Conserving Nature for Health Protection and Climate Change Resilience

Colleen Duncan and Tricia L. Fry

.. the care of the earth is our most ancient and most worthy and, after all, our most pleasing responsibility. To cherish what remains of it, and to foster its renewal, is our only legitimate hope.” (Wendell Berry, 2018, The Art of the Commonplace: The Agrarian Essays of Wendell Berry)


In 1949, Aldo Leopold wrote that by “preserving the integrity, stability and beauty of the biotic community,” we support the health of ecosystems, communities, populations, and individuals (Leopold, 1949). Now, as the World Health Organization (WHO) and others declare climate change the greatest threat to global health in the 21st century (Costello et al., 2009), the biotic community is needed more than ever to build climate resilience. Broadly defined as the ability to recover from or adjust easily to change, resilience is strengthened through the development and maintenance of healthy populations. The determinants of health model (see Chapter 2) includes abiotic, biotic, and social elements that interact to promote health (PHAoC, 2001; AFMC, 2017). These elements transcend species such that improvements of animal health, which includes the environmental systems that support them, confers an important public health benefit (Stephen and Duncan, 2017; Wittrock et al., 2019). Through this process, Nature contributes to the health of all species.

Health threats from climate change are here and are projected to increase. A wide range of direct and indirect health effects evolve from rising temperature, extreme weather, increased airborne pollution, access to food and clean water, and alterations in the distribution and abundance of pathogens. The health impacts are global, with disproportionate consequences for those less prepared to cope (USGCRP, 2016). Substantial health care costs have already been associated with climate change. In the United States, the direct and indirect health costs of six climate-related events exceeded $14 billion (Knowlton et al„ 2011). While much of the health literature on climate change focuses on humans, the effects on animal health cannot be discounted. The pathogenesis of climate-associated disease is presumed to transcend species; however, the topic has received less attention within veterinary circles. Biodiversity loss, declining populations, and species extinctions are attributed to climate change and predicted to increase substantially under projected climate models (Thomas et ah, 2004; Thuiller et ah, 2011; Wiens, 2016). Given the interrelatedness of human and animal systems, health impacts from climate change in one sector will undoubtedly affect the other.

Interventions to improve health in the face of climate change include both mitigation, actions that help to avoid the unimaginable; and adaptation, actions that help us manage the unavoidable. Climate change mitigation refers to human- driven interventions to reduce emissions or enhance the sinks of greenhouse gases (IPCC, 2018). Mitigation efforts can be characterized as a "public good” whose benefits will be conferred upon many who are not directly involved in the action itself. Mitigation efforts that decrease pollution can have positive health consequences for individuals in other parts of the world or future generations (Landrigan et al., 2018). Climate change adaptation refers to processes that moderate harm or exploit beneficial opportunities within the changing climate (IPCC, 2018). Adaptation exists on a variety of scales, from local to global, and includes physical and social attributes. Examples of climate change adaptations include preparing health care systems to manage the increasing burden of climate-associated illness (Bell, 2011), changes in livestock production systems to maintain animal productivity (Hristov et al., 2018) and wild animals altering their distributions to meet their survival needs (Millar and Westfall, 2010). The protection and promotion of Nature and natural systems contributes to both mitigation and adaptation efforts and is therefore a critical component in the development of resilient systems.


The term Nature refers to living and non-living things that occur naturally, ranging in scope from completely natural, wild, systems to elements of the natural world that exist within built environments (Hartig et al., 2014). The interconnectedness of Nature, health, and climate make it a logical area through which health promotions and protection can be maximized. This idea is not new. The idea that one’s local built and natural environments influence health dates to Hippocrates

Schematic representation of pathways through which the natural environment can affect human health. (Figure by Ah Young Kim, based on Hartig et al., 2014.)

FIGURE 15.1 Schematic representation of pathways through which the natural environment can affect human health. (Figure by Ah Young Kim, based on Hartig et al., 2014.)

(Stephen and Ribble, 2001). There is evidence that open space that includes plants and animals has health benefits, and that higher species’ richness increases those benefits even in an urban landscape (Fuller et al., 2007). The extensive human health benefits of Nature include a wide range of cardiovascular, pulmonary, neurological, endocrine, and emotional benefits (Twohig-Bennett and Jones, 2018). These benefits occur through direct and indirect pathways, including air quality, physical activity, social cohesion, and stress reduction (Figure 15.1, Hartig et al., 2014). While there remain gaps in knowledge regarding the type, frequency, and duration of exposure to Nature that confers health benefits, there is ample evidence of the positive effects on physical and mental health (Williams, 2017). Nature access as a health promotion strategy is well documented, and practices such as forest bathing, outdoor preschools, and urban planning projects that promote Nature are being implemented globally (Tan et al., 2013; Hartig and Khan, 2016; Williams, 2017; Xue et al., 2017; White et al., 2019).

Human health and well-being benefits from natural systems extend far beyond the individual. Services that humanity derives from Nature were classified by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) as “nature’s contributions to people” (Diaz et al., 2015). These include provisioning (e.g. production of food and water), regulating (e.g. control of climate and disease), supporting (e.g. nutrient cycles and oxygen production), and cultural (e.g. spiritual and recreational benefits) services (MEA, 2005). Biodiversity, the variety of species in an ecosystem, is the foundation for ecosystem functioning and one of the metrics we can use to measure these services.

Unfortunately, biodiversity is being lost at unprecedented rates (Dirzo et al., 2014). Loss and degradation of habitat is responsible for declining biodiversity and the dysregulation of natural system (Cardinale et al., 2012; Hooper et al., 2012; Rosenberg et al., 2019) and health (Dirzo et al., 2014; Sandifer et al., 2015; Stephens and Athias, 2015). The loss of biodiversity has been deemed as great a threat as the threats posed by climate change. The loss of species and its cascading effects have long been recognized; however, declines in abundance within populations are likely to have even more immediate impactful consequences (Ceballos and Ehrlich, 2002; Gaston and Fuller, 2008; Dirzo et al., 2014). Increasing global temperatures could lead to the extinction of more than one-eighth of Earth’s species by the time global temperatures rise 4.3°C above pre-industrial averages (Diaz, 2019). The synergistic impacts of climate change and declines in biodiversity that cannot be mitigated have the potential to topple many species, communities, and ecosystems beyond their tipping point, resulting in potentially unmitigated changes to economies, agriculture, and health.

Climate change potentiates a wide variety of health outcomes and determinants, such as the built environment in which people reside. In their 2016 assessment of the global burden of disease, the WHO attributed 23% of 12.6 million deaths globally to modifiable environmental risks (Priiss-Ustiin et al., 2016). While the WHO report did not specifically focus on the role of Nature, it highlighted the urgent need to address climate and ecosystem change as the most challenging and significant future environmental health risks. Several infectious disease epidemics have been attributed to the loss of Nature and biodiversity, particularly the loss of appropriate animal habitat (see Ecohealth, 2019, 16:4; Ahmed et al., 2019). For example, in North America, the encroachment of suburbia into forest edges increased the risk of human and companion animals contracting Lyme disease (Ostfeld and Keesing, 2012). The destruction of rainforests in Indonesia triggered the emigration of fruit bats into human-inhabited areas, resulting in the outbreak of the Nipah virus (Epstein et al., 2006). However, the scope and scale of the health impacts of healthy, or unhealthy, environments are considerably greater than these single-agent examples.

Biodiversity preservation is also important in agriculture. Worldwide there is a general decline in the varieties and breeds of plants and animals. The United Nations Food and Agricultural Organization (FAO) highlighted the reliance of food systems on biodiversity and the continual decline of biodiversity within the agricultural sector (FAO, 2019). This lack of diversity compromises agroecosystems resilience against climate change, pests, and pathogens (Diaz, 2019). The United Nations Sustainable Development Goals (SDGs) are a “blueprint to achieve a better and more sustainable future for all” (UN, 2020) (see Chapter 3 for more on the sustainable devcelopment goals). The interconnectedness of health with the other 16 SDGs highlights the strong interdependence of these global issues (Figure 15.2). Health and climate change mitigation is synergistic with other SDGs such as conserving ocean resources, clean energy and, responsible consumption and production (Dfaz, 2019). Climate mitigation and adaptation pathways must ensure that other SDGs, such as poverty, water, and energy access, are not compromised in the process (IPCC. 2018).

Relationship between the I7 UN Sustainable Development Goals and environment-health links. (Figure by Ah Young Kim, based on Priiss-Ustiin et al.. 2016.)

FIGURE 15.2 Relationship between the I7 UN Sustainable Development Goals and environment-health links. (Figure by Ah Young Kim, based on Priiss-Ustiin et al.. 2016.)


As our landscapes become more urban and removed from Nature, we need new reminders, novel approaches, and networks to assure the health-affirming benefits of Nature are accessible and sustainable. This is especially true when climate insecurities are pervasive. What constitutes Nature is debated by environmental philosophers and ethicist, and varies by the observer (Nash, 2001; Callicott and Nelson, 1998). What is common is that Nature confers health benefits, whether the gardens of Versailles, a community vegetable plot, or the vast w ilderness that ties ecosystems together.

Preserving Nature can be done, even in the most urban environments. Singapore with a population density of 7,615 people per km2 (Xue et al., 2017) succeeded in increasing herbaceous cover through urban greening (Tan et al., 2013). Singapore’s Nature is vertical green space. It is manicured, horticultural, and tamed. Singapore’s mission to be a “Garden City” uses native and non-native foliage and technology to blur the lines between city and Nature (Tan et al., 2013). These gardens climb the exterior walls of skyscrapers to provide habitats as well as mitigate the effects of urban heating exacerbated by climate w'arming.

These features ranked as one of the most important elements to Singapore residents (Roth, 2007; Tan et al„ 2013). Singapore’s urban development guidelines require not only mitigating green spaces removed by development but also expansion of green spaces within in the urban ecosystem.

The Yellowstone to Yukon (Y2Y) Initiative, a civil action supported by over 300 organizations, is another example of purposeful greening of landscapes (Locke and Heuer, 2015). Y2Y is a 1.2 million km2 corridor across the Northern Rocky Mountains (Locke and Heuer, 2015; Y2K, 2020). The foundation for its creation was to protect biodiversity and the wilderness character of the land (Locke and Heuer, 2015) with the goal of protecting large landscapes as a solution in support of industry, climate change, and wildlife (Y2Y, 2020). Achieving conservation at such a massive scale was built on small actions, commitments that helped support clean air, water, and diverse plant and animal communities. A component of the Y2Y initiative’s success is the idea that actions taken locally are exploited to provide large-scale habitat for a diversity of species (Pearce et ah, 2008).

Between curated green space of Singapore and the wilds of the Yukon are many grassroots conservation efforts with missions founded on protecting Nature (e.g. Box 15.1). Wild areas help clean water and air, providing global climate change mitigation services. It takes large-scale efforts like those supported by Wildlife Conservation Society and World Wildlife Foundation as well as governments to protect true wilderness; also important is the support of individuals who advocate for Nature through their election of conservation-minded officials and regard of Nature as a resource for all.

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