Ecosystem Approaches to Health and Well‐Being: Navigating Complexity, Promoting Health in Social–Ecological Systems

Abstract

Ecosystem Approaches to Health (also known as ‘ecohealth’) link population or community health and well‐being with the environment and sustainable development. The approach is based on the understanding that health outcomes emerge from interrelationships within social–ecological systems. The ecohealth approach rests on principles of transdisciplinarity, participation, gender and social equity, systems thinking, sustainability, and research‐to‐action. This paper introduces the emerging field of ecohealth as an approach rooted in systems thinking. The approach will be illustrated with three case studies; an application to interrelated crises of poverty, environmental degradation, and zoonotic disease along the Bishnumati River in Kathmandu, Nepal; improvement of community well‐being in a low‐income informal settlement in Chennai, India; and an ongoing project with the Credit Valley Conservation Authority in Southern Ontario, Canada that is oriented to identifying and communicating relationships among ecosystem services and human health so as to demonstrate the importance of watershed management. These projects are typical of the Anthropocene, in which human systems impact the natural systems upon which they depend. Copyright © 2016 John Wiley & Sons, Ltd.

Integrative Propositional Analysis for developing capacity in an academic research institution by improving strategic planning

“…System dynamics modelling has been used to improve operations in a public sector organization (Bianchi, ). The viable system model has been applied to advance the socioecological health of organizations (Bunch, ). Indeed, a combination of theoretical perspectives (viable system model, Team Syntegrity model, and model of systemic control) has been proposed for a more comprehensive and systemic approach (Schwaninger, ).…”

Systems approaches to population health in Canada: how have they been applied, and what are the insights and future implications for practice?

“…Seven Canadian case examples were identified and prioritized for discussion and analysis based on a population health perspective. The cases target childhood obesity (Amed et al 2015), the SDOH in a large urban setting (Mahamoud et al 2013), watershed management and conservation activities for health (Bunch 2016), poverty reduction (FSG 2013), mental health and addictions (Provincial Support System Program 2014), healthy eating among youth (Shahnazari et al 2016), and patient flow within health care (Esensoy and Carter 2015). The cases illustrate the complex nature of health problems as they stemmed from systemic causes and multiple socioecological levels, included issues between various sectors, and featured elements of complex adaptive systems (Nianogo and Arah 2015).…”

“…Childhood obesity interventions tend to be individualistic, without a cohesive strategy across settings (Shahnazari et al 2016). Working in 'silos' is also common, making conversations across organizations and sectors more difficult (Bunch 2016). These highlight the dynamic complexity and counterintuitive system behaviour of these population health problems (Paxton and Frost 2017).…”

“…Both models aim to uncover a better understanding and hypothesis of current and future system-wide behaviour. The watershed initiative recommended health valuation of ecosystem services in order to develop scenarios for conservation actions (Bunch 2016). MaRS Solutions Lab aims to select the smallest interventions with the largest impact for healthy eating (Shahnazari et al 2016).…”

Navigating systems ideas for health practice: Towards a common learning device

“…Claims are often made in health practice towards thinking more holistically about economic and social circumstances (getting the bigger picture) as against focusing on, say, just clinical/biomedical concerns. Examples of more holistic representations include community health analysis and ecosystem approaches to health and well‐being . Notwithstanding such holistic endeavours, the first‐order conversation between “systems” used in such approaches and “situations” being represented requires constant humility in avoiding the trap of mistaking the system for the situation.…”