Issue addressed: Globally and locally, environmental degradation (including climate change) and inequity pose major risks to health. While health promoters recognise the importance of both issues, they may be seen as separate agendas. This study investigated health promotion addressing both issues together. Methods:The study was an investigation of health promotion practice addressing environmental sustainability and equity, conducted in 2013, as part of a communitybased participatory action research project with three Primary Care Partnerships (PCPs) in Victoria, Australia, during 2009-2016. Results: Thirty-two local health promotion projects addressing both environmental sustainability and equity were identified. Analysis showed clusters of environmental, equity and health themes, particularly around: (a) caring for local environment, food, access to nature and Indigenous participation; (b) sustainability of housing, thermal comfort and reducing energy costs; and (c) sustainable and active transport. The study also found a marked decline in the number of PCPs in Victoria identifying environmental sustainability as a priority in 2013, compared to 2009. Analysis of helpful factors and challenges to practice identified by research participants, suggests interrelated political, organisational and discursive factors contributed to this decline. Conclusions:The study suggests local health promotion can contribute to the development of societies that are more ecologically sustainable and more equitable.However, the challenges suggest broader advocacy is required to support local action.So what? Environmental degradation and inequity are major threats to human and ecosystem health. This study shows local health promotion can address both issues concurrently, and provides important information about challenges to this work. K E Y W O R D Sclimate change, ecology, environment, health equity, health promotion | 299

Objective: To analyse a ‘socioecological’ health promotion discourse and its relationship to orthodox ‘economistic’ discourse in Australia. Method: In research on health promotion addressing equity and environmental sustainability, we identified a socioecological discourse, based on an ethic of care for people and ecosystems. Using Foucault's concept of discourse as a regime that produces and legitimises certain kinds of knowledge, and ecofeminist historical analysis, we analysed this discourse and its relationship to economism. Results: The socioecological discourse takes social and ecological wellbeing as primary values, while economism takes production and trade of goods and services, measured by money, as primary. Following British invasion, property‐owning white men in Australia had the right to control and profit from land, trade, and the work of women and subordinate peoples. A knowledge regime using money as a primary measure reflects this history. In contrast, a First Nations’ primary value expressed in the study was ‘look after the land and the children’. Conclusion and implications for public health: Public health often attempts to express value through economism, using monetary measures. However, socioecological discourse, expressed for example through direct measures of social and ecological wellbeing, appears more fit for purpose in promoting a fair and sustainable society.

Shea et al 1 report on an important study regarding education on climate and health (climate-health).Of 84 institutions responding to a survey on climate-health education, almost two-thirds reported that they offered some climate-health education, commonly in the core curriculum, and many were planning to extend their offerings. From the perspective of a climate-health educator, these findings are encouraging, but some caution is needed.The survey was conducted with members of the Global Consortium on Climate and Health Education (GCCHE). The response rate was slightly over 50% (84 of 160 institutions). Most respondents reported a positive response to instituting climate-health curricula, particularly from students, followed by faculty. Just under 40%, however, reported a positive response from administration. Respondents also discussed challenges in developing climate-health curricula, including lack of staff time, lack of teaching materials or staff expertise, and lack of funding for curriculum development. Other challenges included "competing institutional priorities/politics," and a small number of respondents (4) mentioned "administrative or other skepticism about climatehealth science." 1Research on public health practice has identified similar challenges, including politicization of climate change, competing organizational priorities, hierarchical management structures, and a discursive context in which climate change may not be seen as core business for public health. 2,3 These factors can interact and potentially create an atmosphere through which public health practitioners are discouraged from addressing climate-health issues. It is possible that similar factors are at work in some academic settings.

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