252
Highlights
• We consider the breadth of public health domains that are influenced by
biodiversity.
• Existing models of greenspace and health are extended to look at the impact of
biodiversity.
• Recommendations are provided for health professionals working from local to
international levels.
• Nature-based social prescriptions or community referrals could maximise exposure to biodiversity.
• Case studies of health and biodiversity interventions for human and planetary
health are presented.
11.1 Introduction
Public health is “the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society” (Acheson 1988), and it
focuses on the entire spectrum of health and well-being, not only the eradication of
diseases. Public health activities can be targeted at both the population and the individual levels. Population-level interventions include those applied generally, such
as a health campaign to increase knowledge and awareness of health risks or fluoridation of water supplies to reduce tooth decay, to those aiming to address the social,
economic and environmental conditions that cause ill health, such as an urban
regeneration project. Individual-level public health activities include personal services such as vaccinations, behavioural counselling and health advice. Non-medical
interventions to individuals, which take place outside the clinical setting, and have
a positive impact on health and well-being, also fall within the remit of public
health. Such interventions include those promoting exposure to biodiverse
environments.
Modern public health emphasises reducing avoidable differences in ill health
between the most and least well-off in society (Acheson 1998; Marmot 2010).
Morbidity and mortality rates are consistently and starkly higher among those with
lower socio-economic status (SES) – typically 5–10 years’ reduced life expectancy
compared to those who are relatively more affluent (Marmot 2013; Elo 2009).
Individuals of lower SES tend to live and work in less healthy environments and
have higher exposure to disease risk factors; these are “social determinants of
health” (Marmot and Wilkinson 2005). Moreover, lower SES is independently associated with a further 2-year reduction in life expectancy even after accounting for
other risk factors for mortality, such as cardiovascular risk factors (Stringhini et al.
2017). The traditional approach to preventing disease – that is, counselling to reduce
unhealthy behaviours – does not effectively address this phenomenon, because
social and physical environments and circumstances mitigate behaviour change.
Such inequalities are high on the political agenda (Marmot 2010, 2013; Marmot
et al. 2008; Stringhini et al. 2017), and addressing the social determinants of health
P. A. Cook et al.
Highlights
• We consider the breadth of public health domains that are influenced by
biodiversity.
• Existing models of greenspace and health are extended to look at the impact of
biodiversity.
• Recommendations are provided for health professionals working from local to
international levels.
• Nature-based social prescriptions or community referrals could maximise exposure to biodiversity.
• Case studies of health and biodiversity interventions for human and planetary
health are presented.
11.1 Introduction
Public health is “the art and science of preventing disease, prolonging life and promoting health through the organised efforts of society” (Acheson 1988), and it
focuses on the entire spectrum of health and well-being, not only the eradication of
diseases. Public health activities can be targeted at both the population and the individual levels. Population-level interventions include those applied generally, such
as a health campaign to increase knowledge and awareness of health risks or fluoridation of water supplies to reduce tooth decay, to those aiming to address the social,
economic and environmental conditions that cause ill health, such as an urban
regeneration project. Individual-level public health activities include personal services such as vaccinations, behavioural counselling and health advice. Non-medical
interventions to individuals, which take place outside the clinical setting, and have
a positive impact on health and well-being, also fall within the remit of public
health. Such interventions include those promoting exposure to biodiverse
environments.
Modern public health emphasises reducing avoidable differences in ill health
between the most and least well-off in society (Acheson 1998; Marmot 2010).
Morbidity and mortality rates are consistently and starkly higher among those with
lower socio-economic status (SES) – typically 5–10 years’ reduced life expectancy
compared to those who are relatively more affluent (Marmot 2013; Elo 2009).
Individuals of lower SES tend to live and work in less healthy environments and
have higher exposure to disease risk factors; these are “social determinants of
health” (Marmot and Wilkinson 2005). Moreover, lower SES is independently associated with a further 2-year reduction in life expectancy even after accounting for
other risk factors for mortality, such as cardiovascular risk factors (Stringhini et al.
2017). The traditional approach to preventing disease – that is, counselling to reduce
unhealthy behaviours – does not effectively address this phenomenon, because
social and physical environments and circumstances mitigate behaviour change.
Such inequalities are high on the political agenda (Marmot 2010, 2013; Marmot
et al. 2008; Stringhini et al. 2017), and addressing the social determinants of health
P. A. Cook et al.