Ecology and health.

Health is commonly conceived as having fixed and universal aims, while conditions interposed by environmental and cultural conditions are often ignored or at least shunted to one side. Rejecting this point of view, the author asserts that health in any society should be defined in terms of ecological reality--that is, in terms of the cultural and environmental variables affecting the population. He also notes that acceptance of this concept does not imply perpetuation of a natural but static situation. Rather, it implies searching for ways to improve the situation without necessarily striving for international goals that may be unsuitable or impossible to achieve. The concept also implies that we should ask how to define a satisfactory health level for a given set of conditions--and then consider how to achieve that level. The search for answers to these questions and subsequent programs based on the results will require a multidisciplinary approach. Within this context two PAHO facilities, the Pan American Center for Human Ecology and Health (ECO) and the Pan American Center and Engineering and Environmental Sciences (CEPIS), can provide strong support for activities in the Americas. Specifically, ECO is in a good position to collaborate on ecological planning, model-building, and research evaluation, while CEPIS is geared to provide advice and assistance in the key field of environmental sanitation.