Health and the environment: a critical enquiry of the construction and contestation of ecological health

A crucial contemporary public health issue is the construction and contestation of the relevance of the natural world to human health. Taking a critical approach, this thesis examines how the natural environment as a health determinant is positioned in relation to the ‘social’ within social epidemiological studies of health, illness and disease. Using conceptual and empirical forms of enquiry, this study shows how current constructions of natural environmental health drivers contour public health practice in the UK and that by challenging the limits of existing structures, innovative responses emerge, which can generate new frameworks for health policy and practice. Having identified a lacuna in research on the ‘natural’ environment in medical sociology, this inductive qualitative research project brings into conversation the findings from extensive desk and field research. Specially, a study of the elaboration of environmental health discourses within the UK public health policy arena and disciplinary wide discourse analyses of key academic journals are read together to describe the discursive practices shaping environmental public health work in the UK. Linking theory to practice, data from in-depth interviews with sixty health professionals working on health and the environment in the UK and internationally are used to investigate how public health practitioners produce the environment within their work remits. The research breaks ground for further social scientific studies of health and the environment and in particular substantiates the call for an extended notion of the ‘environment’ using ecological principles. Methodologically, the interdisciplinary reach of this research draws attention to the tensions that arise when working across the medical, natural and social sciences. Practical and philosophical questions about the challenge of expanding the sociological imagination in the contemporary moment are also considered. Empirically, to medical sociology the ‘EcoBioPsychoSocial’ framework is offered as a tool for studying health at the nexus between the ‘social’ and the ‘natural environment.’ Finally, the ways informal public health institutions are serving as ‘invisible’ forces impeding the uptake of prevention oriented environmental health policies are findings offered to the health policy arena

The Interplay between Social and Ecological Determinants of Mental Health for Children and Youth in the Climate Crisis

Children and youth are showing increasing levels of mental health distress due to the climate crisis, characterized by feelings of sadness, guilt, changes in sleep and appetite, difficulty concentrating, solastalgia, and disconnection from land. To gain a deeper understanding of the relationship between climate change and children and youth’s mental health, we conducted a rapid review and a thematic analysis of the results in NVivo 12. Our findings show that children and youth experience a plethora of direct and indirect effects from climate change and this impacts their mental wellbeing in diverse and complex ways. Young people also have varied perceptions of climate change based on their social locations and many are dealing with feelings of immense worry and eco-anxiety. The mental health impacts of climate change on children/youth are tied to Social Determinants of Health (SDoH) but also need to be understood in relation to the Ecological Determinants of Health (EDoH). Through an eco-social lens, this paper explores these conceptual issues and uses them to provide a framework for understanding the interplay of social and ecological determinants of mental health for children/youth

Promoting community health and climate justice co-benefits: insights from a rural and remote island climate planning process

Climate change is an environmental crisis, a health crisis, a socio-political and an economic crisis that illuminates the ways in which our human-environment relationships are arriving at crucial tipping points. Through these relational axes, social structures, and institutional practices, patterns of inequity are produced, wherein climate change disproportionately impacts several priority populations, including rural and remote communities. To make evidence-based change, it is important that engagements with climate change are informed by data that convey the nuance of various living realities and forms of knowledge; decisions are rooted in the social, structural, and ecological determinants of health; and an intersectional lens informs the research to action cycle. Our team applied theory- and equity-driven conceptualizations of data to our work with the community on Cortes Island—a remote island in the northern end of the Salish Sea in British Columbia, Canada—to aid their climate change adaptation and mitigation planning. This work was completed in five iterative stages which were informed by community-identified needs and preferences, including: An environmental scan, informal scoping interviews, attending a community forum, a scoping review, and co-development of questions for a community survey to guide the development of the Island’s climate change adaptation and mitigation plan. Through this community-led collaboration we learned about the importance of ground truthing data inaccuracies and quantitative data gaps through community consultation; shifting planning focus from deficit to strengths- and asset-based engagement; responding to the needs of the community when working collaboratively across academic and community contexts; and, foregrounding the importance of, and relationship to, place when doing community engagement work. This suite of practices illuminates the integrative solution-oriented thinking needed to address complex and intersecting issues of climate change and community health

Using Geosocial Networking Apps to Understand the Spatial Distribution of Gay and Bisexual Men: Pilot Study

Background: While services tailored for gay, bisexual, and other men who have sex with men (gbMSM) may provide support for this vulnerable population, planning access to these services can be difficult due to the unknown spatial distribution of gbMSM outside of gay-centered neighborhoods. This is particularly true since the emergence of geosocial networking apps, which have become a widely used venue for meeting sexual partners. Objective: The goal of our research was to estimate the spatial density of app users across Metro Vancouver and identify the independent and adjusted neighborhood-level factors that predict app user density. Methods: This pilot study used a popular geosocial networking app to estimate the spatial density of app users across rural and urban Metro Vancouver. Multiple Poisson regression models were then constructed to model the relationship between app user density and areal population-weighted neighbourhood-level factors from the 2016 Canadian Census and National Household Survey. Results: A total of 2021 app user profiles were counted within 1 mile of 263 sampling locations. In a multivariate model controlling for time of day, app user density was associated with several dissemination area–level characteristics, including population density (per 100; incidence rate ratio [IRR] 1.03, 95% CI 1.02-1.04), average household size (IRR 0.26, 95% CI 0.11-0.62), average age of males (IRR 0.93, 95% CI 0.88-0.98), median income of males (IRR 0.96, 95% CI 0.92-0.99), proportion of males who were not married (IRR 1.08, 95% CI 1.02-1.13), proportion of males with a postsecondary education (IRR 1.06, 95% CI 1.03-1.10), proportion of males who are immigrants (IRR 1.04, 95% CI 1.004-1.07), and proportion of males living below the low-income cutoff level (IRR 0.93, 95% CI 0.89-0.98). Conclusions: This pilot study demonstrates how the combination of geosocial networking apps and administrative datasets might help care providers, planners, and community leaders target online and offline interventions for gbMSM who use apps

Addressing the environmental, community and health impacts of resource development: Challenges across scales, sectors and sites

Work that addresses the cumulative impacts of resource extraction on environment, community, and health is necessarily large in scope. This paper presents experiences from initiating research at this intersection and explores implications for the ambitious, integrative agenda of planetary health. The purpose is to outline origins, design features, and preliminary insights from our intersectoral and international project, based in Canada and titled the “Environment, Community, Health Observatory” (ECHO) Network. With a clear emphasis on rural, remote, and Indigenous communities, environments, and health, the ECHO Network is designed to answer the question: How can an Environment, Community, Health Observatory Network support the integrative tools and processes required to improve understanding and response to the cumulative health impacts of resource development? The Network is informed by four regional cases across Canada where we employ a framework and an approach grounded in observation, “taking notice for action”, and collective learning. Sharing insights from the foundational phase of this five-year project, we reflect on the hidden and obvious challenges of working across scales, sectors, and sites, and the overlap of generative and uncomfortable entanglements associated with health and resource development. Yet, although intersectoral work addressing the cumulative impacts of resource extraction presents uncertainty and unresolved tensions, ultimately we argue that it is worth staying with the trouble

Addressing the environmental, community and health impacts of resource development: Challenges across scales, sectors and sites

Work that addresses the cumulative impacts of resource extraction on environment, community, and health is necessarily large in scope. This paper presents experiences from initiating research at this intersection and explores implications for the ambitious, integrative agenda of planetary health. The purpose is to outline origins, design features, and preliminary insights from our intersectoral and international project, based in Canada and titled the “Environment, Community, Health Observatory” (ECHO) Network. With a clear emphasis on rural, remote, and Indigenous communities, environments, and health, the ECHO Network is designed to answer the question: How can an Environment, Community, Health Observatory Network support the integrative tools and processes required to improve understanding and response to the cumulative health impacts of resource development? The Network is informed by four regional cases across Canada where we employ a framework and an approach grounded in observation, “taking notice for action”, and collective learning. Sharing insights from the foundational phase of this five-year project, we reflect on the hidden and obvious challenges of working across scales, sectors, and sites, and the overlap of generative and uncomfortable entanglements associated with health and resource development. Yet, although intersectoral work addressing the cumulative impacts of resource extraction presents uncertainty and unresolved tensions, ultimately we argue that it is worth staying with the trouble

The Interacting Axes of Environmental, Health, and Social Justice Cumulative Impacts: A Case Study of the Blueberry River First Nations

We consider the case of intensive resource extractive projects in the Blueberry River First Nations in Northern British Columbia, Canada, as a case study. Drawing on the parallels between concepts of cumulative environmental and cumulative health impacts, we highlight three axes along which to gauge the effects of intensive extraction projects. These are environmental, health, and social justice axes. Using an intersectional analysis highlights the way in which using individual indicators to measure impact, rather than considering cumulative effects, hides the full extent by which the affected First Nations communities are impacted by intensive extraction projects. We use the case study to contemplate several mechanisms at the intersection of these axes whereby the negative effects of each not only add but also amplify through their interactions. For example, direct impact along the environmental axis indirectly amplifies other health and social justice impacts separately from the direct impacts on those axes. We conclude there is significant work still to be done to use cumulative indicators to study the impacts of extractive industry projects—like liquefied natural gas—on peoples, environments, and health

What Drives Climate Action in Canada’s Provincial North? Exploring the Role of Connectedness to Nature, Climate Worry, and Talking with Friends and Family

Despite widespread calls to action from the scientific community and beyond, a concerning climate action gap exists. This paper aims to enhance our understanding of the role of connectedness to nature in promoting individual-level climate action in a unique setting where climate research and action are lacking: Canada’s Provincial North. To begin to understand possible pathways, we also examined whether climate worry and talking about climate change with family and friends mediate the relationship between connectedness to nature and climate action. We used data collected via postal surveys in two Provincial North communities, Thunder Bay (Ontario), and Prince George (British Columbia) (n = 628). Results show that connectedness to nature has a direct positive association with individual-level climate action, controlling for gender and education. Results of parallel mediation analyses further show that connectedness to nature is indirectly associated with individual-level climate action, mediated by both climate worry and talking about climate change with family and friends. Finally, results suggest that climate worry and talking about climate change with family and friends serially mediate the relationship between connectedness to nature and with individual-level climate action. These findings are relevant for climate change engagement and action, especially across Canada’s Provincial North, but also in similar settings characterized by marginalization, heightened vulnerability to climate change, urban islands within vast rural and remote landscapes, and economies and social identities tied to resource extraction. Drawing on these findings, we argue that cultivating stronger connections with nature in the places where people live, learn, work, and play is an important and currently underutilized leverage point for promoting individual-level climate action. This study therefore adds to the current and increasingly relevant calls for (re-)connecting with nature that have been made by others across a range of disciplinary and sectoral divides.Other UBCNon UBCReviewedFacultyResearche

Transformative learning for a sustainable and healthy future through ecosystem approaches to health: insights from 15 years of co-designed ecohealth teaching and learning experiences

This paper presents insights from the work of the Canadian Community of Practice in Ecosystem Approaches to Health (CoPEH-Canada) and 15 years (2008–2022) of land-based, transdisciplinary, learner-centred, transformative learning and training. We have oriented our learning approaches to Head, Hands, and Heart, which symbolise cognitive, psychomotor, and affective learning, respectively. Psychomotor and affective learning are necessary to grapple with and enact far-reaching structural changes (eg, decolonisation) needed to rekindle healthier, reciprocal relationships with nature and each other. We acknowledge that these approaches have been long understood by Indigenous colleagues and communities. We have developed a suite of teaching techniques and resources through an iterative and evolving pedagogy based on participatory approaches and operating reciprocal, research-pedagogical cycles; integrated different approaches and ways of knowing into our pedagogy; and built a networked Community of Practice for continued learning. Planetary health has become a dominant framing for health-ecosystem interactions. This Viewpoint underscores the depth of existing scholarship, collaboration, and pedagogical expertise in ecohealth teaching and learning that can inform planetary health education approaches.University of Northern British ColumbiaRevisión por pare