Identifying Vulnerabilities, Barriers, and Opportunities

A systems approach is needed to map the systemic barriers to health equity. Health equity impact assessment methods were developed to help consider the cumulative effects (positive and negative) of a specific policy, program, or project on vulnerable groups of people. These tools have a distinctly anthropocentric perspective. Identifying cumulative impacts is increasingly seen as a best practice in conducting environmental assessments. This approach strives to assess the incremental impact of the action when added to other past, present, and reasonably foreseeable future actions, but it tends to have a focus on biophysical rather than social impacts. Integrated environmental impact assessment aims to combine dimensions of human determinants of health with biological and physical environments to provide a holistic understanding of the interrelationships between the human and the natural environment to help identify the unintended effects of initiatives on human health and/or on the environment. They tend to have more of a focus on sustainability than on health equity. There is a large variety of impact assessment tools and approaches but none have satisfactorily integrated the concerns of equity with human, animal, and ecosystem health. One Health practitioners will need to borrow from and adapt the various tools to best suit the context of specific issues. Figure 3.1 proposes a rubric that might guide an assessment of the interspecies, intergenerational health equity implications of a policy, intervention, or program.

Figure 3.1 considers three equity questions: (i) How will the proposed activities or decisions increase or decrease unnecessary, avoidable, and/or unjust impacts or health outcomes? (ii) How will the proposed activities or decisions increase or decrease the access, quality, or quantity of social or environmental resources or ecological services that are needed to fulfil the determinants of health for humans, animals, and the environment? (iii) How will the policies or practices needed to implement the activities or decisions systematically prevent humans or animals the opportunity to benefit from a determinant of health? Each of these questions will have both spatial dimensions (i.e. over what geographic scale does one consider these questions?) and temporal dimensions (i.e. are these questions answered in the present, over the life course of individuals, other generations, or all of these time periods?). These questions are asked for people, animals, and ecosystems that will be influenced by the decisions and activities being reviewed.

Conceptual framework to guide an interspecies, intergenerational health equity assessments

FIGURE 3.1 Conceptual framework to guide an interspecies, intergenerational health equity assessments.

Identifying which people, animals, or ecosystems are vulnerable to changes due to the proposed activities will require a collaborative, interdisciplinary, and equity informed set of approaches to appraising the situation. The success of such analytical exercises will be influenced by who is involved and what knowledge they bring to the process, underscoring the importance of considering cultural safety and related equity, diversity, and inclusion guidelines. The goal is not to produce an exhaustive conceptualization of the issues and relationships at play because this is rarely possible due to the complex, dynamic nature of ecosystem relationships in a changing world as well as due to intersectoral and disciplinary challenges to integrating knowledge. Rather, the goal is to identify who or what might be vulnerable to socially produced advantages or disadvantages derived from the proposed activities, which in itself will not be a simple or straightforward task. Identifying the right set of variables that allow one to directly measure the impact of a decision on the health of all species and forecast future impacts involves dealing with (i) difficulties detecting changes in ecological drivers of vulnerability and resilience for all species within an effected ecosystem, (ii) insufficient evidence and agreement on the identification of thresholds of impacts that are un/acceptable, (iii) the lack of methods that can integrate multiple socio-ecological scales, (iv) the effects of socio-ecological processes may take decades before changes can be seen, making it hard to recognize relationships, and (v) institutional inertia or barriers to со-managing data, intersectoral or interagency relationships, and interdisciplinary knowledge production.

There is a clear urgency to fully address health inequity as we plan strategies and interventions to cope with the threats and changes acting at the interface of animals, health, and society. One Health actions need to be attentive to barriers preventing individuals and populations, be they human or animals, from accessing and benefiting from the conditions needed to reach their full health potential. Paying attention to the “causes of the causes” of poor health and how they are distributed across species can both help prevent unanticipated consequences and ensure that we create circumstances that concurrently protect and promote the health of people, animals, and their shared environment in a just and fair manner.


Ansari, Walid El. and Arran Stibbe. “Public Health and the Environment: What Skills for Sustainability Literacy - and Why?” Sustainability. 1, no. 3 (2009): 425-440.

Blackstock, Cindy. “The Breath of Life Versus the Embodiment of Life: Indigenous Knowledge and Western Research.” World Indigenous Nation's Higher Education Consortium Journal. (2007): 67-79.

Bracken. Paul. Ian Bremmer. and David Gordon, eds. Managing Strategic Surprise: Lessons from Risk Management and Risk Assessment (Cambridge: Cambridge University Press, 2008).

Braveman, Paula. “Social Conditions. Health Equity, and Human Rights." Health and Human Rights, 12, no. 2 (2010): 31-48.

Braveman. Paula, and Sofia Gruskin. “Defining Equity in Health.” Journal of Epidemiology and Community Health. 57, no. 4 (2003): 254-258.

Braveman. Paula A., Shiriki Kumanyika, Jonathan Fielding. Thomas LaVeist, Luisa N. Borrell. Ron Manderscheid, and Adewale Troutman. “Health Disparities and Health Equity: The Issue Is Justice.” American Journal of Public Health. 101. no. SI (2011): S149-S155.

Canadian Veterinary Medical Association. “The Link: Animal Abuse, Child Abuse, and Domestic Violence.” CVMA. 2020. policy-advocacy/link-between-animal-child-domestic-abuse.

Ceballos, Gerardo. Paul R. Ehrlich. Anthony D. Barnosky, Andres Garcia, Robert M. Pringle, and Todd M. Palmer. “Accelerated Modern Human-Induced Species Losses: Entering the Sixth Mass Extinction." Science Advances. 1, no. 5 (2015): el400253.

Center for Biological Diversity. “Halting the Extinction Crisis.” 2020. https://www.biolog- (accessed June 2020).

Cushing, Lara. Rachel Morello-Frosch, Madeline Wander, and Manuel Pastor. “The Haves, the Have-Nots, and the Health of Everyone: The Relationship Between Social Inequality and Environmental Quality.” Annual Review of Public Health, 36 (2015): 193-209.

De Vos. Jurriaan M.. Lucas N. Joppa. John L. Gittleman, Patrick R. Stephens, and Stuart L. Pimm. “Estimating the Normal Background Rate of Species Extinction.” Conservation Biology, 29. no. 2 (2015): 452-462.

Dobson. Andrew. “Ecological Citizenship.” in Citizenship and the Environment (Oxford: Oxford Scholarship Online. 2004).

Earnshaw, Gwendellyn Io. “Equity as a Paradigm for Sustainability: Evolving the Process Toward Interspecies Equity.” Animal L. 5 (1999): 113.

Febres. Jeniimarie, Hope Brasfield. Ryan C. Shorey. Joanna Elmquist, Andrew Ninnemann, Yael C. Schonbrun, Jeff R. Temple et al. “Adulthood Animal Abuse Among Men Arrested for Domestic Violence.” Violence Against Women, 20. no. 9 (2014): 1059-1077.

Fleming, Mary Louise, Thomas Tenkate, and Trish Gould. “Ecological Sustainability: What Role for Public Health Education?” International Journal of Environmental Research and Public Health, 6, no. 7 (2009): 2028-2040.

FNHA. “First Nations Perspective on Health and Wellness.” First Nations Health Authority. 2020. first-nations-perspective-on-wellness (accessed June 2020).

Garland. Elizabeth. “The Elephant in the Room: Confronting the Colonial Character of Wildlife Conservation in Africa.” African Studies Review, 51, no. 3 (2008): 51-74.

Glotzbach, Stefanie, and Stefan Baumgartner. "The Relationship Between Intragenerational and Intergenerational Ecological Justice.” Environmental Values, 21. no. 3 (2012): 331-355.

Gostin Lawrence A. “Health and Social Justice." Bulletin of the World Health Organization, 89,no. 1 (2011): 224.

Greenwood. Margo Lianne, and Sarah Naomi de Leeuw. “Social Determinants of Health and the Future Well-Being of Aboriginal Children in Canada.” Paediatrics and Child Health. 17, no. 7 (2012): 381-384.

Grzywacz, Joseph G.. Thomas A. Arcury, Antonio Marin. Lourdes Carrillo. Michael L. Coates, Bless Burke, and Sara A. Quandt. “The Organization of Work: Implications for Injury and Illness Among Immigrant Latino Poultry-Processing Workers.” Archives of Environmental and Occupational Health, 62. no. 1 (2007): 19-26.

Holdsworth. William Searle. “Early History of Equity." Michigan Law Review, 13 (1914): 293.

Jones, Camara Phyllis. Clara Yvonne Jones, Geraldine S Perry, Gillian Barclay, and Camille Arnel Jones. “Addressing the Social Determinants of Children's Health: A Cliff Analogy.” Journal of Health Care for the Poor and Underserved, 20, no. 4 (2009): 1-12.

Kapila. Monisha. Ericka Hines, and Martha Searby. “Why Diversity, Equity, and Inclusion Matter.” Independent Sector, 2016. diversity-equity-and-inclusion-matter/ (accessed May 2020).

Keune, Hans, C. Kretsch, G. De Blust, Marius Gilbert, Lucette Flandroy, Karel Van den Berge, V. Versteirt et al. “Science-Policy Challenges for Biodiversity, Public Health and Urbanization: Examples from Belgium.” Environmental Research Letters, 8, no. 2 (2013): 025015.

King. Malcolm, Alexandra Smith, and Michael Gracey. “Indigenous Health Part 2: The Underlying Causes of the Health Gap." Lancet, 374. no. 9683 (2009): 76-85.

Krieger, N. (2014). Discrimination and Health Inequities. International Journal of Health Services, 44(4), 643-710. https://doi.Org/10.2190/HS.44.4.b

Kruize. Hanneke. Mariel Droomers, Irene Van Kamp, and Annemarie Ruijsbroek. “What Causes Environmental Inequalities and Related Health Effects? An Analysis of Evolving Concepts.” International Journal of Environmental Research and Public Health, 11. no. 6 (2014): 5807-5827.

Marmot. Michael. “Social Determinants of Health Inequalities.” Lancet, 365, no. 9464 (2005): 1099-1104. doi: 10.1016/S0140-6736(05)71146-6.

Marmot. M., Friel, S., Bell, R.. Houweling, T. A., and Taylor, S. (2008). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health. Lancet. 372(9650), 1661-1669.

McAdie, Malcolm. Indicators of Individual and Population Health in the Vancouver Island Marmot (Marmota vancouverensis). Masters of Science Dissertation, Thompson

Rivers University, 2018.


Miller, Fiona. Frank Thomalla, Tom Downing, and Matthew Chadwick. “Resilient Ecosystems, Healthy Communities: Human Health and Sustainable Ecosystems After the December 2004 Tsunami.” Oceanography, 19. no. 2 (2006): 50-51.

Nibert. David. “Animals, Immigrants, and Profits: Slaughterhouses and the Political Economy,” in Critical Animal Studies: Thinking the Unthinkable, ed. John Sorenson (Toronto: Canadian Scholars’ Press Inc. 2014), 3-17.

Parkes. Margot W.. Blake Poland, Sandra Allison, Donald C. Cole, Ian Culbert. Maya K. Gislason, Trevor Hancock et al. “Preparing for the Future of Public Health: Ecological Determinants of Health and the Call for an Eco-Social Approach to Public Health Education.” Canadian Journal of Public Health, 111, no. 1 (2020): 60-64.

Pascual, Unai, Jacob Phelps, Eneko Garmendia, Katrina Brown, Esteve Corbera. Adrian Martin. Erik Gomez-Baggethun et al. “Social Equity Matters in Payments for Ecosystem Services.” Bioscience, 64. no. 11 (2014): 1027-1036.

Pendergrass, JoAnna. “Veterinarians: Protecting Pets and People from Abuse.” American Veterinarian, 2017. protecting-pets-and-people-from-abuse (accessed May 2020).

Petersen. Alan. Mark Davis, Suzanne Fraser, and Jo Lindsay. "Healthy Living and Citizenship: An Overview.” Critical Public Health, 20, no. 4 (2010): 391-400.

Rask, Maija, Satu Uusiautti, and Kaarina Maatta. “The Fourth Level of Health Literacy.” International Quarterly of Community Health Education, 34, no. 1 (2014): 51-71.

Shaw, Rosemary. “A Case for Recognizing the Rights of Animals as Workers.” Journal of Animal Ethics, 8, no. 2 (2018): 182-198.

Spoel. Philippa, Roma Harris, and Flis Henwood. “Rhetorics of Health Citizenship: Exploring Vernacular Critiques of Government’s Role in Supporting Healthy Living.” Journal of Medical Humanities, 35, no. 2 (2014): 131-147.

Stephen, Craig. “Rethinking Pandemic Preparedness in the Anthropocene.” Healthcare Management Forum, 33, no. 4 (2020): 153-157.

Stephen, Craig, and Joy Wade. “Wildlife Population Welfare as Coherence Between Adapted Capacities and Environmental Realities: A Case Study of Threatened Lamprey on Vancouver Island." Frontiers in Veterinary Science, 5 (2018): 227.

Stockholm University. “Memory for Stimulus Sequences Distinguishes Humans from Other Animals.” Science Daily, June 2017. releases/2017/06/170620200012.htm (accessed May 2020).

Tehrani, Shadi O., Shilling J. Wu, and Jennifer D. Roberts. “The Color of Health: Residential Segregation, Light Rail Transit Developments, and Gentrification in the United States.” International Journal of Environmental Research and Public Health, 16. no. 19 (2019): 3683. doi: 10.3390/ijerph 16193683.

Tonmyr, Lil. and Cindy Blackstock. “Commentary: Indigenous Health Special Issue.” International Journal of Mental Health and Addiction, 8. no. 2 (2010): 135-144.

UN General Assembly. “Universal Declaration of Human Rights.” UN General Assembly, 302, no. 2 (1948).

UNESCO. “Technical and Vocational Education and Training and the ‘Triple Bottom Line’ of Sustainable Development.” Supplement to UNESCO-UNEVOC Bulletin, No. 9, September 2004. bulletin/Supplement-04-e.pdf (accessed May 2020).

United Nations Strategic Imperative. “Report of the World Commission on Environment and Development: Our Common Future.” United Nations, 1987. Print. Pg 16. https:// (accessed June 2020).

Vucetich, John A., Dawn Burnham, Ewan A. Macdonald, Jeremy T. Bruskotter, Silvio Marchini. Alexandra Zimmermann, and David W. Macdonald. “Just Conservation: What Is It and Should We Pursue It?” Biological Conservation, 221 (2018): 23-33.

< Prev   CONTENTS   Source   Next >