1. Introduction
One of the greatest contribution of science to humanity has been its progressive unveiling of the influence on human health of the environment (in all its aspects: physical, social, economic, political, cultural, and historical), and the many adverse (local and planetary) impacts that human activities have on the environment [
1]. Nonetheless, throughout a good part of the modern public health era, the concept of health was circumscribed to individuals, communities, populations, and on occasion, to nations [
2]. This view has led to the pursuit of health as though disconnected from our lifestyles and environments [
3], as we failed to consider whether health gains were recorded at the expense of eroding the earth’s underpinning natural systems, which provide the essential life sustaining ecosystem services such as water, food, fuel and shelter, on which the human civilization depends. Thus, contributing to past inadequate societal and public health responses to global health challenges [
4].
Learning from the past, an
ecological public health model was proposed to help guide policy responses [
5], which integrates the material, biological, and socio-cultural aspects of public health, while accepting the complexity and non-linearity of natural systems dynamics. Emerging from this framework is
planetary health (PH), which is defined as “
the health of human civilization and the state of the natural systems on which it depends” [
6]. PH seeks to address the challenges of how best to protect and promote human health in an era of global earth’s systems disruptions from human activities [
7,
8]. It also identifies at least six dimensions of fundamental biophysical shifts including (1) global climate system disruption; (2) resource (e.g., arable land and fresh water) scarcity; (3) bio-geochemical cycles (e.g., that of nitrogen, carbon, and phosphorus) reconfiguration; (4) widespread (water, soils and air) pollution; (5) pervasive changes in land cover and use; and (6) rapid biodiversity loss [
9]. These rapid changes in the function of socio-ecological systems, with their adverse influences on ecosystem services, are reported to alter human exposures to infectious diseases [
10] and natural hazards (e.g., heat waves, tropical storms, fires, droughts, and floods) [
3]; and therefore affect important dimensions of human well-being.
Though more consensus remains to be achieved, agricultural expansion, bushmeat hunting, and overall human encroachment into wildlife habitat are reported to be at the roots of zoonotic diseases such as the Ebola [
1] and the coronavirus disease 2019 (COVID-19) [
11]. Still ongoing, the COVID-19 pandemic has plunged the world into an extraordinary crisis [
12], spreading to more than 125 countries [
13], with catastrophic socio-economic consequences [
14,
15], and demonstrating the inter-dependence of national health systems, food systems and supply chains. Attesting to this global cross-country inter-dependence, is the recent call “by the Lancet” for research papers integrating planetary health perspective that cuts across traditional domains of knowledge, governance, and economic sectors to properly address the challenges posed by COVID-19 [
16].
With disregard to any national or physical borders, financial crisis, biodiversity loss, and climate change are also ongoing global challenges that require concerted efforts for their management through collective action [
14]. Among other things, the mitigating responses to the Covid-19 pandemic have demonstrated that overnight transformational changes are possible [
15]. In the same spirit, the pandemic provides nations with the opportunity to now come up with solutions that accelerate the global transition to nature-rich societies, with low-carbon and resilient economies.
Also representing a key milestone in the global health and development community is 2015, which marked the end of the Millennium Development Goals (MDGs) era and the launching of the 17 Sustainable Development Goals (SDGs). The SDGs define 169 targets and 230 indicators leading up to 2030 [
17]. They are categorized into five groups, the so-called 5Ps: People, Planet, Partnership, Peace, and Prosperity, which countries are recommended to promote to create a sustainable world [
18]. By fundamentally shifting the global health and development paradigm, the COVID-19 pandemic leaves much to be done to meet the defined health and non-health related SDGs targets by 2030 [
19]. Nonetheless, and in line with the efforts undertaken globally by the United Nations (UN) country members, including the UN Convention on Biological Diversity (UNCBD), its Framework Convention on Climate Change (UNFCCC), and its General Assembly Nature Summit, the pandemic leaves nations worldwide to come up with transformative economic recovery plans that invest in people, nature, and low-carbon developments [
20].
As the global consensus framework for committing efforts in the present to leave a healthy and sustainable planet for future generations, the SDGs also have at heart the well-being of children and adolescents [
21]. In this regards, the Lancet commission on planetary health suggests that “
Despite present limitations, the SDGs provide a great opportunity to integrate health and sustainability through the judicious selection of indicators relevant to human well-being, the enabling infrastructure for development, and the supporting natural systems… the landscape, ecosystems, and the biodiversity they contain can be managed to protect natural systems, and indirectly, reduce human disease risk…” [
3] Moreover, “
Progress toward planetary health implies the development of an improved understanding of the connections between natural systems and health,… and requires recognition of the benefits to health arising from the conservation and rehabilitation of natural systems and the mitigation of greenhouse gases and other damaging emissions that result from human activities” [
1].
Furthermore, based on the notion of inter-generational justice and fairness, a life course approach to well-being, and of course sustainable economic development [
22], in 2018 a Lancet commission on children’s health and well-being was formed with the aim of considering ways in which society as a whole, including medical professionals and governments, can accelerate progress on the strategies adopted within the context of the SDGs to improve child health and well-being [
22]. One of the concluding calls made by the commission was the urgent need to address the environmental and existential threats (such as the COVID-19 pandemic [
23]) that jeopardize the future for children and adolescents. In line with youths’ well-being are their interests, which focus on enjoying safe and healthy environments with family togetherness [
1].
It is, therefore, within this context of emerging thoughts and scholarly actions that we undertake the present analysis to investigate the role that digital media play in shaping planetary health interests in the global youth population. Our study contributes to the scientific literature in two ways: (i) methodologically, by introducing a random utility-based bivariate ordered probit (RUMBOP) model, which innovates on the previously used models to investigate sustainability; and (ii) practically, by providing new insights of practical relevance to evidence-based sustainable policy making, not just at national or global level, but at the planetary level. Hence, we organize the rest of this paper as follows: In
Section 2 we briefly review the empirical literature underpinning our research hypotheses, and the theoretical literature guiding our conceptual framework; in
Section 3 we describe the methodology followed to meet our research objectives, by first presenting the data, followed by the econometric model with its identification strategy; in
Section 4 we present the findings, which are discussed in
Section 5; in
Section 6 we conclude the analysis by first elaborating on its implications, followed by discussions of its limits and avenues for future research.
5. Discussion
The recent outbreak and still ongoing experience of the COVID-19 pandemic [
11], has demonstrated the cross-country inter-dependence of health systems, food systems and supply chains globally. In doing so, the pandemic offered humanity the opportunity to shift perceptions to a more holistic view of health [
19]; a planetary view in line with the ecological public health framework, which recently emerged due to the growing evidence of the complex relationships between human health and the environment [
16].
With the desire to address the challenges of how best to protect and promote human health in an era of global earth’s systems disruptions from human activities, coupled with increased digital media consumption; the present study relied on the concept of “planetary health” to investigate the potential of strategically designed and digitally mediated socio-ecological communications, to enhance society’s (through its youths) long-term ability to address appropriately ongoing health and ecological crises. To this end, we first operationalized “youths’ planetary health interests” using both “their interests in the biosphere (ecosystem services and sustainability)”, and “their interests in science-based disease prevention”, allowing us to formulate and test four hypotheses. The first three hypotheses (H1 H2 and H3) together implied that frequent use of digital media by the youths globally, positively influenced their planetary health interests. The fourth hypothesis (H4) however, addressed the underlying feedback relationship assumed between human health and the environment under the ecological public health view. Our analysis contributed to the scientific literature in two ways: (i) methodologically, by introducing a random utility-based bivariate ordered probit (RUMBOP) model, which innovates on the previously used models to study sustainability; and (ii) practically, by providing new insights of practical relevance for evidence-based sustainable policy making, not just at national, or global level, but at the planetary level.
Our findings revealed a statistically significant impact of digital media consumption on adolescents’ interests in the biosphere. Indeed, all three measures of digital media consumption (in the form of increased frequency of ecological website visits, news blogs visits, and web-browsing on broad science) significantly influenced youths’ interests in ecosystem services and sustainability. However, these effects appeared negative suggesting a reduction rather than an increase in youths’ interests in the biosphere. Similarly, our findings highlighted a reduction in youths’ interests in science-based disease prevention, from their increased frequency of news blogs visits and web-browsing on broad science. Conversely, increased frequency of ecological website visits was found to positively influence youth’s interests in science-based disease prevention.
Together, the results seem to indicate that in their current state of use, digital media in the form of ecological websites, news blogs, and broad science web-contents are unsuccessful at galvanizing youths’ interests in the biosphere (ecosystem services and sustainability). Even more problematic they contribute to youths’ being less interested in the state of the natural systems on which their well-being depends on. Furthermore, at the exception of ecological websites which appear successful at nurturing youths’ interests in science-based disease prevention, the remaining two digital media (news blogs, broad science web-content) contribute to youths’ being less interested in science-based disease prevention. Overall, our findings seem to indicate that if digital media (in the form of ecological websites, news blogs, and broad science web-content) were to maintain their current (2015) influence on youths’ interests in ecosystem services, sustainability and science-based disease prevention, then they would be contributing to reduce youth’s planetary health interests globally. The long-term consequences of which, in terms of the set 2030 agenda for sustainable development, would eventually be undesirable for nations.
Our findings corroborate the results in [
119], which reports that limited quality, interactivity and readability of 69 adolescent-directed Australian-based websites with health promotion contents, are limiting their effectiveness. Our results also align with the “double-edged-sword” characterization of digital media, when used among youths in a residential treatment setting [
120]. However, our findings come as a contrast to [
121,
122], which report digital media to offer exciting new means for engaging and communicating with adolescents and young adults, for the purposes of providing appropriate intervention and education. Perhaps the digital media under consideration in our present analysis (ecological websites, news blogs, and broad science web-content), are yet to catch up with this potential, by strategically designing and diffusing appropriate socio-ecological communications that adequately target the global youth population [
92].
In addition to the above-discussed results, our analysis also showed a statistically significant strong and positive correlation (0.835) between adolescent students’ interest in the biosphere (ecosystem services and sustainability) and their interest in science-based disease prevention. This somewhat strong positive dependence between the two dimensions of youths’ planetary health interests further support the dynamic relationship between the well-being of the human civilization, and the state of the natural systems on which its depends [
20]. It also confirms the appropriateness of the holistic view of health as embraced in the “ecological public health framework” [
5] and “planetary health” view [
9].
Overall, consistent with [
50], our study shows that digital media has heterogeneous effects on youths’ interests, depending on the digital media type under consideration. This is further consistent with the diverging reports in the literature over the effect of digital media on adolescent’s well-being [
66,
123,
124]. Although the literature has mainly focused on digital media effects on youths’ well-being in terms of academic performance [
125], physical [
126], psychological [
127], socio-neurological [
128], and mental [
129] health outcomes. By focusing here on its effects on youth’s planetary health interest, the current analysis can extend this strand of literature in a meaningful fashion. This is because increased youths’ planetary health interest should contribute to early commitments to science-based health preservation through disease prevention, and ecological conservation by the younger generation. This latter would be key to achieving a socio-economic development that is sustainable at the planetary level.
Furthermore, recall that male adolescents were found to be less interested in both the biosphere and science-based disease prevention compared to their female counterparts. This latter result suggests the presence of a gender-based gradient in youths’ planetary health interest, in favor of the female gender. Although our study is pioneering this latter reported finding within the context of the two dimensions of planetary health, some of its sub-dimensionality do align with the gendered nature of ecosystem services already reported in the ecological economics literature [
130]. Indeed, Using a heuristic device of the “ecosystem-wellbeing chain” to empirically investigate how women and men are able to benefit from ecosystem services across eight communities in coastal Kenya and Mozambique [
131], reported significant gender-based differences across several key aspects such as the division of costs and benefits of ecosystem services, knowledge systems, behavioral expectations, institutions, and access to resources. Our results of the effects of parental education on the two dimensions of youth planetary health interests, further confirm the above-discussed gendered effects. Indeed, while increased paternal education appears to unilaterally be raising adolescents students’ interest in both the biosphere (ecosystem services and sustainability) and science-based disease prevention, the reverse seems to be observed for increased maternal education.
As previously mentioned in ([
100] p.17), when explaining gender-based differences in parental education’s influence on youths’ technological awareness and expectations within the North American Free Trade Bloc, it could be that past differences in occupational preferences lifestyle values, and field-specific beliefs between men and women worldwide, translated into women globally taking less interests, and therefore specializing less in Science Technology, Engineering, and Mathematics (STEM) fields than men. Despite recent years reported closures of this gap by females in some markets [
132], such greater exposure to science for men globally than women in the past, could have potentially contributed to the observed gender-based knowledge gaps on the biosphere and science-based disease prevention at the parental level. In turn, such gendered knowledge gaps could have led to the observed diverging influences of parental education on adolescents’ interests in planetary health in general, and ecosystem services in particular as reported in [
131]. Indeed such, conjecture finds theoretical support from “Expectancy-value theory” that suggests psychological processes in children and adolescents take place within lager ecological systems such as biological and socio-cultural, which are also linked among others to gender socialization, social stratification, and behavior genetics [
133]. Though parental influence is paramount due to parents direct influence on their children prior conception, during pregnancy and childhood, through educational activities and programs that provide the foundations on which later adolescents’ health and ecological interests might reside [
132]. As such, a couple of policy recommendations can be formulated as presented next.