Bridging Theories, Concepts, Organisations, and Collective Knowledge for Health and Sustainability Integration

Complex environmental health issues are examples of ‘wicked problems’ that require cross-sectoral collaboration of the public, private, not-for-profit, and academic sectors together with the communities in which they function. Although the linkages between health and sustainability have been widely acknowledged in theory, stakeholders engaged in sustainable development and health seldom collaborate in practice. Promoting environmental health has remained strongly in the domain of the health sector, despite the ambitious rhetoric of international agreements. This dissertation focuses on cross-sectoral integration of health and sustainable development practices by exploring the bridging of ‘siloed’ knowledge. The emphasis is on collective knowledge and the three characteristics of cross-sectoral partnerships that have been identified as valuable for improving decision-making processes: bridging key discourses, bringing together key groups, and generating new knowledge. Aristotle’s three intellectual virtues, epistemé, techné and phronesis, were modified to help describe these aspects of collective intelligence that could enhance the integration of approaches to health and sustainability. The theoretical foundation for this transdisciplinary research was built primarily on health promotion and sustainability governance literatures, which were examined for their overlapping and complementary aspects. Children’s environmental health was studied as a useful bridging concept and UNESCO-mandated biosphere reserves as bridging organisations for integrating health and sustainability. Activities in all Canadian and British biosphere reserves were assessed for the extent of their focus on health. In addition, by investigating four biosphere reserves as case studies, this research identified barriers to and drivers for integrating health goals into biosphere reserve activities. At the same time, the organisational understanding of matters relevant to children’s environmental health was studied to assess the potential of biosphere reserves as bridging organisations for gathering and mobilising local knowledge on these issues. The findings centre on three new perspectives for mobilising knowledge as it relates to the cross-sectoral integration of health and sustainability: (1) the bridging of health promotion and sustainability governance theories, using children’s environmental health as a bridging concept and area of application, which brings together the key discourses in a transdisciplinary manner (epistemé); (2) the value of bridging organisations offering their skills and functional platforms as mechanisms to facilitate bridging of health and sustainability in practice, by bringing together main stakeholders (techné); and (3) the importance of bridging collective knowledge and combining the theoretical, practical, and ethical aspects of the integration process, to increase the level of understanding of specific problems, in this case children’s environmental health (phronesis). Other contributions offered by this research include the discovery of similarities in health promotion and sustainability governance theories; development of a transdisciplinary ecohealth framework; recognition of biosphere reserves as bridging organisations that function as innovative community-based forums for the integration of sustainable development and public health; and findings that reveal an insufficiency of local data collection on children’s environmental health threats. All in all, the findings in this research offer a conceptual and practical frame for integrating health and sustainability by facilitating cross-sectoral collaboration

Human–nature connection: a multidisciplinary review

In sustainability science calls are increasing for humanity to (re-)connect with nature, yet no systematic synthesis of the empirical literature on human–nature connection (HNC) exists. We reviewed 475 publications on HNC and found that most research has concentrated on individuals at local scales, often leaving ‘nature’ undefined. Cluster analysis identified three subgroups of publications: first, HNC as mind, dominated by the use of psychometric scales, second, HNC as experience, characterised by observation and qualitative analysis; and third, HNC as place, emphasising place attachment and reserve visitation. To address the challenge of connecting humanity with nature, future HNC scholarship must pursue cross-fertilization of methods and approaches, extend research beyond individuals, local scales, and Western societies, and increase guidance for sustainability transformations

Climate Change and Vibrio cholerae in Herring Eggs: The Role of Indigenous Communities in Public Health Outbreak Responses

Climate change brings about novel types of public health emergencies. Unforeseen challenges put additional pressure on health systems and require innovative approaches to address emerging needs. The health of Indigenous Peoples is particularly impacted by the changing climate, because of their close connection to the land. For instance, the physical, emotional, mental, and spiritual well-being of coastal First Nations in British Columbia (BC), Canada, is interconnected with the abundance of healthy marine food sources that form the base of local traditional diets. The 2018 discovery of Vibrio cholerae illness in those who had eaten contaminated herring eggs not only had a clinical health impact but also created concerns for the safety of local food systems. The limited magnitude of the outbreak demonstrates the critical importance of collaborative partnerships between coastal First Nations communities in BC and health authorities working together in outbreak investigations. Yet, the lack of procedures that address cultural and institutional differences led to unnecessary discrepancies in the approach. This paper introduces the public health intervention used during the first ever Vibrio cholerae outbreak in coastal BC. The intervention has the potential to inform best practices when developing emergency response protocols potentially affecting Indigenous people and traditional foods. In this qualitative case study of the formal institutional documents and narratives of the key partners involved in the response, we assess the intervention, highlight the challenges and enablers, share lessons learned, and identify knowledge requirements to improve confidence in the traditional food system and support early warning systems

Leverage points for sustainability transformation

Despite substantial focus on sustainability issues in both science and politics, humanity remains on largely unsustainable development trajectories. Partly, this is due to the failure of sustainability science to engage with the root causes of unsustainability. Drawing on ideas by Donella Meadows, we argue that many sustainability interventions target highly tangible, but essentially weak, leverage points (i.e. using interventions that are easy, but have limited potential for transformational change). Thus, there is an urgent need to focus on less obvious but potentially far more powerful areas of intervention. We propose a research agenda inspired by systems thinking that focuses on transformational ‘sustainability interventions’, centred on three realms of leverage: reconnecting people to nature, restructuring institutions and rethinking how knowledge is created and used in pursuit of sustainability. The notion of leverage points has the potential to act as a boundary object for genuinely transformational sustainability science