVERS TO HEALTH EFFECT VIA THE PROXIMAL ROUTE
Drivers
MODIFIED DPSEEA
(Morris et al, 2006)
Pressures
Experience
Experience
State of the Environment
Exposure or Experience
Supporting
Experience
Human Health And
Wellbeing
Social, economic & environmental etc. context
POLICY
and
ACTION
DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTE
Drivers
ECOSYSTEMS ENRICHED
DPSEEA
(Reis, S. Morris, G et al, 2013 in press)
Pressures
POLICY
Supporting
and
ACTION
Supporting
Ecosystem Services
Experience
Experience
Determinants of health
and wellbeing
Cultural
Regulating
Provisioning
Material Minima
Freedom of Choice
Social Relations
Security
Human Health And
Wellbeing
Social, economic & environmental etc. context
Applying and Ecological Perspective
in Practice
5 Pillars of Ecological Public Health
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
Adopt
Holistic Issue
Framing
Complexity
Planetary
Boundaries
Ecosystem
Services
Interconnectivity
etc
Synthesise a
Mixed
Economy
of Evidence
Qualitative
Develop an
Appropriate
Ethical
Framework
Sustainability
Quantitative
Equity
Experimental
Environmental
Justice
NonExperimental,
Social Justice
Multiple Sources
etc.
Carefully Consider
Infrastructure
Institutional
Work to
Optimise
Governance
Transparency
Educational
Physical
Stakeholder
Engagement
Accountability
etc
5 PILLARS OF ECOLOGICAL PUBLIC HEALTH
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