Health is Nested: Ecosystems Matter to Individual Health

At CAPE, we do our work at the intersection of health and the environment. We’re actively engaged with many current local, national and international events related to health and the environment. This work is happening under the leadership of our newly appointed Executive Director, Dr. Anjali Helferty

Recent CAPE activities include campaigning for the passage and strengthening of critical legislation under Bills C-12, C-230, and C-28, media and public engagement on pressing environmental health issues, participation in pivotal events including the Leaders Summit on Climate and the WHO Pan-American Region Consultation on Climate and Health and more.  To read about these and other activities, you can look to CAPE’s latest news, press releases, and recent media coverage.

Each of the activities we are involved in is reflective of our ongoing commitment at CAPE to take action to enable health for all by engaging with governments, running campaigns, conducting research, drawing media attention to critical issues, collaborating with other organizations, nationally and internationally to work effectively and build power together, and supporting physicians to be advocates for healthier environments and ecosystems.

UN World Environment Day is coming up on June 5, 2021. The theme for this year is “Reimagine. Recreate. Restore. #GenerationRestoration” in support of ecosystem restoration. The restoration process includes reviving and protecting ecosystems. As physicians and health care providers, we know that ecosystems matter to us for many reasons, including that humans and their health are part of and rely on them.

Health is not just a medical issue. Individuals live within families, communities, ecosystems, and planetary-level conditions. Health is wholeness, intertwined with and impacted by multiple factors in the social, political and economic world. The intersection of health and environments, represents a fundamental and symbiotic relationship between the two.

To illustrate this relationship, we can think of health as nested in the levels of society and inter-relationships through the life cycle. The environments we work, live and play in all interact to influence health. Good health hinges on the protectiveness of the nest. If the nest is not protective, health may be threatened.

The socio-ecological model (see figure below) shows the big picture of health and the nestedness of the individual. Sites where interventions promote health, prevent illness and uphold justice are visible through the multiple levels of the nest, from the individual to families, organizations, community, society, the planetary ecosystem and through time.

Legislation, policies and regulations that prioritize profit over people and their environments are barriers to health for many living on these lands today called Canada. To focus on health simply as a condition of the individual ignores the fact that lifestyle choices and personal behaviours that influence health outcomes are not equally shared. For example, the daily realities of systemic disparities and structural inequities that create environmental racism, gendered discrimination, and poverty make some people more vulnerable to adverse health impacts. Likewise, individual, behaviour-based actions for pollution control of emission reductions are insufficient without industrial, national and international strategies to address more widespread environmental impacts and related adverse health effects. 

As illustrated in the nested framework, the big picture of health incorporates societal factors.  This includes legislation, regulation, and policies that recognize the interconnectedness of the whole social, political and economic ecosystem. Our health nest is not complete without strong laws and regulations that protect us from exposure to toxins and pollution, environmental racism, or different impacts of sex and gendered factors. The right to a healthy environment should extend to all living in Canada and on this planet.

In the wake of Earth Day and with World Environment Day approaching, we move forward with enacting our pledges to restore our earth and revive our ecosystems for a healthy recovery. Equipped with the scientific evidence of environmental health impacts, the knowledge of environmental racism, and the political will of our leaders, collaborative and just multilevel interventions for better health are possible.

CAPE continues its advocacy through a lens that recognizes that health is nested. The big picture of health captures the socio-ecological complexities of our relationships with each other, with societal systems and structures within a broader planetary ecosystem. Together, we can better protect human health by protecting the planet.

Adapted from Bronfenbrenner’s Ecological Theory, first developed in the 1970s and modified over time. The graphic shows the nested set of structures and relationships in the ecological environment, moving from the innermost level, the person, to the outermost, the chronosystem, representing the passage of time. Bronfenbrenner, U. (1994). Ecological models of human development. In International Encyclopedia of Education (Vol. 3, 2nd ed.). Oxford: Elsevier.