People who live in developed nations are, by many measures, healthier than ever before. Yet the planet has borne an onslaught of environmental insults — climate change chief among them — unlike any in human history. This alone threatens everyone’s well-being, a conundrum that scientists call the “ecological paradox.” They believe humans are forfeiting the health of future generations in order to reap economic gains now.
“We may be living longer, but we are doing it in a way that will rob our children of their health, well-being and long lives,” said Gina McCarthy, who served as administrator of the Environmental Protection Agency during the Obama Administration. “We need to be looking at how human interference in Earth’s natural systems is playing out, and how humans are changing them. We also must find different solutions, not the traditional ones.”
This means society must begin to focus more on the health of forthcoming generations, a process that will require “a game-changing shift in thinking,” said Susanne Sokolow, a senior research scientist at the Stanford Woods Institute for the Environment. “Biotechnology has advanced medicine and helped to provide lifesaving diagnostics and treatments, with immediate health benefits, but the future pipeline of new drugs, new antibiotics, and new diagnostics may not provide the panacea that we hope for if the natural ecosystems, on which our lives and livelihoods depend, disappear.”
In recent years, this realization has led to the emergence of a new and growing field, that of planetary health, a discipline that has prompted a global effort to turn what was earlier an academic curiosity into a serious scrutiny of the array of environmental consequences on the worldwide burden of disease.
“It used to be only gee-whiz interesting only to geeky people like me,” said Samuel Myers, senior research scientist in the department of environmental health at the Harvard T. H. Chan School of Public Health. “But now we know that with ecology, everything is connected to everything. What’s happened in recent years has been a recognition that the human impact on all our planet’s natural systems — climate change, changes in land cover, fisheries, fresh water systems, pollution, air and water quality — all of these transformations are now at a magnitude that threaten global health in a way that is no longer just interesting but deeply urgent.”
The biggest worry is over the fate of the world’s food supply resulting from a changing climate, land degradation, water scarcity, and the loss of pollinators, Myers said. “We are completely remaking the conditions that underpin our whole food production system,” he said. “We are doing that at the exact same time we need to increase global food production to keep up with demand.”
Dr. Courtney Howard, an emergency physician and president of the Canadian Association of Physicians for the Environment, agreed. “Only about 30% of overall health is determined by actual healthcare, and the rest by what happens outside healthcare structures,” she said.
“We need to be talking about things humans care about — food, clean water, and shelter — instead of about polar bears,” she added. “I live in Canada’s subarctic — closer to the polar bears than most people — and it’s unlikely I would change my behavior on their behalf. But I’d move mountains if it meant that I could contribute to my kids having a steady food supply in the year 2040.”
Myers directs the Planetary Health Alliance, an international coalition of more than 70 universities, non-government and governmental organizations, research institutes and others working to address planetary health issues through education, projects, communication and efforts to influence policy. “We see the Alliance as the connective tissue for this growing field,” he said. “We are trying to be the center of gravity to help everybody find each other. We want to connect the research community, and bring science to policy. This isn’t about academic curiosity but an applied field.”
Organization members have initiated several programs, including working on an overseas fisheries management project, and cooperating with foreign governments to help them better understand the health impact of their environmental decisions. For example, they have shown the Indonesian government the health hazards caused by fires, in particular how land use decisions ultimately affect health outcomes, Myers said.
In another example, the Upstream Alliance has been working to re-establish a lost prawn species to sub-Saharan Africa which experienced a rise in a human parasite as a result. The organism causes schistosomiasis, an intestinal or urinary infection caused by parasitic flatworms.
“Our disease control approach is to restore natural snail predators (prawns) within the aquatic ecosystems where schistosomiasis has emerged, especially in managed ecosystems like irrigation schemes throughout the developing world where some of the highest parasite transmission sites exist today,” Sokolow said. “So far, results point toward synergy between focusing on restoring ecosystems and bringing medicine and drugs to people: the two together can achieve more in terms of disease reduction than either intervention alone.”
In an effort to better integrate research communities and focus on collaborative solutions, Sokolow and other groups have begun to analyze existing data on interventions at the local and regional scale that have had a direct and measurable benefit for human health. “We hope to put these concrete examples in context and synthesize how they can advance a planetary health agenda for the 21st Century,” she said.
In addition to individual projects, education also is a key component of the effort, Myers said. “Planetary health was not even a term in usage until about two years ago,” he said. “Now we have courses on it all over the world. We are teaching the first course at Harvard, with the second year coming up this spring. Some courses are at the graduate level, some at the undergraduate level, and we are starting to talk to groups interested in K-12. It’s a great way to teach the interdisciplinary nature of science and how it interacts with society.” He said education goals also include settings in developing nations, partnering with the World Federation of Academic Institutions for Global Health.
McCarthy, who has focused her efforts on climate change since leaving the EPA, is cautious about collapsing the issue of climate change into the larger movement, still frustrated that the science of climate still is not universally accepted. “Why can’t we make it personal enough so that people will embrace the issue? How do you make it about me? My life? My children?”
“We need something that breaks through,” she added. “The planetary health movement does one important thing, which is to tell us that there are real threats to human beings if we don’t do something.”