Ecosystem Health

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Ecosystem Health Balancing Climate Change with
Health Care
John Howard MD, FRCPC Professor of Paediatrics
and MedicineSchulich School of
MedicineUniversity of Western Ontario Chair,
Canadian Association of Physicians For the
Environment
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Objectives

• To emphasize that health is not the same as
  health care
• To suggest that there are other important issues
  other than health care

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What is Ecosystem Health??
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The Evolution of the Doctor-Patient relationship

• 1) Traditional Medical Model
• 2) Patient-Centered Model
• 3) Ecosystem Health Model

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Traditional Medical ModelWhere we were

1. What is the disease?
2. How do I fix it?

HEALTH
Disease

• Patient

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Patient-Centered Model

1. What is the disease?
2. How do I fix it?
3. What is my patient's unique illness??
4. How do I help my patient?

HEALTH
Illness
Disease

• Patient

Context
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Ecosystem Health

• The health of the context and the interaction
  of the context with human health
• - the physical, social, economic and political
  environment

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Ecosystem Health Model

1. What is the disease?
2. How do I fix it?
3. What is my patient's unique illness??
4. How do I help my patient?
5. Why is this patient here?
6. What can I do to prevent others from having the
   same illness?

HEALTH
Illness
Disease

• Patient

Home
Community
Region
World
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What is Health?
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Spiritual
Moral
Environmental
Social
Nutritional
Community
Health
Physical
Mental
Personal Health
Political
Economic
Societal Health
Ecosystem Health
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Spiritual Health - Aboriginal

• The Earth is our Mother, the female giver of Life
  to all her children, some of whom are human
  beings.
• We are related to the animals, the plants, the
  birds, the insects, and they are related to us.
  Our lives depend on them.

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Moral Health
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Is societys attitude to climate change morally
healthy?
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Revelations

• Many/all diseases have a significant Ecosystem
  Health component
• We need to put less money in sickness care!
• Uncertainty is more important than certainty
• Bigger is better!
• Things can be done!
• Accountability should be replaced by
  responsibility

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37/5years 7.4/year
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Health
Sickness
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Where are we going?
2016
2010
of Provincial Budget
Year
2044 100
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Health Care

• NOT a determinant of health
• The majority of the health care dollar is spent
  in the last 6 months of ones life - 1993
• Average health expenditures on people who are in
  their last year of life is between 50 and 100
  times more than expenditures on those who are
  not. - Health Canada -2005

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Is there a crisis?If so what is the crisis?
Expectations
Expectations
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CAPE is a group of physicians, allied health care
practitioners and citizens committed to a healthy
and sustainable environment.
www.cape.ca
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