Traversing the Eco-Healthscape: The Final Frontier in Understanding Shared Determinants of Health at the Animal-Society Interface
The World Health Organization’s Ottawa Charter for Health Promotion (WHO, 1986) states: “Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.” This has been a cornerstone in the development of a healthy settings approach to health promotion and public health (Kickbusch, 2003). This approach recognizes the need to develop strategies, programmes, and policies that contribute to total population health in a given setting, rather than targeting specific at-risk groups. This chapter examines the healthy settings approach in a One Health world by considering how geographical contexts have been framed in research relevant to animal, the environment, and human health.
Over the last two decades, the role of geography in understanding, predicting, and shaping health and disease has grown, through the expansion of health geography and spatial epidemiology (Meade, 2014; Kearns and Moon, 2002). Locations linked with health surveillance data, for example, can help reveal patterns of disease relative to the underlying population. Spatial patterns can reveal clues about aetiology and risk factors. In health surveillance, this sort of analysis can lead to early detection of emergence, spillover, geographic spread, or evidence of co-infection and interaction among pathogens, hosts, and vectors (Mayer, 2000; Robertson et al., 2010). Disease data linked to other environmental datasets through location references can help identify spatial risk factors. This approach is widely used in the study of distribution of both chronic and infectious diseases in humans and increasingly in animals.
Despite these successes in “spatial” approaches to health and disease, key challenges remain. Epidemiologically significant events can be (and often are) the outcome of unpredictable and seemingly random interactions. The challenges of making useful spatial associations begin to compound for diseases that are shared between species, where early risk factors interact in unpredictable ways in extremely complex processes. Animal and human data are collected for widely varying purposes, with different methods, sampling approaches, and data formats, which complicates developing a data acquisition and analysis strategy (Robertson et al., 2016). Needing to monitor interactions between multiple species, their environment, and human populations (all of which have different restrictions across political boundaries, and different surveillance methods and approaches) creates difficulties for spatial risk factor surveillance for emerging zoonoses. While spatially explicit methods are commonly used in understanding wildlife, spatial information alone rarely tells us much about population health overall. Population declines or collapses are rarely explained only by where wildlife are located. Integration of spatially explicit health information, encompassing wildlife, domestic animals, humans, and the environment, remains elusive. A shift in thinking is now promoting One Health through a health promotion lens: to monitor and understand those shared dimensions that contribute positively to health - across generations, places, and species boundaries (see Chapter 2 for more on the evolution of One Health).
We propose the idea of an “Eco-Healthscape,” which combines what we might traditionally consider as EcoHealth approaches to health assessment, with the notion of landscape approaches to health. A “landscape,” in a geographical sense, is defined relationally rather than as a particular spatial scale. A landscape is a geographical unit, which may change and fluctuate over time that incorporates some heterogeneity with respect to the habitat experienced by an individual species. A landscape definition is linked to habitat area, dispersal characteristics, habitat quality/disturbances, and species interactions. Landscapes are in constant interaction with the ecosystems and social systems within which they are embedded. An Eco-Healthscape emerges from the complex interactions among constituent species and their landscapes. Moving beyond identifying threats to one species to a more holistic multi-species assemblage perspective means thinking about ecosystem functions, actors, and populations on their own intrinsic terms rather than in relation to the services they provide to humans.
In this chapter, we explore how to identify, shape, and create a healthy Eco-Healthscape. We review spatial approaches to health and disease, followed by considering how recent ideas from health geography can inform the conceptualization and operationalization of Eco-Healthscape approaches to One Health. A caribou case study illustrates some of the ideas in practice, followed by a discussion of preliminary conclusions regarding an Eco-Healthscape approach to promoting health of animals, humans, and our shared environment.
Prioritizing Space in Ecological Research
The idea that ecological systems can be understood without considering the geographic contexts and their effects within which those systems operate was called into question by Peter Kareiva in the journal Ecology in 1994. Further papers (e.g. Holmes et al„ 1994) identified that spatially explicit processes were vital to specific ecological systems, and modelling their spatial patterns and dynamics was needed to understand them. Incorporating spatial dynamics into ecological theory helped make better predictions, create sound management strategies, and understand ecological responses to disturbances. The spatial ecology field has grown to encompass a variety of frameworks, methods, and theoretical developments. Some of these were made possible by new technologies for monitoring landscapes, tracking animals through space and time, and mapping and monitoring disturbances, their impacts, and responses. However, by the mid-2000s - despite hundreds of papers describing spatial effects in ecological systems - it became clear that spatial ecological theory, techniques, and applications were not enough to aid in the management and conservation of declining and threatened wildlife populations (e.g. Mladenoff, 2005).
Most ecological theory and the knowledge it generates relate to systems in the absence of humans. Humans, however, are very much a major part of ecological development, maintenance, and resilience (Burke and Mitchell, 2007). Incorporating humans into conservation and ecosystem restoration is now considered a vital aspect of successful restoration and conservation efforts. The field of restoration ecology grew to try to fill the gaps in applying ecological theory to restoring real-world systems.
This tension between “space” (i.e. spatial properties and relationships as an important object of study) and "place” (i.e. spatial properties and relationships as perceived and valued by people) has been going on in the geographical literature since at least the 1960s. On the one hand, spatial effects and properties can increasingly be mapped and monitored and used to create complex spatially explicit models of disease risk or species niches. On the other hand, understanding how human values, attitudes, and behaviours coincide to shape priorities and approaches to understanding animal and environmental health remains more sporadic and disjointed. A healthy-settings approach that leads to healthy lives for humans and animals needs to consider both spatial and platial factors in its definition of “settings.”