Lecture 3: Ecosystem Health, Disease Ecology and Beyond

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Lecture 3 Ecosystem Health, Disease Ecology and
Beyond

• Denise Cloutier-Fisher, PhD
• Assistant Professor, Dept. of Geography/Centre on
  Aging

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Population Health (Federal Provincial
Territorial Task Force on Population Health, 1997)

• Approach
• Interrelated conditions and factors that
  influence health of populations over the life
  course,
• Identifies systematic variations in the pattern
  of their occurrence
• Applies the knowledge gained to develop and
  implement policies and actions to improve the
  health and well-being of populations.

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Health Goals for British Columbia 1997
Source Provincial Medical Health Officer
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Examples of Healthy Community /Population Health
Indicators
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Examples of Healthy Community /Population Health
Indicators continued
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Examples of Healthy Community /Population Health
Indicators continued
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Disease Ecology Triangle
Source Meade and Earickson 2000
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Disease Ecology
Meade and Earickson 2000
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Disease Ecology

• Detail oriented reductionist
• Human health is enclosed by the triangle of
  population (gender, age and genetics), habitat
  (natural, social and built) and behaviour
  (beliefs, social organization and technology).
• The body is continuously assaulted and rallies or
  suffers due to organic or non-organic stimuli or
  insults e.g., bacteria, viruses, protozoa,
  parasites, electromagnetic radiation, violence

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Ecosystem Approaches

• Traditionally, a hallmark of the ecosystem
  approach is transdisciplinarity
• Focus on holistic, interdependencies between
  elements
• Problems of dysfunction and emphasis on
  preventive approaches
• Key challenges
• Establish methods of classifying dysfunctions
• Identify cross-linkages between environment,
  humans, public policy

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3. Ecosystems holistic/integrated/interdependent

• A healthy ecosystem has been described as an
  environment that maintains its biodiversity, is
  stable over time, and is resilient to change
  (Rapport et al., 1995).
• We have never given our planet a comprehensive
  physical to measure its health. (Lash 2002)

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Ecosystem Characteristics

• Have a life of their own with or without humans
• Are more than a community of species but less
  than a biosphere
• Boundaries are arbitrary by necessity
• function well without humans but..

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Measuring Ecosystem Health

• Concern with characteristics that differentiate
  healthy from sick ecosystems?
• , e.g., loss of species, biomagnification,
  toxicity
• Concern with ability to bounce back/recover
  equilibrium (systems theory)
• after stresses or perturbations
• forest fires, oil tanker spills, droughts
• Id magnitude of risk factors
• e.g., exposure to anthropogenic stresses such as
  pesticide contamination.

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Health Ecology

• Holistic, integrative approach
• everything is linked
• Traditional studies cannot understand complex
  phenomena
• Ecology the study of interrelationships between
  all - a vision of totalities

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Principles in Health Ecology

• Multi-dimensional nature of the environment
• Integrative nature of human/environment relations
  
• Sustainability recognition of limits
• Life expectancy- longevity/Q of L
• Theoretical model/logical framework
• Managing resources and risks

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Biomedical model of health and illness

• reductionist
• Foundation of Western medicine
• Diseases represent departures from normal
• Body as mechanical defective parts replaced
• Medical care focus on care not cure
• Problematic for individuals with chronic
  conditions
• Led to professionalization of medicine
• Disease ecology/population health (mixed)

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Biopsychosocial Model of Health and Illness

• Illness determined by physiological systems,
  psychological and socioeconomic (environment,
  lifestyle)
• Interdependent systems determine health
• Ecosystem health/health ecology interdependent,
  population health

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Theoretical developments in health and illness

• Positivistic and Post-positivistic
• Positivistic
• Governed by natural laws and the scientific
  method
• causes
• Tend to be quantitative and reductionist
• Macro-scale privileges certain viewpoints over
  others
• Post-positivistic
• Concerned with individual experiences and
  perceptions of health, illness, behaviour, etc.
• Understanding, humanistic, constructivist
• Micro-scale micro-geographies of everyday
  existence
• otherness

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Lets look at two scenarios

• QUESTIONS
• Think about theoretical and empirical axes eg.
  Positivism/post-positivism and approaches
• Do theoretical and empirical approaches such as
  the ecosystem health, disease ecology or
  population health approach help us to find
  solutions to the issues raised by the following
  scenarios?
• What kinds of questions do we answer with
  positivistic approaches, with post-positivistic
  or humanistic approaches?

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References

• Population Health Approach Health Canada,
  http//hc-sc.gc.ca/hppb/phdd/determinants/e_determ
  inants.html to end of table on key determinants
• Evans, R.G. and Stoddart, G.L. (1990). Producing
  Health, Consuming Health Care, in Social Sciences
  and Medicine Vol 31 No 12, p1347-1363.
• Meade, M.S. and R.J.Earickson, (2000). Medical
  Geography, 2nd edition, chapter 2, The Human
  Ecology of Disease, p 21-54. and 254-261.
  Guilford Press New York.
• Lash,J.(2002) People and Ecosystems the fraying
  web of life, ISUMA, Fall 2002 p 20-24 (online
  www.isuma.net).
• Rapport, D. et al., (1999) Ecosystem Health
  the concept, the ISEH and the Important Tasks
  Ahead, Ecosystem Health Vol 5 No 2 p 82-90
  http//www.ecosystemhealth.com/images/ISEHCommenta
  ry.pdf,