National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
Faculty of Health, University of Canberra, Canberra, Australia.
Public Health. 2015 Oct;129(10):1361-8. doi: 10.1016/j.puhe.2014.11.013. Epub 2015 Apr 17.
The establishment of ecological public health as crucial to modern public health is overdue. While the basic concepts have been gestating for decades, receptivity within broader public health has been limited. This position is changing, not least as the population-level impacts of climate change and, more broadly, of limits to growth are emerging from theory and forecasting into daily reality. This paper describes several key elements of ecological public health thinking. These include the 'environmental' risks to human health (often systemic and disruptive, rather than local and toxic) posed by climate change and other forms of adverse global environmental change. Closer recognition of the links between social and environmental factors has been urged--an 'eco-social' approach--and, relatedly, for greater co-operation between social and natural sciences. The authors revisit critics of capitalism who foresaw the global capture and transformation of ecosystems for material human ends, and their resultant despoliation. The perennial call within public health to reduce vulnerability by lessening poverty is more important than ever, given the multifactored threat to the health of the poor which is anticipated, assuming no radical strategies to alleviate these pressures. But enhanced health security for the poor requires more than the reconfiguring of social determinants; it also requires, as the overarching frame, ecological public health.
将生态公共卫生作为现代公共卫生的核心的建立已经是刻不容缓。尽管这些基本概念已经酝酿了几十年,但在更广泛的公共卫生领域的接受程度仍然有限。这种情况正在发生变化,尤其是随着气候变化以及更广泛的增长极限对人口层面的影响从理论和预测逐渐变成现实。本文描述了生态公共卫生思维的几个关键要素。这些要素包括气候变化和其他形式的不利全球环境变化对人类健康构成的(往往是系统性和颠覆性的,而不是局部和有毒性的)“环境”风险。人们更加认识到社会和环境因素之间的联系——一种“生态社会”方法——并且,相关地,社会科学和自然科学之间需要加强合作。作者重新审视了那些预见了为了物质人类目的而对全球生态系统进行捕获和转化,以及由此导致的破坏的资本主义批评者。鉴于预计穷人的健康将受到多方面的威胁,鉴于没有缓解这些压力的激进策略,公共卫生界减少贫困人口脆弱性的长期呼吁比以往任何时候都更加重要。但是,穷人的健康安全保障不仅需要重新配置社会决定因素;作为总体框架,生态公共卫生也是必要的。