(35) Holistic Approaches to Health and Sustainability

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INTRO: Hello deep thinkers, this is your host Agrita and welcome to Mind Full of Everything, the podcast that questions the deeper and bigger things in life, from intersectional environmentalism to self-development and everything else in between. Health has become an area of major concern for all of us during the COVID-19 pandemic, both health professionals/scientists and the general public, therefore, holistic approaches to health are essential for addressing modern day health issues and crises. This episode explores the three main conceptual health frameworks, OneHealth, EcoHealth and Planetary Health, and the need for health approaches to be interdisciplinary to ensure all aspects of health are at par, in terms of quality of scientific research conducted. 

Sustainability is almost synonymous with environmental protection and working towards a future where the environment and natural resources are conserved and sustained for upcoming generations. I mean, I automatically assume this; as soon as I see the term sustainability on book covers, profiles of job or internship vacancies, website, social media, etc. I prepare myself to see content on the environment, climate change, zero waste, etc. And of course, we can attribute this to the collective growing concern around the impacts of anthropogenic climate change. 10 years back, if I heard the word sustainable, the environment wouldn't be the first thing I would think of for sure. 

Although it's very important that we focus on environmental sustainability and work towards living in more sustainable ways, sustainable living is really not limited to environmental protection. In fact, is way more than that. The environment is a massive part to it, but not the only component. 

For those of you that are new to the podcast, first of all welcome and I really do hope that you enjoy it here! As you begin to explore the podcast more, you will begin to see that I really don't settle for one area of society and living at all. I think that's pretty evident in the name of the podcast itself! In my latest episode Reconnecting With Yourself and in the ones before that, I explained my tendency to make connections with practically everything I possibly can. I strongly believe that everything is connected in some way so interconnectivity is a massive part of not only my life but life as a whole. 

But the way in which I present my ideas, the way in which I structure my episodes and emphasise on certain areas of the topics I discuss, the theme of sustainability begins to emerge within each episode, not just environmental ones. I tend to take a holistic approach to sustainability, highlighting the importance of it in your personal lives and for the health of the planet, also showing that both of these aspects of living aren't mutually exclusive, but inherently interdependent. Although I specifically focus on the intersections of mental health with planetary health, whilst also looking at the two separately because both don't necessarily influence each other in every single case, it's also very important to look at physical health and look at the intersection of planetary health and human, as well as animal, health through a medical lens. 

The reason why I focus so much on mental health, well the two reasons why I focus so much on mental health, is because one poor mental health is essentially a global crisis. Many call it a mental health epidemic. So, discussing mental health issues, my experiences or other people's experiences really helps remove social stigma around mental health and for me that's extremely vital and I feel like that should be a major concern for everyone. The second reason is that I don't specialize in medical health. I am an environmental science student, I'm in the third year of my undergraduate degree, so I don't have any expertise in the medical field. Although I do recognise that it’s extremely important, I don't necessarily have much interest in the area [medicine], so for me, commenting on it wouldn't really make sense. 

However, seeing the current climate crisis we are in along with the ongoing humanitarian crises around the world, health issues need to be addressed holistically, which they have been in the past and now are being further developed. Within scientific research, there are three most popular holistic interdisciplinary health frameworks that exist: EcoHealth, OneHealth and Planetary Health. These frameworks do have overlaps, but subtle differences separate them into three separate health approaches. One Health and EcoHealth are more established frameworks, however, Planetary Health is gaining rapid popularity amongst global institutions, despite it being relatively new to the science world. In many cases, Planetary Health is being proposed as an alternative to One Health and EcoHealth, although there really isn't the “right” way to go about addressing health issues, of the environment humans and also animals. This podcast episode is based off the scientific paper by Lerner and Berg that was released in 2017, it is linked on my website, mindfullofeverything.home.blog. 

So, if we were to talk about these three conceptual frameworks separately, One Health is split in two, a narrow description and also a wide one. The narrow description was the original approach taken for the One Health concept, being that the approach combines the disciplines of public health and veterinary medicine, looking to reduce the impacts of health crises that originate at the interface between humans, animals and their corresponding environments. The wider definition, which was developed from the old and narrow approach, includes veterinary medicine and public health, but it also includes environmental health, ecology, human medicine, micro/molecular biology and health economics. The wider definition has been extended beyond the conventional medical approach due to the criticism that the approach was too fixated on the medicine discipline rather than the public health and environmental health disciplines. 

There has also been critique on the framework not being as interdisciplinary as it should be, particularly lacking the incorporation of social sciences, which was the most surprising thing for me. When we look at health, it has to include social sciences and the different factors that contribute to poor health, especially from social vulnerability. So, factors such as rural and urban Development, demographics etc. therefore this approach needed to undergo radical change. Additionally, One Health still has human and animal health at the core of the concept, with the environment being a product of health outcomes rather than the separate component of health. 

EcoHealth, as you can see by the name, involves health of humans, animals and ecosystems. In this case, ecosystems are a separate component of health, and it [approach] extends into environmental and social economic sustainability. In some applications of the belief, EcoHealth focuses primarily on biodiversity and how biodiversity protection impacts wellbeing of humans and animals, as well as integrity of ecosystems. This health approach has a stronger focus on the interdependency of species health and environmental health, essentially that sustainability within wellbeing of all species cannot be obtained until the health of the planet is sustained. So, in this case, it is more of an interdisciplinary approach compared to one health. It includes practices such as veterinary medicine, public health, human medicine, conservation and ecosystem management, rural and urban development, and planning. 

Social sciences have also now been integrated into the conceptual framework and whats even better, indigenous knowledge has been acknowledged as a key source of information, along with western science. This health approach is more at population level and it involves disciplines such as sustainable development and environmental equity, therefore, it requires a participation from policymakers and scientists. 

Planetary Health has been developed by the Rockefeller Foundation and Lancer Commission; in 2015 report was released by the Commission called Safeguarding Human Health in the Anthropocene epoch, which again you can find it on my website. The definition of the health approach is essentially based off the concept of human health being dependent on flourishing natural systems and the stewardship of these natural systems. The paper highlights the major gaps in the conventional systems of knowledge that we depend on in the western world and also governance that prevents society from addressing the threats of planetary health in a better way. Therefore, the paper calls for improvement of governance by integrating social, economic and environmental policies to fortify planetary health solutions. Therefore, the focus is on enhancing quality of life and health for all individuals, communities and populations, as well as the integrity of ecosystems through promotion of sustainable but also equitable patterns of consumption to address specific drivers of environmental change that are risking the wellbeing of populations. 

However, is quick to notice, and something that has been picked up by Lerner and Berg as well, that Planetary Health is an extremely anthropogenic conceptual framework. It focuses on mitigating the impacts of environmental change primarily on human health and wellbeing. Compared to the incorporation of animal health in One Health and EcoHealth, any benefits from conserving biodiversity or ecological systems as a whole are for the benefit of society, and the only acknowledgment of animal health is made with reference to disease transmission to humans as well as animal food products. 

The field initially involved public health practitioners, policymakers, and health professionals, but the health professionals were only for human health, so zoologists, ecologists, veterinarians or other [animal] biologists were excluded from the field. In the 2017 Lancet paper, a wide range of disciplines were included such as ecology, environmental sciences, human medicine, agricultural sciences, economy, energy, marine sciences and many more. So, the need for an approach to be interdisciplinary has been understood by the Rockefeller Foundation. However, Lerner and Berg recommend that Planetary Health should be grouped with concepts such as Global Health rather than health concepts such as One Health and EcoHealth because of how anthropogenic-focused the approach is compared to the other two that prioritize both animal and human health. In fact, the only real difference between Global health and Planetary Health is the emphasis on the importance of sustainability in the latter. 

A lot of reports, institutions like WHO and authors have called for a merging of One Health and EcoHealth due to the similarities of both having a more holistic approach to health, even though One Health is more about improving animal and human health and EcoHealth has more about looking at the relationship between species health to health of ecosystems. So, One Health can look at health at the individual level, but EcoHealth is more on population and ecosystem level; these differences in scales can be quite difficult to merge the two concepts. 

There are also other barriers to combining these two approaches. For instance, there is an apparent lack of research into the incorporation of mental health into the frameworks, especially how mental health will be approached for both humans and animals. And the study of health of animals is very limited, with plants and ecosystem health studies being even more limited, so these discrepancies need to be addressed before attempting to merge One Health and EcoHealth. An even wider concept of One Welfare has also been proposed, which focuses on humans, animals and social welfare, but we need to understand the risks of involving a high number of disciplines, especially to the structure of the framework and any conflicts that could arise due to this amalgamation of knowledge systems. It's vital that we understand the risks before proposing wide concepts like One Welfare or merging One Health and EcoHealth. However, it is possible, and many papers have proposed One Welfare as a better approach. 

I personally think that EcoHealth is a better holistic health approach relative to the others in terms of interdisciplinary, but also in terms of sustainability at all levels. It's the only approach that emphasises on the importance of decolonising science through incorporation of indigenous knowledge and directly focusing on sustainable development with a key focus on environmental equity. The only health approach that mentions this explicitly. Although I totally acknowledge that this conclusion has been made with my bias towards ecological and social sustainability, for example, Planetary Health has been seen as a better approach for pandemic prevention because of its human-centric approach to health, especially because pandemics disproportionately affect humans. Therefore, using this approach would make sense. 

But I think we can see that this discourse on holistic health approaches just demonstrates the complexity of the relationships between species and the planet, and how using just one approach for practically all cases will always be inadequate to improve health outcomes. 

Whilst all of these approaches are very important, I've realised how little attention has been given on mental health of humans, let alone animal mental health. Wellbeing has been mentioned across the three approaches, but little clarification has been given on what this really includes. And so, this brings me back to the start of the episode, in order to achieve sustainability within societies, including animals, all aspects of health need to be addressed. Environmental health, physical health, but also mental health, especially looking at how environmental health influences mental health of individuals, communities and populations, and how environmental equity can help reduce the mental health stresses on certain parts of society 

Many studies have been conducted to look at this intersection, and I personally have explored this in my previous episodes. For example, the Healing Power of Nature episode, which is part of the Beautiful Planet series, looks at the mental and physical health benefits of immersing in nature. I gave statistical evidence on the wide range of benefits that we can receive from being in natural spaces and also natural medicine, and I also talked about using ecotherapy as a form of therapy for certain mental health problems. I also discussed the intersection of poor mental health with environmental problems with Gretchen Hernandez in the Men's Mental Health Matters Too episode, where Gretchen describes her pain of losing her family home to the wildfires in California and the danger of dying trees around her home. If you haven't listened to both of these episodes, or one, I highly recommend that you do!

So, wellbeing has been mentioned across these approaches, but health frameworks still haven't been explicit enough in addressing the intersection between environmental health and mental health of species, so I definitely think that's an area of improvement for all approaches to solving health issues. Regardless, ensuring that the way in which we explore health outcomes involves a wide range of scientific disciplines, along with indigenous knowledge, and maintaining a balance between studies conducted for human, animal and environment health will help us better improve the health and wellbeing of the planet as a whole. 

OUTRO: Happy New year deep thinkers! I hope you have a happy and save one. I wanted to start off the year with an episode that is specifically linked to sustainability because it's a nice way to recap on what Mind Full of Everything is about, for those that need to the podcast, but also looking at sustainability beyond the environment angle and into the health aspect, especially because health at this moment in time is so important for us to pay attention to, both physical and mental health. Creating this episode has been very informative for me, I hope it is informative for you as well, and also reassuring that health is being looked at in the scientific community in such a holistic way, and that it’s developed so much over the years. Remember to subscribe to the podcast on your podcast app of choice. Follow me on Instagram, Facebook, Twitter and Pinterest. You can support the show by giving reviews and buying my eco-friendly podcast merch. Thank you all for your support, until the next episode, happy listening!