Human ecology and public health

Understanding patterns of health and disease requires that the focus in public health is not only on personal behaviours, biologic traits and specific risks but also on characteristics of the social and physical environments that shape human experience. At the end of the 20th century a challenge of the dominance of biomedicine and the need to give greater emphasis to the ecological context in the study of human health and disease was growing.1,2,3 The emerging new paradigm of public health is based on a holistic conception of health and on creating social and environmental conditions conducive for health.4,5 The social and physical surroundings in which people live affect their health. Individuals and populations are embedded within social, political and economic systems that shape behaviours and offer or constrain access to resources necessary to maintain health. Recognition that health is a product of the antecedent biological evolution interacting with current social and environmental conditions facilitates identification of social and environmental determinants that might be amenable to community interventions and can lead to improved health outcomes. Public health problems are increasingly global and complex, especially environmental and social threats arising from global environmental changes, driven by rapid industrialization, population growth, over-consumption of natural resources and the inappropriate use of technology. Large proportions of the life-supporting resources of the ecosystems are being degraded and used unsustainably. According to the Millennium Ecosystem Assessment, health consequences of these changes are already visible and could grow worse over the next 50 years.6 Scientists, policy makers and public health practitioners meet unfamiliar challenges when trying to address broad contextual issues in population health. To tackle the impact of Global Environmental Changes, the public health community needs to be equipped with the necessary scientific and technical means to anticipate and prevent human health consequences, for current and future generations, arising from degrading life support systems.7 Public health researchers have a significant responsibility for undertaking research that will assist society to understand and avert the health impacts of global changes. They are expected to expand and strengthen the knowledge of the implications of a depleted or destroyed natural environment for population health and of the social and health implications of increasing population and consumption in a world of finite resources. Creating social and environmental conditions conducive to health is a multi-sectoral responsibility. The public health community has to take the lead in building strong partnerships and to be in the forefront of promoting population health as a key criterion of sustainable development.