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Cross-learnings from public health, environmental and First Nations’ knowledges

Introduction by Croakey: Every day, there is another rash of headlines to remind us of the urgency of addressing the planetary health crisis, with one of the latest being ‘Trees and land absorbed almost no CO2 last year. Is nature’s carbon sink failing?’.

Clearly, we are collectively failing to respond with the urgency and ingenuity required.

However, researchers Dr Sabrina Chakori, Arush Lal and Dr Tamara Riley argue below that transformational change can come, if only cross-learnings from public health, environmental sciences and First Nations knowledges could be applied.

The researchers are Fellows of the Planetary Health Equity Hothouse’s 2024 Future Leaders Program, which recently took place at the ANU, and seeks to “create new opportunities for knowledge mobilisation that aims to improve planetary health equity”.

Their article below is part of a wide-ranging series by the Program’s Fellows for Croakey readers.


Sabrina Chakori, Arush Lal and Tamara Riley write:

As planetary health comes under existential threat from a range of crises, it is clear that business as usual is not an option, and that transformative change is needed.

This means that we all need to re-examine our ways of working, and to engage with opportunities for interdisciplinary and transdisciplinary approaches.

As scholars with expertise in public health, environmental sciences and First Nations knowledges, we believe that our fields can learn much from each other in order to advance planetary health equity.

Environmental sciences focus

Environmental change arenas remain dominated by economodernist discourses, in which technological advances continue to be the focus of transition discourses.

Technocratic approaches emphasise the need to improve efficiency and to have individuals adopt new technologies, such as electric cars.

From driving electric cars to consumers’ responsibilities in recycling practices, much of the environmental discourse perpetuates a neoliberal response to a more systemic crisis.

Individuals’ responsibilities are put forward as central levers for change, despite increasing literature showing that there are systemic drivers to the crisis of the Capitalocene, or “the age of capital”.

For example, post-growth and degrowth literature points out the need to transition away from the growth-driven economy, so that social and ecological well-being would be prioritised over growth-driven goals (i.e. growth in the Gross Domestic Product).

Postcolonial, feminist and political ecology studies also call for a more systemic approach to the polycrisis, inviting a broader exploration of exploitative and extractive systems.

Lessons for environmental change

Broadly speaking, environmental change arenas grapple with the challenge of elevating the discourse to systemic challenges and opportunities. However, public health fields have already fostered an engagement with the social, political and commercial determinants of health.

Actors working in sustainability transitions can learn from public health scholars and activists.

Engaging with the determinants – the drivers – of socio-ecological degradation is fundamentally important if we aim to catalyse systemic change in the short, closing window of opportunity left to avoid the most catastrophic impacts on the less privileged communities.

Exploring and tackling the social, political, and commercial determinants of planetary health would help open possibilities for the system to be radically rethought.

Environmental sciences have contributed greatly to diagnosing and alerting us to the negative ecological impacts of our system.

From water pollution studies, through GHGs emissions monitoring, to e-waste generation explorations, scientific studies have for several decades evaluated and monitored the negative impacts across various domains.

However, the upstream drivers of the current consumptogenic system – or growth-driven capitalist system – warrant more attention.

Several public health studies not only engage directly with these aspects – for example, unveiling obesogenic environments – but they also provide useful methods that could help explore the governance of transitions more.

Focusing on the determinants of socioecological wellbeing and on related governance aspects that could unlock alternative development and transition pathways.

Moreover, for several decades, public health studies have used efficient methods and approaches to research the role of actors (for example, food and tobacco corporations) influencing the social, political, and commercial determinants of health.

These approaches could be adopted in other domains to unveil power dynamics that continue to undermine sustainability transitions, such as resource-intensive and fossil-fuel industries that leverage their resources and positions to slow down transitions.

Environmental and public health arenas could, therefore, converge on approaches to expose and influence what some scholars would call Social Corporate IRresponsibility.

First Nations rights

Additionally, some studies highlight that green growth ecomodernist development narratives and plans risk exacerbating existing inequities, advancing “green” imperialism.

For example, a study recently identified 5,097 mining projects involving about 30 minerals needed in the energy transition and showed that 54 percent of these projects are located on or near Indigenous peoples’ lands.

Transitions are leading to the expansion of commodities frontiers, where people and nature are being exploited further to fuel the growth-driven system.

Therefore, sustainability transition movements, such as degrowth movements, should pay attention to not overshadowing the struggles of existing movements, such as the rights of First Nations peoples.

Acknowledging and supporting the leadership of First Nations peoples in caring for Country is integral as we continue to see the health impacts of the escalating climate crises.

To achieve ecological sustainability, environmental actors can learn from First Nations advocates who respect and care for the environment, and recognise the important role of traditional Indigenous knowledges in sustainable and thriving ecosystems.

Lessons for public health

Public health actors can catalyse stalled progress on major global health issues by leveraging three key lessons from their counterparts in environmental science and activism: urgency, scale, and diversity.

Urgency

As a public health practitioner, Arush Lal has witnessed firsthand how our field often struggles to meet the moment with the urgency it demands – particularly when it comes to the rising burden of noncommunicable diseases (NCDs).

Despite chronic conditions like diabetes and cardiovascular disease contributing the lion’s share of deaths each year, the global response remains underfunded and slow-moving.

Environmental activists, on the other hand, understand that waiting too long can lead to irreversible damage, as seen in climate change advocacy.

We in public health need to apply that same urgency to NCD prevention and treatment, pushing for more rapid financing mechanisms and bold policy reforms that tackle the structural barriers to chronic disease care.

Treating the socioeconomic impacts of NCDs as with same level of emergency as climate change could prevent millions of premature deaths in the coming decades.

Scale

Another key lesson public health stakeholders can learn from environmental movements is the ability to organise at scale.

Universal health coverage (UHC) campaigns, while supported in principle in most societies, have often lacked the broad mobilisation that environmental campaigns have successfully harnessed.

From grassroots actions to global summits, environmental activists have spearheaded movements that galvanise people across communities and borders. Public health can do the same by building coalitions for UHC that unite a range of actors committed to the right to health – from governments to health workers to civil society.

This approach is crucial to empowering UHC movements to expand beyond technical debates around health insurance schemes and essential benefit packages into mass public demands for equitable access to healthcare.

Diversity

Finally, diversity is a cornerstone of effective activism in the environmental space – something that pandemic preparedness and response initiatives desperately need.

During the COVID-19 crisis, the lack of diverse voices at decision-making tables led to inequitable impacts and fragmented responses (PPE not fit for women health workers, ineffective vaccination outreach to people of colour, overlooking the needs of migrant communities and LGBTQ populations).

By drawing on the environmental movement’s practice of integrating a wide range of stakeholders (particularly historically marginalised communities), public health can improve future pandemic preparedness and response efforts.

Embracing a more inclusive approach, as environmental activists have done, can lead to stronger, more resilient systems that are better equipped to handle global health threats at all levels of health systems.

First Nations knowledges

While many health systems have entrenched hierarchies and siloed expertise, there are opportunities to adopt cross-sectoral collaboration, improve coordination and share power – with important lessons that can be drawn from the experience and knowledge of First Nations communities.

First Nations’ knowledge emphasises holistic approaches to health, where addressing risk of disease is tied to maintaining balance between physical, cultural, and spiritual wellbeing.

We can learn from First Nations’ approaches to community-driven solutions with community empowerment and leadership integral to sustainable health campaigns.

This is in line with the United Nations Declaration on the Rights of Indigenous Peoples that promotes Indigenous communities to develop, determine and lead their own health programs.

First Nations cultures foster deep connections to animals and Country, reinforcing the importance of integrating human, environmental, and animal health – providing valuable lessons in diversity for pandemic preparedness and response.

Decolonial approaches, which deconstruct and challenge entrenched systems, offer a path forward for both public health and environmental movements, ensuring a future that respects cultural diversity, promotes equity, and advances health for all.

Author details

From L to R: Dr Sabrina Chakori, Arush Lal and Dr Tamara Riley

Dr Sabrina Chakori, CSIRO, Australia’s National Science Agency, is a researcher, educator and multi-award social entrepreneur. Her research explores degrowth transitions across different domains, such as food systems and circular models. Sabrina is also the founder of the Brisbane Tool Library and co-founder of the Degrowth Journal.

Arush Lal, London School of Economics & Political Science, is a PhD Candidate examining the politics of global health governance and diplomacy. With a focus on strengthening equity and resilience in pandemic preparedness and primary health care, Arush recently served as Senior Technical Advisor for Health Integration on the USAID COVID-19 Response Team and as Commissioner on the Chatham House Commission for Universal Health.

Dr Tamara Riley, The Australian National University, is a Research Fellow within Yardhura Walani, the National Centre for Aboriginal and Torres Strait Islander Wellbeing Research. Tamara conducts interdisciplinary and One Health research to inform approaches to current and emerging health challenges for Indigenous populations.


See other articles in the Planetary Health Equity Hothouse Series 2024

 

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