1. Building Health and Wellbeing on Ecological Principles
George Morris
20th February 2013

2. 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

3. 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

4. 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

5. Making the case for an Ecological Perspective on Wellbeing The Principle of Transition
I speak of the principle of transition for two reasons. The first is it’s importance to health and wellbeing of a continually change but also because, although I will provide a list to support this discussion it can never be complete. It is about breaking down the provcesses of change into manageable chunks. The material the cultural the biological and the social worlds.

6. “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”
A statement of the obvious perhaps but the importance becomes clear when one thinks of it in this way. The transitions act on
Rayner & Lang (2012)

7. 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

8. Many Transitions are Key for Health and Wellbeing
Epidemiological

9. Disease

10. Making the Case for an Ecological Perspective on Wellbeing The Environment in Health and Wellbeing

11. 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

12. Good Places Better Health
Prototype Phase
(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

13. It has been especially valuable in showing thethe value of Conceptual Models in complex situations as:
‘Tools to think with’
‘Tools to Unify’
‘Tools to Communicate and Engage’

14. MODIFIED DPSEEA Drivers Pressures State of the Environment POLICY and
(Morris et al, 2006)
Pressures
Experience
State of the Environment
POLICY
and
ACTION
Supporting
Exposure or Experience
Experience
Human Health And Wellbeing
Social, economic & environmental etc. context

15. Making the Case for an Ecological Perspective on Wellbeing Planetary Crisis

16. A Safe Operating Space for Humanity:
Planetary Boundaries
Rockstrom et al (2009)

17. Applying an Ecological Perspective in Practice Developing Ecological Public Health

18. HUMAN HEALTH ECOSYSTEMS HEALTH
“THE DYNAMICS OF ECOLOGICAL PUBLIC HEALTH”
HUMAN
HEALTH
ECOSYSTEMS
HEALTH
Rayner and Lang (2012)

19. 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)

20. 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
Knowledge is reached when the degree of uncertainty is reduced sufficiently to take action.
Adapted from Rayner and Lang (2012)

21. Applying and Ecological Perspective in Practice Ecosystem Services and Human Wellbeing

23. Link to Wellbeing Through:
Ecosystem Services
Link to Wellbeing Through:
HUMAN SECURITY
Personal Safety
Secure Resources etc.
Security from Disasters etc
PROVISIONING
Food
Freshwater
Fuel
Wood
Fibre etc.
MATERIAL MINIMA
Adequate Livelihoods
Shelter etc.
Fuel, Food, Fibre etc.
SUPPORTING
Nutrient Cycling
Soil Formation
Primary Production
REGULATING
Climate Reg.
Flood Reg.
Water Purif.
SOCIAL RELATIONS
Social Cohesion
Mutual Respect
Ability to Help others
FREEDOM OF CHOICE
Opportunity to achieve what
an individual values doing
and being
As we speak, Ecosystem Services is not part of the lingua franca of public health. It has power and utility for public health
CULTURAL
Aesthetic
Spiritual
Educational
Cultural
HEALTH
Strength
Feeling Well
Access to Clean Air, Water, etc.

24. Applying and Ecological Perspective in Practice Tools To Think With

25. Through our impact on the proximal environment
TWO PATHWAYS
DRIVERS
POLICY
and
ACTION
Through our impact on the proximal environment
Though our
influence
on ecosystems
Human Health and Wellbeing

26. MODIFIED DPSEEA Drivers Pressures State of the Environment POLICY and
DRIVERS TO HEALTH EFFECT VIA THE PROXIMAL ROUTE
MODIFIED DPSEEA
Drivers
(Morris et al, 2006)
Pressures
Experience
State of the Environment
POLICY
and
ACTION
Supporting
Exposure or Experience
Experience
Human Health And Wellbeing
Social, economic & environmental etc. context

27. ECOSYSTEMS ENRICHED DPSEEA
DRIVERS TO HEALTH EFFECT VIA AN ECOSYSTEM SERVICES ROUTE
Drivers
ECOSYSTEMS ENRICHED DPSEEA
(Reis, S. Morris, G et al, 2013 in press)
Pressures
POLICY
and
ACTION
Cultural
Supporting
Supporting
Regulating
Ecosystem Services
Provisioning
Experience
Material Minima
Experience
Freedom of Choice
Determinants of health and wellbeing
Social Relations
Security
Human Health And Wellbeing
Social, economic & environmental etc. context

28. Applying and Ecological Perspective in Practice 5 Pillars of Ecological Public Health

29. 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
Synthesise a Mixed Economy
of Evidence
Develop an
Appropriate Ethical
Framework
Carefully Consider
Infrastructure
Work to
Optimise
Governance
Institutional
Educational
Physical
Complexity
Planetary
Boundaries
Ecosystem
Services
Interconnectivity
etc
Transparency
Stakeholder
Engagement
Accountability
etc
Qualitative
Quantitative
Experimental
Non-Experimental,
Multiple Sources
Sustainability
Equity
Environmental
Justice
Social Justice
etc.
5 PILLARS OF ECOLOGICAL PUBLIC HEALTH

30. DARWIN’S ENTANGLED BANK
The Entangled Bank