The Emerging Concept of Planetary Health: Connecting People, Place, Purpose and Planet

A special issue of Challenges (ISSN 2078-1547). This special issue belongs to the section "Planetary Health".

Deadline for manuscript submissions: closed (31 May 2020) | Viewed by 332483

Special Issue Editors


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1. School of Medicine, University of Western Australia, Nedlands, WA 6009, Australia
2. ORIGINS Project, Telethon Kids Institute at Perth Children’s Hospital, Nedlands, WA 6009, Australia
3. NOVA Institute for Health of People, Places and Planet, 1407 Fleet Street, Baltimore, MD 21231, USA
Interests: planetary health; ecological and social justice; immunology and inflammation; microbiome science; NCDs (noncommunicable diseases); nutrition; life-course wellness and ‘DOHaD’ (development origins of health and disease); integrative approaches to wellness and disease prevention
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Collection Editor
inVIVO Planetary Health, Research Group of the Worldwide Universities Network (WUN), 6010 Park Ave, Suite #4081, West New York, NJ 07093, USA
Interests: planetary health; natural environments; nature relatedness; mind–body medicine; nutrition; social and ecological justice; placebo; microbiota; history of medicine; philosophy of biology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The emerging concept of planetary health emphasizes that human health is intricately connected to the health of natural systems within the Earth’s biosphere—and that the health of all species depends on the health, biodiversity and stability of whole systems. Planetary health is a product of human social, political and economic ‘ecosystems’.

The global challenges facing humanity include climate change, biodiversity losses, population growth, grotesque socioeconomic inequalties, environmental degradation, health disparities, the dominance of ultra-processed foods, and the pandemic crisis of non-communicable diseases (NCDs). In addition, there is ongoing political polarization and conflict, and growing ‘dis-ease’ which compromises quality of life and sets individuals on a path to NCDs. These concerns are all interrelated; health at all levels—person, place and planet—is interdependent.

This Special Issue focuses on understanding and improving the complex relationships between human health and planetary health, including how the eco-biological interactions in our living environments (including food systems, climate change and biodiversity and microbial ecology) impact well-being, together with the wider societal factors that govern these. They require a greater understanding of our psychological relationships with the Earth and its natural systems. Lack of experience in nature and emotional disconnection from the natural environment, especially in children, may undermine the goals of planetary health.

The dramatic increasing burden of human disease can be seen as the culmination of a ‘dual burden’—increasing adverse exposures (e.g. fast food, toxins and stress) coupled with loss of much that was protective in ancestral environments. The facets of ‘loss’ extend from the physical (loss of biodiversity, species, local foods and produce) to the loss of community (loss of language, tradition, and stories) and the far less tangible aspects of loss (such as loss of value systems, loss of purpose, peace, respect, spirituality, compassion, hope and optimism). This suggests that the solutions must lie in restoring protective and buffering factors, minimizing adversity and inequality, and addressing the underlying systemic causes.

We invite submissions that consider aspects of these complex systems as they pertain to the broader context of planetary health, including unique perspectives, potential solutions, new proposals for collaboration, strategies for advocacy, public education, policy proposals, models for systemic change, community case studies, novel application or integration of technologies.

Prof. Dr. Susan Prescott
Dr. Alan C. Logan
Collection Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Challenges is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • planetary health
  • ecology; biodiversity; ecosystems
  • social and ecological justice
  • microbial ecosystems; microbial diversity; disease associations
  • environmental degradation; biodiversity loss; climate change
  • urban landscapes; natural environments; nature-relatedness
  • inflammation and non-communicable diseases (NCDs)
  • mental health; emotions and wellbeing; solastalgia; ecological grief
  • food systems; nutrition; food processing and nutritional ecology
  • lifestyle and the exposome
  • life-course (developmental origins); transgenerational perspectives; epigenetics
  • traditional cultures; belief systems; spirituality and value systems
  • systems biology; dynamic data clouds; data systems required to characterize and understand biological complexity

Published Papers (38 papers)

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Research

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11 pages, 596 KiB  
Article
The Mismatch between Anthropogenic CO2 Emissions and Their Consequences for Human Zinc and Protein Sufficiency Highlights Important Environmental Justice Issues
by Elizabeth R. H. Moore, Matthew R. Smith, Debbie Humphries, Robert Dubrow and Samuel S. Myers
Challenges 2020, 11(1), 4; https://doi.org/10.3390/challe11010004 - 22 Feb 2020
Cited by 1 | Viewed by 4766
Abstract
The impacts of climate change are not equally distributed globally. We examined the global distribution of CO2 emissions and the ensuing distribution of increases in the risk of zinc and protein deficiency resulting from elevated atmospheric CO2 concentrations. We estimated cumulative [...] Read more.
The impacts of climate change are not equally distributed globally. We examined the global distribution of CO2 emissions and the ensuing distribution of increases in the risk of zinc and protein deficiency resulting from elevated atmospheric CO2 concentrations. We estimated cumulative per capita (2011–2050) CO2 emissions for 146 countries using existing measurement data and by apportioning regional emissions projections. We tested the relationship between cumulative per capita CO2 emissions and the risk of additional zinc and protein deficiency at the population-level and country-level. At the population-level (i.e., population-weighted), we observed a significant inverse association between CO2 emissions and the percentage of the population placed at additional risk of zinc (p-value: <0.001) and protein (p-value: <0.01) deficiencies. Country-level (i.e., unweighted) analyses produced significant but less strong associations. Populations with lower per capita CO2 emissions between 2011 and 2050 will experience a disproportionately high nutritional burden, highlighting socioeconomic, geospatial, and intergenerational injustices. Full article
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11 pages, 1641 KiB  
Article
Environmental Impact of the Average Hong Kong Diet: A Case for Adopting Sustainable Diets in Urban Centers
by Tsz Wing Tang and Tanja Sobko
Challenges 2019, 10(2), 5; https://doi.org/10.3390/challe10020005 - 06 Dec 2019
Cited by 2 | Viewed by 9732
Abstract
As global population growth continues, the rapidly increasing demand for food and the environmental impact of this demand is a growing concern. Most food in Hong Kong is imported, which has implications for the associated environmental footprint. The carbon and water footprints (CF [...] Read more.
As global population growth continues, the rapidly increasing demand for food and the environmental impact of this demand is a growing concern. Most food in Hong Kong is imported, which has implications for the associated environmental footprint. The carbon and water footprints (CF and WF) of the average Hong Kong diet were estimated from available sources and compared to well-accepted sustainable diets to characterize environmental sustainability. The total CF was 5701.90 g CO2-eq per capita/day, and the WF was 4782.31 L per capita/day. While meat products contributed only 22% to the weight, they were responsible for 57% and 53% of the total CF and WF, respectively. The impacts of the Hong Kong diet were greater than those of well-accepted sustainable diets, possibly due to the heavy consumption of meat and the import of foods. This confirms an urgency to increase environmental awareness among Hong Kong’s consumers and make interventions toward the adoption of sustainable, plant-based diets. Full article
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27 pages, 1392 KiB  
Article
Addressing the Environmental, Community, and Health Impacts of Resource Development: Challenges across Scales, Sectors, and Sites
by Margot W. Parkes, Sandra Allison, Henry G. Harder, Dawn Hoogeveen, Diana Kutzner, Melissa Aalhus, Evan Adams, Lindsay Beck, Ben Brisbois, Chris G. Buse, Annika Chiasson, Donald C. Cole, Shayna Dolan, Anne Fauré, Raina Fumerton, Maya K. Gislason, Louisa Hadley, Lars K. Hallström, Pierre Horwitz, Raissa Marks, Kaileah McKellar, Helen Moewaka Barnes, Barbara Oke, Linda Pillsworth, Jamie Reschny, Dionne Sanderson, Sarah Skinner, Krista Stelkia, Craig Stephen, Céline Surette, Tim K. Takaro and Cathy Vaillancourtadd Show full author list remove Hide full author list
Challenges 2019, 10(1), 22; https://doi.org/10.3390/challe10010022 - 20 Mar 2019
Cited by 15 | Viewed by 9325
Abstract
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 [...] Read more.
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. Full article
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8 pages, 214 KiB  
Communication
Planetary Health Ethics: Beyond First Principles
by Alexander Foster, Jennifer Cole, Andrew Farlow and Ivica Petrikova
Challenges 2019, 10(1), 14; https://doi.org/10.3390/challe10010014 - 15 Feb 2019
Cited by 13 | Viewed by 7547
Abstract
Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging movement has not yet agreed upon a code [...] Read more.
Planetary health is a transdisciplinary approach that aims to advance the understanding of the links between human-driven changes to the planet and their consequences, and to develop appropriate solutions to the challenges identified. This emerging movement has not yet agreed upon a code of ethics to underpin the rapidly expanding body of research being carried out in its name. However, a code of ethics might support the principles for planetary health set out in the Canmore Declaration of 2018. Phrases such as “Public Health 2.0”, “Human Health in an Era of Global Environmental Change”, or “A safe and just operating space for humanity” are often used in planetary health discussions, but are not always clearly defined and so far, the field lacks a strong guiding ethical framework. In this paper, we propose a starting point towards a code of ethics for planetary health that builds on the Canmore Declaration. We chose to propose 12 ethical principles in recognition of the need for a 12-Step Programme for the planet. The human race must identify and reject damaging behaviours. Evidence of the harm we are causing the planet is no longer enough and refraining from certain current practices is essential for Earth’s future health. We must motivate advocacy and calls for action. We believe a shared ethical code can act as a tool to enable and encourage that process. This paper is presented to the planetary health community as a starting point, not as a finished agenda. We welcome comments, critiques, additions and the opportunity to rework our approach accordingly. Full article
15 pages, 228 KiB  
Article
(Bio)Ethics in a Pluralistic Society
by Ben Gray
Challenges 2019, 10(1), 12; https://doi.org/10.3390/challe10010012 - 22 Jan 2019
Cited by 3 | Viewed by 5063
Abstract
Traditional (bio) ethics relies to a large degree on the analysis of problems to determine the right course of action. In particular, in medicine, a dominant text declares that there is a “Common Morality” that applies to all people. This paper will argue [...] Read more.
Traditional (bio) ethics relies to a large degree on the analysis of problems to determine the right course of action. In particular, in medicine, a dominant text declares that there is a “Common Morality” that applies to all people. This paper will argue that ethics is culture bound and that, in a pluralistic society, a common morality approach to the resolution of problems has significant limitations. I will argue that more attention needs to be paid to the process of agreeing to a way forward given that there is disagreement. I will illustrate how this applies not only at the clinical level but also at the level of national and international politics. A theoretical understanding of compromise and a look at ways of describing the way people make ethical decisions as opposed to seeking an ideal ethical code is presented as a way in which we can manage problems better in a pluralistic society. Full article
21 pages, 354 KiB  
Article
Leadership Evolution for Planetary Health: A Genomics Perspective
by Jacinta T Ryan, Sandra Jones, Peter A Hayes and Jeffrey M Craig
Challenges 2019, 10(1), 4; https://doi.org/10.3390/challe10010004 - 15 Jan 2019
Cited by 2 | Viewed by 4699
Abstract
We are living in the Anthropocene period, where human activity has become the dominant influence on climate and the environment. Addressing the question of how nature and societies will evolve in the Anthropocene is one of the grand challenges of our time. This [...] Read more.
We are living in the Anthropocene period, where human activity has become the dominant influence on climate and the environment. Addressing the question of how nature and societies will evolve in the Anthropocene is one of the grand challenges of our time. This challenge requires a new form of leadership, one capable of transmuting the eroding relationship between business, society and nature. Yet at this critical time, leadership theory is at a crossroads, with many arguing that leadership, as a field of study, should be abandoned. Operating in parallel to this Anthropocene challenge is an increasing understanding of the complexity of the genome, including the inherent plasticity of our genomic hierarchies, and the influence of the genome on health, disease and evolution. This has demanded a change in thinking to view the genome from an evolutionary systems perspective. To address the imbalance presented by the Anthropocene, we propose using a genomic lens as the basis for thinking about leadership evolution. In arguing this, we aim to provide the pathway for an improved synergistic relationship between business, society and nature, one that can guide the future of humanity in the unstable world we have created. Full article
22 pages, 3634 KiB  
Article
Improving Health and Wealth by Introduction of an Affordable Bacterial Starter Culture for Probiotic Yoghurt Production in Uganda
by Nieke Westerik, Alex Paul Wacoo, Esther Anyimo, William Matovu, Gregor Reid, Remco Kort and Wilbert Sybesma
Challenges 2019, 10(1), 2; https://doi.org/10.3390/challe10010002 - 09 Jan 2019
Cited by 10 | Viewed by 6400
Abstract
In rural Africa, income generating activities of many households heavily depend on agricultural activities. In this paper, we present the results of a multi-year intervention whereby dairy farmers and small-scale entrepreneurs were taught to convert their milk into a probiotic yoghurt using an [...] Read more.
In rural Africa, income generating activities of many households heavily depend on agricultural activities. In this paper, we present the results of a multi-year intervention whereby dairy farmers and small-scale entrepreneurs were taught to convert their milk into a probiotic yoghurt using an innovative bacterial starter culture and basic equipment. This intervention creates additional sources of income and employment for people involved in the delivery of milk as well as production, distribution, and sales of yoghurt. Besides the economic benefits, the consumption of the probiotic yoghurt can contribute to reduction of the incidence and severity of diarrhea, respiratory tract infections, atopic diseases, alleviate the symptoms of stomach ulcers, and decrease the uptake of aflatoxins in the body. With minimal external financial support, 116 communities or small entrepreneurs have been able to start, expand, and maintain a business by production and sales of probiotic yoghurt. Applied business models and success rate in terms of revenues and profitability varied per region and depended on location, culture, ownership structure, wealth status, and gender. Full article
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13 pages, 1062 KiB  
Article
Tracking Trends in Emissions of Developmental Toxicants and Potential Associations with Congenital Heart Disease in Alberta, Canada
by Deliwe Precious Ngwezi, Lisa K. Hornberger, Jose Luis Cabeza-Gonzalez, Sujata Chandra, Deborah Fruitman and Alvaro Osornio-Vargas
Challenges 2018, 9(2), 28; https://doi.org/10.3390/challe9020028 - 12 Jul 2018
Cited by 1 | Viewed by 3642
Abstract
Congenital heart disease (CHD) is a serious anomaly for which the etiology remains elusive. We explored temporal trend associations between industrial developmental toxicant (DT) air emissions and CHD in Alberta. Patients born between 2004–2011 with a diagnosis of CHD and 18 DTs from [...] Read more.
Congenital heart disease (CHD) is a serious anomaly for which the etiology remains elusive. We explored temporal trend associations between industrial developmental toxicant (DT) air emissions and CHD in Alberta. Patients born between 2004–2011 with a diagnosis of CHD and 18 DTs from the National Pollutant Release Inventory (2003–2010) were identified. We applied principal component analysis (PCA) to DT amounts and toxicity risk scores (RS) and defined yearly crude CHD and septal defects rates for urban and rural regions. Correlations between DT groups and CHD rates were examined with Spearman test and Bonferroni correction was conducted for multiple comparisons. PCA identified three DT groups: Group 1 (volatile organic compounds (VOCs) and other gases,) Group 2 (other VOCs), and Group 3 (mainly heavy metals). Province-wide, we found associations between Group 1 DTs and CHD and septal defect rates, when using amounts (r = 0.86, CI 0.39, 0.97 and r = 0.89, CI 0.48, 0.98, respectively) and RS (r = 0.88, CI 0.47, 0.98 and r = 0.85, CI 0.36, 0.97, respectively). Rural Group 2 DTs were positively associated with septal defect rates in both amounts released and RS (r = 0.91, CI 0.55, 0.98 and r = 0.91, CI 0.55, 0.98, respectively). In this exploratory study, we found a temporal decrease in emissions and CHD rates in rural regions and a potential positive association between CHD and septal defect rates and mixtures of organic compounds with or without gases. Full article
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16 pages, 2474 KiB  
Article
Industrial Developmental Toxicants and Congenital Heart Disease in Urban and Rural Alberta, Canada
by Deliwe P. Ngwezi, Lisa K. Hornberger, Jesus Serrano-Lomelin, Charlene C. Nielsen, Deborah Fruitman and Alvaro Osornio-Vargas
Challenges 2018, 9(2), 26; https://doi.org/10.3390/challe9020026 - 01 Jul 2018
Cited by 8 | Viewed by 4190
Abstract
The etiology of congenital heart defects (CHD) is not known for many affected patients. In the present study, we examined the association between industrial emissions and CHD in urban and rural Alberta. We acquired the emissions data reported in the Canadian National Pollutant [...] Read more.
The etiology of congenital heart defects (CHD) is not known for many affected patients. In the present study, we examined the association between industrial emissions and CHD in urban and rural Alberta. We acquired the emissions data reported in the Canadian National Pollutant Release Inventory (n = 18) and identified CHD patients born in Alberta from 2003–2010 (n = 2413). We identified three groups of emissions after principal component analysis: Groups 1, 2, and 3. The distribution of exposure to the postal codes with births was determined using an inverse distance weighted approach. Poisson or negative binomial regression models helped estimate associations (relative risk (RR), 95% Confidence Intervals (CI)) adjusted for socioeconomic status and two criteria pollutants: nitrogen dioxide and particulate matter with a mean aerodynamic diameter of ≤2.5 micrometers. The adjusted RR in urban settings was 1.8 (95% CI: 1.5, 2.3) for Group 1 and 1.4 (95% CI: 1.3, 1.6) for both Groups 2 and 3. In rural postal codes, Groups 1 and 3 emissions had a RR of 2.6 (95% CI: 1.03, 7). Associations were only observed in postal codes with the highest levels of emissions and maps demonstrated that regions with very high exposures were sparse. Full article
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Review

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15 pages, 531 KiB  
Review
High-Rise Apartments and Urban Mental Health—Historical and Contemporary Views
by Danica-Lea Larcombe, Eddie van Etten, Alan Logan, Susan L. Prescott and Pierre Horwitz
Challenges 2019, 10(2), 34; https://doi.org/10.3390/challe10020034 - 31 Jul 2019
Cited by 15 | Viewed by 27189
Abstract
High-rise apartment buildings have long been associated with the poor mental health of their residents. The aims of this paper are to examine whether this connection is necessarily so, by reviewing the evidence relating to the relationships between high-rise living and social wellbeing, [...] Read more.
High-rise apartment buildings have long been associated with the poor mental health of their residents. The aims of this paper are to examine whether this connection is necessarily so, by reviewing the evidence relating to the relationships between high-rise living and social wellbeing, occupant’s stress levels, and the influence they have on mental health. From selected literature, psychological stress and poor mental health outcomes of the populations that live in high-rise apartments are indeed apparent, and this is particularly so for apartments in poor neighbourhoods. Yet many apartments in developed cities are in affluent areas (particularly those with views of green/blue space), where residences on higher floors are more expensive. Either way, high-rise living and mental health outcomes are a social justice issue. Our review allows us to propose two models relating to high-rise living relevant today, based on these differences. Full article
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20 pages, 349 KiB  
Review
Philanthrocapitalism: Promoting Global Health but Failing Planetary Health
by Colin D Butler
Challenges 2019, 10(1), 24; https://doi.org/10.3390/challe10010024 - 23 Mar 2019
Cited by 3 | Viewed by 18416
Abstract
Focusing on the Bill and Melinda Gates Foundation (BMGF) as a case study, this paper explores the relationship between philanthrocapitalism, economic history, and global and planetary health. The Wellcome Trust is also briefly discussed, chiefly in the context of planetary health. The paper [...] Read more.
Focusing on the Bill and Melinda Gates Foundation (BMGF) as a case study, this paper explores the relationship between philanthrocapitalism, economic history, and global and planetary health. The Wellcome Trust is also briefly discussed, chiefly in the context of planetary health. The paper argues that in the last 45 years there has been an increased preference for market-based approaches, often called neoliberalism, particularly in the U.S. and its allies. This has generated greater inequality in many high-income settings and weakened the norm of taxation. This has provided a setting in which philanthrocapitalism has flourished, including the BMGF. The latter has in turn become an important actor for global health, partially balancing the adverse consequences of neoliberalism. Planetary health is here defined as the interaction between global health and global environmental change, including to the climate and other elements of the Earth System. Although the Wellcome Trust has recently made funds available for ecological health research, it continues to invest in fossil fuels. The Gates Foundation provide no or minimal grants for ecological or planetary health but appear to have recently substantially divested from fossil fuels, for unclear reasons. The paper concludes that these large philanthrocapitalist organizations partly compensate for the decline in attention to global health driven by market-preferring solutions, but remain insufficiently proactive in the face of the great dangers associated with declining planetary health. Full article
7 pages, 196 KiB  
Review
More Than Idyll Speculation: Utopian Thinking for Planetary Health
by Julian W. Fernando, Léan V. O’Brien, Madeline Judge and Yoshihisa Kashima
Challenges 2019, 10(1), 16; https://doi.org/10.3390/challe10010016 - 18 Feb 2019
Cited by 9 | Viewed by 4705
Abstract
The problems and challenges associated with planetary health are vast and interconnected, and are therefore requiring of research which takes an all-of-society perspective. Following calls for input from behavioural scientists in discussions about planetary health, we here present a review and synthesis of [...] Read more.
The problems and challenges associated with planetary health are vast and interconnected, and are therefore requiring of research which takes an all-of-society perspective. Following calls for input from behavioural scientists in discussions about planetary health, we here present a review and synthesis of recent research on utopian thinking and lay beliefs about societal change. For some time, utopian theorists have recognised the capacity of ideals for society to motivate social change behaviour, but this has largely been ignored by behavioural scientists. However, recent research has shown that utopian thinking elicits social change behaviour among ordinary people, and that a utopia with pro-environmental content tends to be especially motivating. Furthermore, changes which are seen as increasing levels of warmth and morality in society elicit greater levels of support and motivation to bring about those changes. These findings have implications for how social movements for planetary health can proceed and provide hope for motivating the necessary social change. We present this work in the hope that it can contribute to the furtherance of efforts for the achievement of planetary health. Full article
29 pages, 4948 KiB  
Review
Geographical Analysis of the Distribution of Publications Describing Spatial Associations among Outdoor Environmental Variables and Really Small Newborns in the USA and Canada
by Charlene C. Nielsen, Carl G. Amrhein and Alvaro R. Osornio-Vargas
Challenges 2019, 10(1), 11; https://doi.org/10.3390/challe10010011 - 21 Jan 2019
Cited by 2 | Viewed by 4395
Abstract
Newborns defined as being of “low birth weight” (LBW) or “small for gestational age” (SGA) are global health issues of concern because they are vulnerable to mortality and morbidity. Prenatal exposures may contribute to LBW/SGA. In this review, we searched peer-reviewed scientific literature [...] Read more.
Newborns defined as being of “low birth weight” (LBW) or “small for gestational age” (SGA) are global health issues of concern because they are vulnerable to mortality and morbidity. Prenatal exposures may contribute to LBW/SGA. In this review, we searched peer-reviewed scientific literature to determine what location-based hazards have been linked with LBW/SGA in the industrialized nations of Canada and the USA. After selecting studies based on inclusion/exclusion criteria, we entered relevant details in to an evidence table. We classified and summarized 159 articles based on type of environment (built = 108, natural = 10, and social = 41) and general category of environmental variables studied (e.g., air pollution, chemical, water contamination, waste site, agriculture, vegetation, race, SES, etc.). We linked the geographic study areas by province/state to political boundaries in a GIS to map the distributions and frequencies of the studies. We compared them to maps of LBW percentages and ubiquitous environmental hazards, including land use, industrial activity and air pollution. More studies had been completed in USA states than Canadian provinces, but the number has been increasing in both countries from 1992 to 2018. Our geographic inquiry demonstrated a novel, spatially-focused review framework to promote understanding of the human ‘habitat’ of shared environmental exposures that have been associated with LBW/SGA. Full article
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16 pages, 876 KiB  
Review
Environmental Impact on Health across Generations: Policy Meets Biology. A Review of Animal and Human Models
by Marianne Lønnebotn, Natalia El-Merhie, John W. Holloway, William Horsnell, Susanne Krauss-Etschmann, Francisco Gómez Real and Cecilie Svanes
Challenges 2018, 9(2), 42; https://doi.org/10.3390/challe9020042 - 11 Dec 2018
Cited by 2 | Viewed by 5611
Abstract
Intrauterine and early life has been accepted as important susceptibility windows for environmental exposure and disease later in life. Emerging evidence suggests that exposure before conception may also influence health in future generations. There has been little research on human data to support [...] Read more.
Intrauterine and early life has been accepted as important susceptibility windows for environmental exposure and disease later in life. Emerging evidence suggests that exposure before conception may also influence health in future generations. There has been little research on human data to support this until now. This review gives evidence from epigenetic as well as immunologic research, and from animal as well as human models, supporting the hypothesis that there may be important susceptibility windows before conception in relation to exposure such as obesity, diet, smoking and infections. It is likely that we can identify vulnerability windows in men and women in which interventions may have an impact on several generations in addition to individual health. Establishing vulnerability windows affecting health over future generations, and not only in the now or the near future of the individual, may provide tremendous opportunities for health policy and practice. Full article
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10 pages, 5833 KiB  
Review
Planetary Health and the Future of Human Capacity: The Increasing Impact of Planetary Distress on the Human Brain
by Chong Chen and Shin Nakagawa
Challenges 2018, 9(2), 41; https://doi.org/10.3390/challe9020041 - 22 Nov 2018
Cited by 8 | Viewed by 5476
Abstract
All awareness, thoughts, emotions, perceptions, memories, actions—everything that encompasses our human capacity and reality—are mediated through the biological interface of our brains. While the source of consciousness remains a fundamental and elusive question, it is also inescapable that threats to biological health can [...] Read more.
All awareness, thoughts, emotions, perceptions, memories, actions—everything that encompasses our human capacity and reality—are mediated through the biological interface of our brains. While the source of consciousness remains a fundamental and elusive question, it is also inescapable that threats to biological health can compromise any and all aspects of psychological and neurological functioning, from the first moments of life. The effects of environmental threats to specific aspects of individual brain health are well recognized, yet precious little attention is given to the collective effects of planetary-scale environmental damage, and the erosion of numerous planetary systems, on the biology of the human brain. Although, these are likely to vary widely with individual circumstances, it is also inevitable that the ‘dysbiotic drift’ (increasing life in distress) at the planetary scale is reflected at the personal scale, with a collective shift towards increased biological stress of all kinds. Here, we make the case that ‘planetary distress’ is directly implicated in a collective increase in ‘personal distress’, and that multifaceted biological pressures, as well as psychological pressures, are implicated in the mental health crisis and predisposition to numerous disorders in brain development, functioning and aging. In turn, this has implications for every aspect of health, capacity, and the very essence of human experience for generations to come. Viewed on this scale, we call for a quantum shift in efforts to address the many factors affecting brain health, ranging from air pollution to disappearing greenspace. These all stem from ecological imbalance and point to a unifying need to restore planetary health. Ultimately, the future of human capacity depends on this. Full article
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Other

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12 pages, 841 KiB  
Perspective
Indigenous Natural and First Law in Planetary Health
by Nicole Redvers, Anne Poelina, Clinton Schultz, Daniel M. Kobei, Cicilia Githaiga, Marlikka Perdrisat, Donald Prince and Be’sha Blondin
Challenges 2020, 11(2), 29; https://doi.org/10.3390/challe11020029 - 28 Oct 2020
Cited by 45 | Viewed by 21463
Abstract
Indigenous Peoples associate their own laws with the laws of the natural world, which are formally known as or translated as Natural or First Law. These laws come from the Creator and the Land through our ancestral stories and therefore, they are sacred. [...] Read more.
Indigenous Peoples associate their own laws with the laws of the natural world, which are formally known as or translated as Natural or First Law. These laws come from the Creator and the Land through our ancestral stories and therefore, they are sacred. All aspects of life and existence depend on living and following these natural First Laws. Since colonization, Indigenous Peoples’ Natural Laws have been forcibly replaced by modern-day laws that do not take into account the sacred relationship between the Earth and all of her inhabitants. The force of societies who live outside of Natural Law has ensured the modern-day consequences of not living in balance with nature. Pandemics and global environmental change, including climate change, are all consequences of not following the Natural Laws that are encapsulated by the interconnected nature of the universe. Here we discuss Natural Law from an Indigenous paradigm and worldview which carries implications for planetary health and wider environmental movements around the globe. Full article
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19 pages, 1854 KiB  
Perspective
Towards Healthy Planet Diets—A Transdisciplinary Approach to Food Sustainability Challenges
by Stefan C. Dekker, Aletta D. Kraneveld, Jerry van Dijk, Agni Kalfagianni, Andre C. Knulst, Herman Lelieveldt, Ellen H. M. Moors, Eggo Müller, Raymond H. H. Pieters, Corné M. J. Pieterse, Stephanie Rosenkranz, Laurentius A. C. J. Voesenek and August C. M. van Westen
Challenges 2020, 11(2), 21; https://doi.org/10.3390/challe11020021 - 18 Sep 2020
Cited by 5 | Viewed by 5772
Abstract
The future of food is one of the major world-wide challenges. In this perspective paper, we set-up a framework for a multi-disciplinary future food systems approach, building on the UN Sustainable Development Goals. We hereby combine a truly sustainable approach including social science [...] Read more.
The future of food is one of the major world-wide challenges. In this perspective paper, we set-up a framework for a multi-disciplinary future food systems approach, building on the UN Sustainable Development Goals. We hereby combine a truly sustainable approach including social science aspects combined with the One Health approach. Scientists from a large number of backgrounds have addressed four key areas that are discussed in more detail in this paper: (i) nature inspired food production, (ii) sustainable immune resilience, (iii) social and cultural change of food behavior, and (iv) food fairness. We believe that transformations to integrated future food system approaches should move beyond single solutions and can only be solved by working in transdisciplinary settings of science, society, and industry. Full article
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23 pages, 5382 KiB  
Viewpoint
Project Earthrise: Inspiring Creativity, Kindness and Imagination in Planetary Health
by Alan C. Logan, Susan H. Berman, Brian M. Berman and Susan L. Prescott
Challenges 2020, 11(2), 19; https://doi.org/10.3390/challe11020019 - 04 Sep 2020
Cited by 8 | Viewed by 7715
Abstract
The concept of planetary health blurs the artificial lines between health at scales of person, place and planet. At the same time, it emphasizes the integration of biological, psychological, social and cultural aspects of health in the modern environment. Our grandest challenges in [...] Read more.
The concept of planetary health blurs the artificial lines between health at scales of person, place and planet. At the same time, it emphasizes the integration of biological, psychological, social and cultural aspects of health in the modern environment. Our grandest challenges in the Anthropocene ultimately stem from human attitudes to each other and to our environment. However, solutions rarely confront the underlying value systems that created these interconnected problems, or the attitudes that perpetuate them. Too often, the dominant focus is on the “worst of human nature”, and devalues or neglects the importance of empathy, kindness, hope, love, creativity and mutual respect—the deeper values that unite, empower and refocus priorities of individuals and groups. Here, we call to normalize more creative, mutualistic approaches—including the perspectives of traditional and indigenous cultures—to positively influence normative value systems. We revisit the power of inspiration with the profound example of the Apollo 8 Earthrise photo which galvanized a fledgling planetary health movement over 50 years ago. Through the inaugural Earth Day that followed, we are reminded that its early organizers were not constrained in how they defined the “environment”. They and their primary speakers were as concerned about value systems as they were about pollution—that we cannot hope to solve our problems without addressing the attitudes that created them in the first place. We explore the ways in which the awe of Earthrise—and the contemporary science of creativity and studies of utopian thinking—might reinvigorate imagination, kindness and mutualism. We revisit the fundamental challenge offered by Pulitzer-Prize-winning microbiologist Rene Dubos and others in the afterglow of the Earthrise photo, and the inaugural Earth Day. This is a question of imagination: What kind of world we want to live in? Full article
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11 pages, 14619 KiB  
Perspective
Bringing Fronts Back: A Research Agenda to Investigate the Health and Well-Being Impacts of Front Gardens
by Lauriane Suyin Chalmin-Pui, Alistair Griffiths, Jenny J. Roe and Ross W. F. Cameron
Challenges 2019, 10(2), 37; https://doi.org/10.3390/challe10020037 - 24 Sep 2019
Cited by 8 | Viewed by 7370
Abstract
This perspective article proposes an agenda to investigate the impacts of front gardens (yards) on health and well-being. As front gardens are increasingly being paved over, significant ecological benefits will be lost. In addition, urban green infrastructure has a measurable role to play [...] Read more.
This perspective article proposes an agenda to investigate the impacts of front gardens (yards) on health and well-being. As front gardens are increasingly being paved over, significant ecological benefits will be lost. In addition, urban green infrastructure has a measurable role to play in addressing major public health issues related to mental health, chronic stress, inflammatory, and cardiovascular diseases. The social value of front gardens remains un-quantified. Future research can contribute to assessing the psycho-socio-cultural value of front gardens, and fostering healthy environments for people to live, work, and play in. A better understanding of the health impacts of front gardens can provide a relatable argument to protect permeable surfaces and spaces for nature, as well as to discourage the general public from paving over their front gardens. We propose eight central research questions to be addressed in future work, and elaborate on further variables, lines of inquiry, and suggested intervention trials and observational studies. Potential research findings will have implications for decision-making in fields of horticulture, landscape architecture, urban planning, and public health. Full article
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4 pages, 202 KiB  
Viewpoint
Social Cohesion and City Green Space: Revisiting the Power of Volunteering
by Viniece Jennings
Challenges 2019, 10(2), 36; https://doi.org/10.3390/challe10020036 - 20 Sep 2019
Cited by 1 | Viewed by 4055
Abstract
Urban green spaces can facilitate positive social interactions in numerous ways. These interactions may lead to the development of social cohesion among city dwellers. This article provides a viewpoint on the potential role that the presence of green space and volunteering can play [...] Read more.
Urban green spaces can facilitate positive social interactions in numerous ways. These interactions may lead to the development of social cohesion among city dwellers. This article provides a viewpoint on the potential role that the presence of green space and volunteering can play in the construct of social cohesion. Specifically, the article focuses on one aspect of social cohesion, volunteerism, as a way to illustrate the immense potential of social cohesion to link health with place and the planet. Full article
18 pages, 2005 KiB  
Commentary
The Scientist: Creator and Destroyer—“Scientists’ Warning to Humanity” Is a Wake-Up Call for Researchers
by Marek Cuhra
Challenges 2019, 10(2), 33; https://doi.org/10.3390/challe10020033 - 31 Jul 2019
Cited by 2 | Viewed by 7761
Abstract
Scientists investigate, describe, invent and create. Most advances in medicine, technology and understanding of the living world in the context of the cosmos, are attributable to systematic efforts by expert researchers. However, pervasive toxins, persistent environmental pollution, destructive weaponry and resource depletion are [...] Read more.
Scientists investigate, describe, invent and create. Most advances in medicine, technology and understanding of the living world in the context of the cosmos, are attributable to systematic efforts by expert researchers. However, pervasive toxins, persistent environmental pollution, destructive weaponry and resource depletion are also outcomes of scientific efforts. Furthermore, although we have reached great advances in some research fields, other issues are enigmatic and arguably could be investigated with other methods or mindsets. That, however, brings us to a paradoxical realization: Despite the fact that there are more scientists in this world than ever before, due to socialization and indoctrination we are currently suffering from reduced cognitive diversity within academic disciplines. Arguably, scientists are not taught to think independently and differently, instead we are educated into a compliant, univocal and homogenous, ‘Wissenschaftlicher Denkkollektiv.’ Full article
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28 pages, 1941 KiB  
Perspective
Beyond Science and Technology: Creating Planetary Health Needs Not Just ‘Head Stuff’, but Social Engagement and ‘Heart, Gut and Spirit’ Stuff
by Trevor Hancock
Challenges 2019, 10(1), 31; https://doi.org/10.3390/challe10010031 - 14 Jun 2019
Cited by 11 | Viewed by 7444
Abstract
I have been involved in studying and working within what is now called the Anthropocene for almost 50 years, and in all that time, not only have we failed to make much progress, but the state of the Earth’s ecosystems has generally worsened. [...] Read more.
I have been involved in studying and working within what is now called the Anthropocene for almost 50 years, and in all that time, not only have we failed to make much progress, but the state of the Earth’s ecosystems has generally worsened. Yet somehow we must create a world in which everyone on Earth has good health and a good quality of life—a matter of social justice—while living within the physical and ecological constraints of the one small planet that is our home; this is the focus of the new field of planetary health. Our worsening situation is not due to lack of knowledge, science and technology; in broad terms, we knew most of the challenges and many of the needed solutions back in the 1970s. Instead, the challenges we face are social, rooted in cultural values, political ideologies, legal and economic systems, ethical principles and spiritual/religious beliefs. Therefore, we have to move beyond science and technology and address these broader socio-cultural issues by engaging in economic, legal and political work, complementing and supplementing ‘head stuff’ with ‘heart, gut and spirit stuff’, and working from the grass roots up. Full article
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14 pages, 1038 KiB  
Case Report
A Collaborative Research Exploration of Pollutant Mixtures and Adverse Birth Outcomes by Using Innovative Spatial Data Mining Methods: The DoMiNO Project
by Osnat Wine, Osmar R. Zaiane and Alvaro R. Osornio Vargas
Challenges 2019, 10(1), 25; https://doi.org/10.3390/challe10010025 - 25 Mar 2019
Cited by 1 | Viewed by 4076
Abstract
Environmental health research is gaining interest due to the global concern of environmental factors impacting health. This research is often multifaceted and becomes complex when trying to understand the participation of multiple environmental variables. It requires the combination of innovative research methods, as [...] Read more.
Environmental health research is gaining interest due to the global concern of environmental factors impacting health. This research is often multifaceted and becomes complex when trying to understand the participation of multiple environmental variables. It requires the combination of innovative research methods, as well as the collaboration of diverse disciplines in the research process. The application of collaborative approaches is often challenging for interdisciplinary teams, and much can be learned from in-depth observation of such processes. We share here a case report describing initial observations and reflections on the collaborative research process of the Data Mining and Neonatal Outcomes (DoMiNO) project (2013–2018), which aimed to explore associations between mixtures of air pollutants and other environmental variables with adverse birth outcomes by using an innovative data mining approach. The project was built on interdisciplinary and user knowledge participation with embedded evaluation framework of its collaborative process. We describe the collaborative process, the benefits and challenges encountered, and provide insights from our experience. We identified that interdisciplinary research requires time and investment in building relationships, continuous learning, and engagement to build bridges between disciplines towards co-production, discovery, and knowledge translation. Learning from interdisciplinary collaborative research experiences can facilitate future research in the challenging field of environmental health. Full article
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9 pages, 636 KiB  
Commentary
Multiomics and Systems Biology Are Needed to Unravel the Complex Origins of Chronic Disease
by David Martino, Rym Ben-Othman, Danny Harbeson and Anthony Bosco
Challenges 2019, 10(1), 23; https://doi.org/10.3390/challe10010023 - 21 Mar 2019
Cited by 3 | Viewed by 4534
Abstract
Modernization has now been linked to poor developmental experience, the onset of immune dysregulation and rising rates of chronic diseases in many parts of the world. Research across the epidemiological, clinical, and basic science domains supports the concept that poor developmental experience, particularly [...] Read more.
Modernization has now been linked to poor developmental experience, the onset of immune dysregulation and rising rates of chronic diseases in many parts of the world. Research across the epidemiological, clinical, and basic science domains supports the concept that poor developmental experience, particularly during prenatal life, can increase the risk of chronic disease, with enduring effects on long-term health. Single ‘omics’ approaches are ill-suited to dealing with the level of complexity that underpins immune dysregulation in early life. A more comprehensive systems-level view is afforded by combining multiple ‘omics’ datasets in order to delineate correlations across multiple resolutions of the genome, and of the genomes of the microorganisms that inhabit us. In this concept paper, we discuss multiomic approaches to studying immune dysregulation and highlight some of the challenges and opportunities afforded by this new domain of medical science. Full article
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13 pages, 224 KiB  
Perspective
Intertwined Strands for Ecology in Planetary Health
by Pierre Horwitz and Margot W. Parkes
Challenges 2019, 10(1), 20; https://doi.org/10.3390/challe10010020 - 14 Mar 2019
Cited by 11 | Viewed by 5360
Abstract
Ecology is both blessed and burdened by romanticism, with a legacy that is multi-edged for health. The prefix ‘eco-’ can carry a cultural and political (subversive) baggage, associated with motivating environmental activism. Ecology is also practiced as a technical ‘science’, with quantitative and [...] Read more.
Ecology is both blessed and burdened by romanticism, with a legacy that is multi-edged for health. The prefix ‘eco-’ can carry a cultural and political (subversive) baggage, associated with motivating environmental activism. Ecology is also practiced as a technical ‘science’, with quantitative and deterministic leanings and a biophysical emphasis. A challenge for planetary health is to avoid lapsing into, or rejecting, either position. A related opportunity is to adopt ecological thought that offers a rich entrance to understanding living systems: a relationality of connectedness, interdependence, and reciprocity to understand health in a complex and uncertain world. Planetary health offers a global scale framing; we regard its potential as equivalent to the degree to which it can embrace, at its core, ecological thought, and develop its own political narrative. Full article
5 pages, 792 KiB  
Viewpoint
Bees in the D: A Message of Conservation from an Urban Environment
by Brian Peterson Roest
Challenges 2019, 10(1), 19; https://doi.org/10.3390/challe10010019 - 08 Mar 2019
Cited by 3 | Viewed by 4410
Abstract
Examples of urban restoration and rewilding are critical in promoting grass roots efforts to restore ecosystems diversity in built environments. Honey bees are a vital part of many ecosystems, and urban beekeeping is a growing initiative with multiple benefits, spanning from ecological revitalization, [...] Read more.
Examples of urban restoration and rewilding are critical in promoting grass roots efforts to restore ecosystems diversity in built environments. Honey bees are a vital part of many ecosystems, and urban beekeeping is a growing initiative with multiple benefits, spanning from ecological revitalization, to community cooperation, education, and cohesion. Here, we provide our own experience establishing an extensive system of roof top apiaries as cooperative effort between residents, schools, organizations, and businesses in the city of Detroit, Michigan. Our goal was to contribute to both the health of honey bee colonies and the education of their importance to our urban environment, through wide community engagement including interactive children’s educational events. Honey produced from this not-for-profit initiative is donated to local charities and small businesses, for fundraising, and also used for food and beverages in hospitality around the city. Research collaborations with scientists studying honey bee colony health, including the microbiome of honey bees, will explore possible solutions to help protect from pathogens and diseases. Most of all, we hope that this example will be of inspiration to others to take steps towards ecological solutions, in any and every form, within their own communities. Full article
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26 pages, 2369 KiB  
Perspective
Narrative Medicine Meets Planetary Health: Mindsets Matter in the Anthropocene
by Susan L. Prescott and Alan C. Logan
Challenges 2019, 10(1), 17; https://doi.org/10.3390/challe10010017 - 20 Feb 2019
Cited by 7 | Viewed by 8219
Abstract
The emerging concept of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political, and otherwise)—emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere. In the clinical setting, [...] Read more.
The emerging concept of planetary health—defined as the interdependent vitality of all natural and anthropogenic ecosystems (social, political, and otherwise)—emphasizes that the health of human civilization is intricately connected to the health of natural systems within the Earth’s biosphere. In the clinical setting, narrative medicine underscores the importance of absorbing, reflecting upon, and responding to the narratives—the stories—conveyed by patients. Education and interventions using the tenets of narrative medicine have demonstrated value to both patient and provider. Given the grand interconnected challenges of our time—compounded by misinformation and quasi-scientific narratives propagated by the ideology of neoliberalism—we argue that the principles and practice of narrative medicine can be applied on a larger scale, one with planetary health in mind. The role of beliefs, expectations, and agency—mindsets—in the link between narrative and planetary health are emphasized. We use a story of our own to demonstrate that the biological buffering capacity in response to a fast-food meal does not sit on a level socioeconomic playing field. Patient, community, and global health narratives are melding with powerful narratives set by commercial entities. The success of planetary health as a new concept will be strengthened by attention to the ways in which storytelling can influence positive change. No less important is an understanding of the ways in which stories contribute to what ails person, place, and planet. Full article
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16 pages, 758 KiB  
Perspective
Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind
by David H. Nelson, Susan L. Prescott, Alan C. Logan and Jeffrey S. Bland
Challenges 2019, 10(1), 15; https://doi.org/10.3390/challe10010015 - 18 Feb 2019
Cited by 15 | Viewed by 10866
Abstract
Four decades ago, several health movements were sprouting in isolation. In 1980, the environmental group Friends of the Earth expanded the World Health Organization definition of health, reminding citizenry that, “health is a state of complete physical, mental, social and ecological well-being and [...] Read more.
Four decades ago, several health movements were sprouting in isolation. In 1980, the environmental group Friends of the Earth expanded the World Health Organization definition of health, reminding citizenry that, “health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—personal health involves planetary health”. At the same time, a small group of medical clinicians were voicing the concept of “clinical ecology”—that is, a perspective that sees illness, especially chronic illness, as a response to the total lived experience and the surroundings in which “exposures” accumulate. In parallel, other groups advanced the concept of holistic medicine. In 1977, the progressive physician-scientist Jonas Salk stated that “we are entering into a new Epoch in which holistic medicine will be the dominant model”. However, only recently have the primary messages of these mostly isolated movements merged into a unified interdisciplinary discourse. The grand, interconnected challenges of our time—an epidemic of non-communicable diseases, global socioeconomic inequalities, biodiversity losses, climate change, disconnect from the natural environment—demands that all of medicine be viewed from an ecological perspective. Aided by advances in ‘omics’ technology, it is increasingly clear that each person maintains complex, biologically-relevant microbial ecosystems, and those ecosystems are, in turn, a product of the lived experiences within larger social, political, and economic ecosystems. Recognizing that 21st-century medicine is, in fact, clinical ecology can help clear an additional path as we attempt to exit the Anthropocene. Full article
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7 pages, 188 KiB  
Concept Paper
The Effects of Chlorinated Drinking Water on the Assembly of the Intestinal Microbiome
by David Martino
Challenges 2019, 10(1), 10; https://doi.org/10.3390/challe10010010 - 20 Jan 2019
Cited by 12 | Viewed by 13769
Abstract
This concept paper discusses the potential impact of chlorinated public drinking water on the assembly of the intestinal microbiome in infancy. The addition of chlorine or hypochlorite to metropolitan drinking water is routinely used worldwide as a sanitizer because of its potent anti-microbial [...] Read more.
This concept paper discusses the potential impact of chlorinated public drinking water on the assembly of the intestinal microbiome in infancy. The addition of chlorine or hypochlorite to metropolitan drinking water is routinely used worldwide as a sanitizer because of its potent anti-microbial properties. It is one of the most effective means of delivering safe drinkable water because it produces a residual disinfectant that persists within the distribution system. Levels of chlorine used to treat metropolitan water are considered safe for the individual, based on toxicity studies. However, to our knowledge there have been no studies examining whether levels of persistent chlorine exposure from tap water are also safe for the ecosystem of microorganisms that colonize the gastrointestinal tract. Given the importance of the microbiome in health, persistent exposure to low levels of chlorine may be a hitherto unrecognized risk factor for gut dysbiosis, which has now been linked to virtually every chronic non-communicable disease of the modern era. Although effects may be subtle, young children and infants are more susceptible to ecological disturbance, given that the microbiome is highly influenced by environmental factors during this period. Here I outline considerations for the safety of water disinfectants not just in terms of toxicity to the host, but also for the ecosystem of microorganisms that inhabit us. Research in this is likely to bear fruitful information that could either bring attention to this issue, potentially driving new innovations in public water management; or could help confirm the safety profile of chlorine levels in public drinking water. Full article
14 pages, 1186 KiB  
Perspective
Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health
by Jake M. Robinson and Martin F. Breed
Challenges 2019, 10(1), 9; https://doi.org/10.3390/challe10010009 - 17 Jan 2019
Cited by 75 | Viewed by 18943
Abstract
There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative [...] Read more.
There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative approaches aimed at addressing these issues—also known as nature-based solutions. An example of an emerging nature-based solution is a ‘green prescription’, broadly defined as a nature-based health intervention. Green prescriptions are typically designed for patients with a defined need and they have the potential to supplement orthodox medical treatments, particularly those aimed at addressing noncommunicable diseases. It is also thought that green prescriptions could bring about significant environmental, economic, and social co-benefits. However, researchers have recently expressed concerns over taking the ‘dose of nature’ approach, in that it may be too reductionistic for the complex social settings in which it is provided. Here we frame a holistic philosophical perspective and discuss green prescribing logic, types, mechanisms and fundamental remaining questions and challenges. We place a significant emphasis on the potential co-benefits of green prescriptions, and the importance of taking a planetary health approach. More research is needed to determine how this potential can be realised, and to further understand the complexities of the nature–human health relationship. However, with additional research and support, there is huge potential for green prescriptions to contribute to both reactive (health care) and proactive (health promoting) public health solutions whilst enhancing the natural environment. Full article
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7 pages, 1402 KiB  
Viewpoint
Planetary Health: A New Reality
by Jonathan D. Salk
Challenges 2019, 10(1), 7; https://doi.org/10.3390/challe10010007 - 16 Jan 2019
Cited by 5 | Viewed by 5266
Abstract
The grand challenges of our time—climate change, biodiversity losses, and global non-communicable disease rates—underscore that humanity and the planet are in crisis. Planetary health provides a unifying concept wherein efforts toward remediation and survival can be concentrated. Evidence derived from the animal kingdom [...] Read more.
The grand challenges of our time—climate change, biodiversity losses, and global non-communicable disease rates—underscore that humanity and the planet are in crisis. Planetary health provides a unifying concept wherein efforts toward remediation and survival can be concentrated. Evidence derived from the animal kingdom and from human demography suggest that there is cause for optimism in planetary health. With proper navigation, a transition toward a new epoch—one of symbiotic flourishing—is possible. Responses to the current challenges can usher in a new reality, one in which the core value is the well-being of all. This paper presents the philosophies and perspectives of renown biophilosopher, Jonas Salk, who—after developing the first effective vaccine to prevent polio, one of the great achievements in public health—expanded his vision beyond the prevention of individual diseases to that of addressing the basic problems of humankind. This vision is very much in line with our current understanding of and approach to planetary health. In response to changing conditions, planetary limits, and evolutionary pressure, new values, new communities, and new modes of interacting will likely emerge and be integrated with developments in science, technology, economics, the arts, and international relations, resulting in our survival and enhanced health and well-being. Full article
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9 pages, 922 KiB  
Viewpoint
Sanitization of Early Life and Microbial Dysbiosis
by Shelly Jun, Kelsea Drall, Brittany Matenchuk, Cara McLean, Charlene Nielsen, Chinwe V. Obiakor, Aaron Van der Leek and Anita Kozyrskyj
Challenges 2018, 9(2), 43; https://doi.org/10.3390/challe9020043 - 18 Dec 2018
Cited by 3 | Viewed by 5125
Abstract
Childbearing and infant care practices have dramatically evolved since the 15th century. Shifting away from traditional home-based experiences, with the emergence of the microbial aware era and the hospital as a quintessential sanitizing machine, early life has now long been characterized as a [...] Read more.
Childbearing and infant care practices have dramatically evolved since the 15th century. Shifting away from traditional home-based experiences, with the emergence of the microbial aware era and the hospital as a quintessential sanitizing machine, early life has now long been characterized as a condition to be medically managed. Paradoxically, this ‘germ-free’ march towards a healthier early life environment has opened the door to greater microbial susceptibility and dysbiosis. Many studies have now established that infant exposure to excessive sanitation and hygiene regimens are associated with an increased risk for and onset of childhood immune system diseases. In this paper, we explore the ways in which biomedical-centered efforts to enhance early life have come at a cost to planetary health, in relation to infant microbial succession. We examine three major areas of early life that have been subject to the ‘ripple effect’ of hygiene and sanitation concerns—childbirth, home environment, and breastfeeding. Full article
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15 pages, 2056 KiB  
Perspective
Walking Ecosystems in Microbiome-Inspired Green Infrastructure: An Ecological Perspective on Enhancing Personal and Planetary Health
by Jake M. Robinson, Jacob G. Mills and Martin F. Breed
Challenges 2018, 9(2), 40; https://doi.org/10.3390/challe9020040 - 16 Nov 2018
Cited by 46 | Viewed by 18066
Abstract
Principles of ecology apply at myriad scales, including within the human body and the intertwined macro and microscopic ecosystems that we depend upon for survival. The conceptual principles of dysbiosis (‘life in distress’) also apply to different realms of life—our microbiome, [...] Read more.
Principles of ecology apply at myriad scales, including within the human body and the intertwined macro and microscopic ecosystems that we depend upon for survival. The conceptual principles of dysbiosis (‘life in distress’) also apply to different realms of life—our microbiome, the macro environment and the socioeconomic domain. Viewing the human body as a holobiont—a host plus billions of microbial organisms working symbiotically to form a functioning ecological unit—has the potential to enhance personal and planetary health. We discuss this ecological perspective in our paper. We also discuss the proposals to rewild the microbiome, innovative microbiome-inspired green infrastructure (MIGI) and the basis of prescribing ‘doses of nature’. Particular emphasis is given to MIGI—a collective term for the design and management of innovative living urban features that could potentially enhance public health via health-inducing microbial interactions. This concept builds upon the microbiome rewilding hypothesis. Mounting evidence points to the importance of microbial diversity in maintaining favorable health. Moreover, connecting with nature—both physically and psychologically–has been shown to enhance our health and wellbeing. However, we still need to understand the underlying mechanisms, and optimal types and levels of exposure. This paper adds to other recent calls for the inclusion of the environment-microbiome-health axis in nature–human health research. Recognizing that all forms of life—both the seen and the unseen—are in some way connected (ecologically, socially, evolutionarily), paves the way to valuing reciprocity in the nature–human relationship. It is with a holistic and symbiotic perspective that we can begin to integrate strategies and address connected issues of human and environmental health. The prospective strategies discussed in our paper focus on enhancing our connections with the natural world, and ultimately aim to help address the global challenge of halting and reversing dysbiosis in all its manifestations. Full article
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5 pages, 2743 KiB  
Viewpoint
Planetary Health: Are We Part of the Problem or Part of the Solution?
by Monica Gagliano
Challenges 2018, 9(2), 38; https://doi.org/10.3390/challe9020038 - 28 Sep 2018
Cited by 2 | Viewed by 5290
Abstract
Planetary health, formally defined as the interdependent vitality of all natural and anthropogenic ecosystems—social, political, and otherwise—is a vast concept that has now entered the scientific lexicon. The problems associated with planetary ill-health—biodiversity losses, climate change, environmental degradation, and other problems of so-called [...] Read more.
Planetary health, formally defined as the interdependent vitality of all natural and anthropogenic ecosystems—social, political, and otherwise—is a vast concept that has now entered the scientific lexicon. The problems associated with planetary ill-health—biodiversity losses, climate change, environmental degradation, and other problems of so-called “anthropocene syndrome”—are considered so enormous that they can immobilize us; we may feel environmental guilt, but that alone cannot save us or the planet. What is missing is environmental empathy, the nurturance of our capacity to recognize the planet and its many life forms as more than elusive entities to be objectified. Although experts in planetary health have called for a more sophisticated understanding of the psychological connections between humans and the natural world, these appeals are almost exclusively cordoned off from the taboos of science; applying concepts of “self” to non-human animals, and especially non-mammals, are generally proscribed. Here, I will personalize the planetary health concept by describing my research-based endeavors on the Great Barrier Reef—experiences that would change my scientific career and personal life forever. The small damselfish, Pomacentrus amboinensis, became the teacher; the student-in-me departed the reef with an education in environmental empathy, and a greater understanding of the urgency with which we must alter our teaching in ecology and other branches of science. Planetary health as a unifying, multidisciplinary effort generally lacks a narrative perspective in academia; I am hopeful that others will share their narrative perspectives and, in doing so, foster the growth of environmental empathy. Full article
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59 pages, 860 KiB  
Meeting Report
Seventh Annual Conference of inVIVO Planetary Health on Transforming Life: Unify Personal, Public, and Planetary Health
by Susan L. Prescott, Anita L. Kozyrskyj, Alan C. Logan and Dianne E. Campbell
Challenges 2018, 9(2), 36; https://doi.org/10.3390/challe9020036 - 24 Aug 2018
Cited by 1 | Viewed by 5229
Abstract
inVIVO Planetary Health is a progressive, humanist scientific movement promoting both evidence and advocacy around concepts of planetary health which denote the interdependence between human health and place at all scales. Our seventh annual conference was held in Canmore, Alberta 4-6th April [...] Read more.
inVIVO Planetary Health is a progressive, humanist scientific movement promoting both evidence and advocacy around concepts of planetary health which denote the interdependence between human health and place at all scales. Our seventh annual conference was held in Canmore, Alberta 4-6th April 2018, themed “Transforming Life: Unify Personal, Public, and Planetary Health” included diverse topics and perspectives to emphasise the interdependent vitality of all natural and anthropogenic ecosystems—social, political and otherwise. A key outcome of this meeting was the The Canmore Declaration: Statement of Principles for Planetary Health (published separately) which underscores that improving the health of all systems depends on: mutualistic values; planetary consciousness; advocacy; unity of purpose; recognition of biopsychosocial interdependence; emotional bonds between people and the land; efforts to counter elitism, social dominance and marginalization; meaningful cross-sectoral and cross-cultural narrative; self-awareness; and a personal commitment to shaping new normative attitudes and behaviors. Here we present the collection of abstracts of invited lectures and oral communications presented during the meeting. These formed the foundations and direction for discussions that became the basis of The Canmore Declaration. Full article
18 pages, 492 KiB  
Conference Report
The Canmore Declaration: Statement of Principles for Planetary Health
by Susan L. Prescott, Alan C. Logan, Glenn Albrecht, Dianne E. Campbell, Julian Crane, Ashlee Cunsolo, John W. Holloway, Anita L. Kozyrskyj, Christopher A. Lowry, John Penders, Nicole Redvers, Harald Renz, Jakob Stokholm, Cecilie Svanes, Ganesa Wegienka and On Behalf of inVIVO Planetary Health, of the Worldwide Universities Network (WUN)
Challenges 2018, 9(2), 31; https://doi.org/10.3390/challe9020031 - 26 Jul 2018
Cited by 59 | Viewed by 16861
Abstract
The term planetary health—denoting the interdependence between human health and place at all scales—emerged from the environmental and preventive health movements of the 1970–80s; in 1980, Friends of the Earth expanded the World Health Organization definition of health, stating: “health is a [...] Read more.
The term planetary health—denoting the interdependence between human health and place at all scales—emerged from the environmental and preventive health movements of the 1970–80s; in 1980, Friends of the Earth expanded the World Health Organization definition of health, stating: “health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—personal health involvesplanetary health”. Planetary health is not a new discipline; it is an extension of a concept understood by our ancestors, and remains the vocation of multiple disciplines. Planetary health, inseparably bonded to human health, is formally defined by the inVIVO Planetary Health network as the interdependent vitality of all natural and anthropogenic ecosystems (social, political and otherwise). Here, we provide the historical background and philosophies that have guided the network, and summarize the major themes that emerged at the 7th inVIVO meeting in Canmore, Alberta, Canada. We also provide the Canmore Declaration, a Statement of Principles for Planetary Health. This consensus statement, framed by representative participants, expands upon the 1986 Ottawa Charter for Health Promotion and affirms the urgent need to consider the health of people, places and the planet as indistinguishable. Full article
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6 pages, 4252 KiB  
Viewpoint
The Value of Global Indigenous Knowledge in Planetary Health
by Nicole Redvers
Challenges 2018, 9(2), 30; https://doi.org/10.3390/challe9020030 - 26 Jul 2018
Cited by 27 | Viewed by 7826
Abstract
In order to fulfill a broader vision of health and wellness, the World Health Organization (WHO) 2014–2023 strategy for global health has outlined a culturally sensitive blending of conventional biomedicine with traditional forms of healing. At the same time, scientists working in various [...] Read more.
In order to fulfill a broader vision of health and wellness, the World Health Organization (WHO) 2014–2023 strategy for global health has outlined a culturally sensitive blending of conventional biomedicine with traditional forms of healing. At the same time, scientists working in various fields—from anthropology and ecology to biology and climatology—are validating and demonstrating the utility of Indigenous knowledge. There is a misperception that Indigenous peoples are in need of Westernized science in order to “legitimize” our knowledge systems. The Lancet Planetary Health Commission report calls for the “training of indigenous and other local community members” in order to “help protect health and biodiversity” (p. 2007). Such calls have merit but appear authoritarian when they sit (unbalanced) without equally loud calls for the training of (socially dominant) westernized in-groups by Indigenous groups “in order to help protect health and biodiversity.” The problems of planetary health are both profound and complex; solutions can be found in a greater understanding of the self and the universe and the land as a medicine place. The following message was delivered as part of a keynote at the inVIVO Planetary Health Conference in Canmore, Alberta, Canada—20 points of consideration for a planetary health science in its pure, raw form, on behalf of the Indigenous elders. Full article
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27 pages, 1568 KiB  
Commentary
Larger Than Life: Injecting Hope into the Planetary Health Paradigm
by Susan L. Prescott and Alan C. Logan
Challenges 2018, 9(1), 13; https://doi.org/10.3390/challe9010013 - 20 Mar 2018
Cited by 25 | Viewed by 11305
Abstract
The term planetary health, popularized in the 1980s and 1990s, was born out of necessity; although the term was used by many diverse groups, it was consistently used to underscore that human health is coupled to the health of natural systems within the [...] Read more.
The term planetary health, popularized in the 1980s and 1990s, was born out of necessity; although the term was used by many diverse groups, it was consistently used to underscore that human health is coupled to the health of natural systems within the Earth’s biosphere. The interrelated challenges of climate change, massive biodiversity losses, environmental degradation, grotesque socioeconomic inequalities, conflicts, and a crisis of non-communicable diseases are, mildly stated, daunting. Despite ‘doomsday’ scenarios, there is plenty of room for hope and optimism in planetary health. All over planet Earth, humans are making efforts at the macro, meso and micro scales to promote the health of civilization with the ingredients of hope—agency and pathway thinking; we propose that planetary health requires a greater commitment to understanding hope at the personal and collective levels. Prioritizing hope as an asset in planetary health necessitates deeper knowledge and discourse concerning the barriers to hope and the ways in which hope and the utopian impulse are corrupted; in particular, it requires examining the ways in which hope is leveraged by advantaged groups and political actors to maintain the status quo, or even promote retrograde visions completely at odds with planetary health. Viewing the Earth as a superorganism, with humans as the collective ‘nervous system’, may help with an understanding of the ways in which experience and emotions lead to behavioral responses that may, or may not be, in the best interest of planetary health. We argue that the success of planetary health solutions is predicated on a more sophisticated understanding of the psychology of prevention and intervention at all scales. Full article
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