Ecosystems and Human Health (eBook)

Dr. Crescentia Dakubo is a specialist in ecosystems approaches to human health. She is an Assistant Professor at the Northern Ontario School of Medicine, West Campus, Thunder Bay,  and an Adjunct Professor of the Department of Health Sciences, Faculty of Health and Behavioural Sciences, Lakehead University, Ontario, Canada.

Preface 5
Contents 9
Part I Ecohealth: The Ecosystem Approach to Human Health 15
1 Exploring the Linkages Between Ecosystems and Human Health 16
1.1 Introduction 16
1.2 Ecosystem Services and Human Health 20
1.3 Land Fragmentation and Health 22
1.4 Water Resource Development and Health 23
1.5 Urbanization and Health 25
1.6 Modern Food Production Systems and Health 26
1.7 Climate Change and Health 27
1.8 Wars, Conflicts and Health 29
1.9 Conclusion 29
References 30
2 Evolution Towards an Ecosystem Approach to Public Health 33
2.1 Introduction 33
2.2 Old Public Health and the Biomedical Approach 34
2.3 The New Public Health and Ecological Approaches 37
2.4 Integrated Approaches to Natural Resource Management 39
2.5 Making the Links with Sustainable Development 41
2.6 Modeling Human Health from an Ecosystem Perspective 42
2.7 Towards Critical Public Health 45
2.8 Conclusion 46
References 46
3 Ecosystem Approaches to Human Health: Key Concepts and Principles 49
3.1 Introduction 49
3.2 The Concept of Human Health 52
3.3 The Concept of Ecosystem 53
3.4 Assessing the Health of Ecosystems 55
3.5 The Ecosystem Approach to Human Health: Key Issues 56
3.6 The Ecohealth Research Framework 58
3.6.1 Integrating Transdisciplinary, Indigenous, and Stakeholder Perspectives 60
3.6.2 Making use of Collaborative and Inclusive Processes 61
3.6.3 Taking Heterogeineity and Difference into Account 61
3.6.4 Historicizing Environment and Health Problems 62
3.6.5 Infusing Critical Social Theory into Ecohealth Research 62
3.7 Conclusion 63
References 63
Part II Methodological Approaches and Processes for Conducting Ecohealth Research 66
4 Community-Based Participatory Research for Ecohealth 67
4.1 Introduction 67
4.2 Participatory Action Research 69
4.3 Being Critical About Participatory Research Approaches 71
4.3.1 Being Critical About ''Community'' 72
4.3.2 Being Critical about ''Participation'' 74
4.3.3 Being Critical About ''Empowerment'' 75
4.4 Conclusion 76
References 77
5 The Process of Conducting an Ecohealth Research Project: A Participatory Action Research Approach 80
5.1 Introduction 80
5.2 Gaining Entry into the Research Community 82
5.3 Forming a Transdisciplinary Research Team 83
5.4 Recruiting Research Participants 85
5.5 Data Gathering Processes 86
5.6 Focus Group Discussions 88
5.7 Follow-up and In-depth Individual Interviews 88
5.8 Strategic Planning for a Healthy Community 89
5.9 Steps to Planning for a Healthy Community 90
5.9.1 Step 1: Mapping Out a Vision for a Healthy Community 90
5.9.2 Step 2: Analysing Underlying Obstacles and Barriers to Achieving a Healthy Community 90
5.9.3 Step 3: Identifying Appropriate Strategic Directions for a Healthy Community 90
5.9.4 Step 4: Identifying Systematic Actions and Assessing Community Capacity 91
5.9.5 Step 5: Developing an Implementation Schedule and Carrying Out Proposed Actions 91
5.10 Site Visits 92
5.11 Secondary Data Sources 92
5.12 Data Management and Analysis 92
5.13 Conclusion 93
References 94
Part III Case Studies: Application of the Ecohealth Approach 95
6 Applying an Ecosystem Approach to Community Health Research in Ghana: A Case Study 96
6.1 Introduction 96
6.2 Health and Environment Challenges of the Study Community 98
6.3 Making Use of an Ecosystem Approach to Community Health Research 100
6.4 Forming a Transdisciplinary Research Team and Setting the Research Agenda 101
6.5 Findings of the Study 102
6.5.1 Community Members' Perceptions of Health and Poor Health 102
6.5.2 Indicators of Good Health and Poor Health 104
6.5.3 Identifying Major Community Health Problems 105
6.5.4 Examining the Underlying Causes of Poor Health in the Community 107
6.6 Analysing Participants Responses from a Political Ecology of Health Perspective 109
6.7 Conclusion 113
References 113
7 Planning for a Healthy Community: A Case Study Phase II 116
7.1 Introduction 116
7.2 Mapping Out A Vision for a Healthy Community 118
7.3 Identifying Obstacles to Achieving a Healthy Community 121
7.4 Assessing Our Strengths and Resources 124
7.5 Identifying Strategic Directions and Systematic Actions for a Healthy Community 125
7.5.1 Building Community Capacity to Manage Local Environments Sustainably 126
7.5.2 Strengthening Intersectoral Collaboration 127
7.5.3 Broadening the Concept of Community Participation 128
7.5.4 Communicating Environment and Health Information Effectively 128
7.5.5 Building on Local Knowledge Systems 129
7.6 Building Community Capital: Integrating the Strategic Directions 131
7.7 Drawing up an Implementation Plan 132
7.8 Conclusion 134
References 134
8 Challenges and Ethical Dilemmas in Conducting Participatory Ecohealth Research 136
8.1 Introduction 136
8.2 Gaining a Second Entry into the Community 137
8.3 Establishing Equal Partnerships Between Participants and the Research Team 140
8.4 Participatory Ecohealth Research as Transformative and Empowering 141
8.5 To Be or Not To Be: Insider Outsider Relations 143
8.6 Dealing with Vulnerability in Focus Group Discussions 144
8.7 Are all Voices and Knowledges Captured through Group Processes 145
8.8 Conclusion 146
References 147
9 Ecosystem Approaches to Indigenous Health 148
9.1 Introduction 148
9.2 Indigenous Peoples and Communities 150
9.3 Indigenous Conceptions of Health and Links to Country 151
9.4 Colonized and Politicized Indigenous Ecosystems: Implications for Human Health 153
9.4.1 Mercury Poisoning in Grassy Narrows First Nations 153
9.5 Climate Change and Indigenous Health 155
9.6 Examining Indigenous Health Problems from a Political Ecology of Health Perspective 157
9.7 Ecosystem Approaches to Indigenous Health 159
9.8 Conducting Research with Indigenous Communities: Some Considerations 160
9.9 Conclusion 163
References 163
10 Policy Frameworks on Health and Environment Linkages 166
10.1 Introduction 166
10.2 Global Policy Frameworks on Health, Environment and Development 167
10.3 Regional Initiatives on Health and Environment: Africa and Europe 170
10.3.1 Health and Environment Policy Frameworks in Africa 171
10.3.2 Health and Environment Policy Frameworks in Europe 174
10.4 Developing Integrated Policy Frameworks: Issues and Challenges 176
10.5 Influencing Policy Through Community-Based Ecohealth Research 179
10.6 Conclusion 180
References 180
Part IV A Critical Approach to Ecohealth Research and Practice 182
11 Applying Critical Theory to Environment and Health Issues 183
11.1 Introduction 183
11.2 Critical Theoretical Perspectives 184
11.3 The Production of Scientific Knowledge Claims 185
11.3.1 Processes Through which Scientific Knowledge Claim Authority 186
11.4 Constructing Subject Positions Through the Use of Binary Logic 187
11.5 Scientific Interventions and Forms of Resistance 189
11.6 Conclusion 189
References 190
12 Examining Environmental Problems from a Critical Perspective 191
12.1 Introduction 191
12.2 Examining Various Environmental Discourses 193
12.3 Key Features of Political Ecology 195
12.4 Political Ecology of Health 199
12.5 Conclusion 200
References 201
13 Examining Public Health Concerns from a Critical Perspective 204
13.1 Introduction 204
13.2 Public Health as Discourse 205
13.3 Negotiating Definitions of Health and Ill Health 206
13.4 Negotiating the Determinants of Health Problems 207
13.5 Historicizing Health Problems 208
13.6 Conclusion 209
References 210
14 Towards a Critical Approach to Ecohealth Research and Practice 211
14.1 Introduction 211
14.2 Identifying Environmental Problems from a Critical Perspective 212
14.3 Explaining Environmental Problems from a Critical Perspective 214
14.4 Identifying Health Problems from a Critical Perspective 215
14.5 Explaining Health Problems from a Critical Perspective 217
14.6 Contextualizing Environment and Health Experiences 218
14.7 Developing Mutually Acceptable Ecohealth Interventions 220
14.8 Approaching Transdisciplinarity and Participation from a Critical Perspective 222
14.9 Towards a Reflexive Ecohealth Research Practitioner 223
14.10 Conclusion 224
References 225
Index 226