1. Health and the Environment Shall we change the subject?
Nick Fox
University of Sheffield

2. Introduction How health and environment interact.
Anthropocentrism vs. anti-humanism.
An anti-humanist approach to health and the environment.
Changing the subject.

3. Perspectives on ‘Health and the Environment’
Human health is threatened by environmental factors e.g. climate change.
Improving the environment can enhance human health.
Improvements in health threaten the environment (e.g. population growth, economic development).
Initiatives can reduce the environmental impact of health care.
Gaia-inspired conceptions of humans as part of a self-regulating environmental system.

4. Contradictory forces?
Are human health and environmental health potentially antagonistic?
How can human health and environmental health be complementary?
Should human or environmental health have priority?

5. Anthropocentrism
Gives priority to human bodies, human subjects and human experience.
Reflected in:
Humanism
Romanticism
Individualism
Popular politics

6. Anthropocentrism and health
Most health care and medical theory is inevitably anthropocentric.
Health has become a ‘good’ that is almost unquestionable.
Public health has the capacity to avoid anthropocentrism, by focusing on networks and interactions rather than bodies.

7. Anthropocentrism, health and environment
With human health privileged, then the environment becomes the context within which public health is threatened or enhanced.
Examples:
Improving the built environment.
Addressing environment risks e.g. pollution, UV radiation.
Health and safety, health protection, HPA.

8. An alternative approach
Anti-humanism: a philosophical or ontological position that intentionally overturns the priority or privilege accorded to humans.
Focuses on the non-human, the inanimate, and social formations.
Considers the way that these elements affect each other: humans are no longer the sole ‘agents’.

9. Anti-humanist method
Focus not on bodies or subjects, but on assemblages of relations between bodies, things, ideas and social institutions.
Look at how these relations affect or are affected, rather than at ‘agency’.
Explore the capacities that these affects produce in bodies and other entities.
This is how we ‘change the (human) subject’.

10. Anti-humanism, health and environment 1
Humans are not prior or privileged.
Focus on assemblages of organic and inorganic: bodies, things, social formations.
‘Environment’ is no longer separate from bodies: the latter are part of an assemblage that is ‘environment’.

11. Anti-humanism, health and environment 2
Trace how relations in the assemblage affect and are affected by each other.
Look at the capacities produced in bodies and things by these affects.
A body’s capacities determine its ‘health’: its ability to affect and be affected, and what it can do.
(Poor health outcomes are not attributes of human bodies but of the assemblage.)

12. Ex. 1: city transport
housing – work places – shops – services - workers – (capitalist) economic system - wages – transport infrastructure – fossil fuels – renewable fuels – pollution - public transport - private transport – etc.
A sustainable city transport policy can optimise the affective flows in this assemblage.
‘Health’ emerges as a ‘by-product’ of the capacities produced by sustainable transport.

13. Ex. 2: water management
population – agriculture - industry – water sources – climate – investment – water use and recycling technologies - water and sewage infrastructure – economic development – cultural water use beliefs – micro-organisms – etc.
A sustainable water management policy can optimise the affective flows in this assemblage.
‘Sustainable water management policy enhances capacities (e.g. access to affordable clean water, sewage management) to produce ‘health’.

14. Ex. 3: global warming
humans – industry - fossil fuels – sunlight – atmosphere - weather systems – politics - economics - cultural formations
Balancing the production and capture of atmospheric carbon can stabilise global temperatures , and thus reduce ecosystem variability.
A stable ecosystem will enhance human opportunities and hence health.

15. Conclusions Environment is an assemblage.
Humans are an element in this assemblage.
Elements in the assemblage affect each other.
Engineering assemblages can produce capacities that enhance health.
Change the subject from ‘human health’ to ‘environmental assemblages and affects’.
This suggests a distinctive, environmental approach to public health.

16. Health and the Environment Shall we change the subject?
Nick Fox
University of Sheffield