Rebecca Patrick

Health promotion and climate change: exploring the core competencies required for action

Climate change poses serious threats to human health and well-being. It exacerbates existing health inequities, impacts on the social determinants of health and disproportionately affects vulnerable populations. In the Australian region these include remote Aboriginal communities, Pacific Island countries and people with low incomes. Given health promotions remit to protect and promote health, it should be well placed to respond to emerging climate-related health challenges. Yet, to date, there has been little evidence to demonstrate this. This paper draws on the findings of a qualitative study conducted in Victoria, Australia to highlight that; while there is clearly a role for health promotion in climate change mitigation and adaptation at the national and international levels, there is also a need for the engagement of health promoters at the community level. This raises several key issues for health promotion practice. To be better prepared to respond to climate change, health promotion practitioners first need to re-engage with the central tenets of the Ottawa Charter, namely the interconnectedness of humans and the natural environment and, secondly, the need to adopt ideas and frameworks from the sustainability field. The findings also open up a discussion for paradigmatic shifts in health promotion thinking and acting in the context of climate change.

Incorporating sustainability into community-based healthcare practice.

There is now irrefutable evidence that climate change and increasing environmental degradation negatively affect population health. Healthcare plays an important role in addressing these emerging environmental challenges, considering its core aim is to protect and promote health. Preliminary research in Victoria, Australia, suggests that healthcare practitioners are endeavouring to factor in environmental concerns into their practice. Health promotion, an integral part of the healthcare system, is considered an area of practice that can support action on sustainability. Based on five qualitative case studies and key stakeholder interviews, this article explores key barriers and facilitators to incorporating sustainability into community-based healthcare practice. The findings demonstrate that despite multiple barriers, including funding and lack of policy direction, health promotion principles and practices can enable action on sustainability.

Exploring Ecosystems and Health by Shifting to a Regional Focus: Perspectives from the Oceania EcoHealth Chapter.

This article highlights contributions that can be made to the public health field by incorporating “ecosystem approaches to health” to tackle future environmental and health challenges at a regional level. This qualitative research reviews attitudes and understandings of the relationship between public health and the environment and the priorities, aspirations and challenges of a newly established group (the Oceania EcoHealth Chapter) who are attempting to promote these principles. Ten semi-structured interviews with Oceania EcoHealth Chapter members highlighted the important role such groups can play in informing organisations working in the Oceania region to improve both public health and environmental outcomes simultaneously. Participants of this study emphasise the need to elevate Indigenous knowledge in Oceania and the role regional groups play in this regard. They also emphasis that regional advocacy and ecosystem approaches to health could bypass silos in knowledge and disciplinary divides, with groups like the Oceania EcoHealth Chapter acting as a mechanism for knowledge exchange, engagement, and action at a regional level with its ability to bridge the gap between environmental stewardship and public health.

Public health guide to field developments linking ecosystems, environments and health in the Anthropocene

The impacts of global environmental change have precipitated numerous approaches that connect the health of ecosystems, non-human organisms and humans. However, the proliferation of approaches can lead to confusion due to overlaps in terminology, ideas and foci. Recognising the need for clarity, this paper provides a guide to seven field developments in environmental public health research and practice: occupational and environmental health; political ecology of health; environmental justice; ecohealth; One Health; ecological public health; and planetary health. Field developments are defined in terms of their uniqueness from one another, are historically situated, and core texts or journals are highlighted. The paper ends by discussing some of the intersecting features across field developments, and considers opportunities created through such convergence. This field guide will be useful for those seeking to build a next generation of integrative research, policy, education and action that is equipped to respond to current health and sustainability challenges.

Healthy Cities and the Transition movement: converging towards ecological well-being?

This commentary identifies similarities, differences and opportunities for synergy and mutual learning between the Healthy Cities and the Transition movements. We outline what we consider to be the ‘pressing issues’ facing humanity and the planet in the early 21st century; consider the extent to which health promotion has engaged with and addressed these issues; compare Healthy Cities and the Transition movement; and conclude by suggesting possibilities for moving forward.

Governance for health in the Anthropocene

The purpose of this paper is to explore the pressing issues facing health and health systems governance in the Anthropocene – a new geological time period that marks the age of colossal and rapid human impacts on Earth’s systems.,The viewpoint illustrates the extent of various human induced global ecological changes such as climate change and biodiversity loss and explores the social forces behind the new epoch. It draws together current scientific evidence and expert opinion on the Anthropocene’s health and health system impacts and warns that many these are yet unknown and likely to interact and compound each other.,Despite this uncertainty, health systems have four essential roles in the Anthropocene from adapting operations and preparing for future challenges to reducing their own contribution to global ecological changes and an advocacy role for social and economic changes for a healthier and more sustainable future.,To live up to this challenge, health services will need to expand from a focus on health governance to one on governance for health with a purpose of achieving equitable and sustainable human development.,As cities and local governments work to create more healthy, just and sustainable communities in the years ahead, health systems need to join with them as partners in that process, both as advocates and supporters and – through their own action within the health sector – as leading proponents and models of good practice.

Urbanisation, climate change and health equity: how can health promotion contribute?

We live in a world that is constantly changing and is challenging established approaches to managing human and ecological health. Two key drivers of change are urbanisation and global climate change. This commentary is concerned with the interrelationship of these drivers with human and ecological health, proposing that health promotion practitioners need to actively seek a new role in the process of creating urban environments that support social and ecological well-being. It provides practitioners with an up-to-date synthesis of climate change science and future projections, the literature around the health impacts of climate change and potential health challenges to urban communities. We argue that health promotion cannot respond to the challenges created by climate change and urbanisation, nor can it meet its own mandate without shifting from an anthropogenic-focussed approach toward embracing a multi-scale, collaborative approach outside the health sector. We suggest that the underlying principles of health promotion, which include equity and community engagement at all scales, are critical to the evolution of thriving urban environments. Food security is given as an example to demonstrate the proposed shift away from an anthropogenic and urban focus toward a socio-ecological approach (i.e. resilience thinking) that provides a framework for collaboration between sectors working with unpredictable global systems. In so doing, the commentary provides practitioners with guidance on the complex science of climate change and its impact on health in urban settings, as well as highlighting the skills that they can bring to creating resilient urban settlements in these times of change.

One planet regions: planetary health at the local level

One of the key lessons that can be learnt from the history of public health is that many major public health advances—from clean drinking water to tobacco control—have been led at the local level. As we enter the Anthropocene, and strive to embrace an ecosocial approach that can address the implications for population health of the global ecological changes humans are creating,1 once again much of the leadership and action will need to occur at the local level.

Exploring Australian health promotion and environmental sustainability initiatives

Issue addressed Health promotion practitioners have important roles in applying ecosystem approaches to health and actively promoting environmental sustainability within community-level practice. The present study identified the nature and scope of health promotion activities across Australia that tackle environmental sustainability. Methods A mixed-method approach was used, with 82 participants undertaking a quantitative survey and 11 undertaking a qualitative interview. Purposeful sampling strategies were used to recruit practitioners who were delivering community-level health promotion and sustainability programs in Australia. The data were analysed thematically and interpretation was guided by the principles of triangulation. Results Study participants were at various stages of linking health promotion and environmental sustainability. Initiatives focused on healthy and sustainable food, active transport, energy efficiency, contact with nature and capacity building. Conclusion Capacity building approaches were perceived as essential to strengthening this field of practice. Healthy and sustainable food and active transport were suitable platforms for simultaneously promoting community health and sustainability. There was potential for expansion of programs that emphasise contact with nature and energy issues, as well as interventions that emphasise systems thinking and interdisciplinary approaches. So what? It was promising that Australian health promotion programs have started to address complexity rather than single issues, as evidenced by explicit engagement with environmental sustainability. However, more effort is required to enable a shift towards ecosystem approaches to health.

Where ecosystems, people and health meet: academic traditions and emerging fields for research and practice

Human-driven environmental change has brought attention to the importance of ecosystems in sustaining human health and well-being. There are various schools of thought and fields of inquiry and action that seek to understand health in relation to linked social and ecological phenomena. We describe 18 such fields and outline common elements and incongruities among them. They converge around the application of systems thinking and crossing disciplinary boundaries, while differences are found in methodologies, research foci and problem framing. Although fields encourage sustainable and equitable pathways for health promotion, depoliticized and ahistorical approaches continue to be standard practice. Future research calls for a deeper commitment to examining ourselves as political actors, making space for conversations around power dynamics, and (re)centering participants in research methodologies.Human-driven environmental change has brought attention to the importance of ecosystems in sustaining human health and well-being. There are various schools of thought and fields of inquiry and action that seek to understand health in relation to linked social and ecological phenomena. We