Alison Barrett writes:
How do we protect and enhance human health in expanding urban environments?
This was the topic of a recent Healthy Environment and Lives (HEAL) Network South Australia regional hub meeting, which identified the importance of increasing urban green spaces, caring for Country, community engagement and co-design, OneHealth approaches and some “hot spot” concerns.
Below are seven key takeaways.
1. Policy support for urban green spaces
“We actually know that urban green spaces are good for health…but how do we get more?” said Professor Craig Williams, from the University of South Australia and Chair of the HEAL Network SA hub, in his opening remarks at the meeting.
He said because we have good evidence, some policy-based solutions are needed.
Williams referred to a paper he recently co-authored with several members of the HEAL Network that argued the case for a co-ordinated health in all policies approach for increasing urban green spaces.
The authors wrote that the National Health and Climate Strategy identifies health in all policies as a key objective that may enable the space and opportunity to elevate green space and trees in the political decision-making process.
“Such an approach would better link the health cost and benefits of green space (principally enjoyed at the state and federal level) with the expenditure for green space creation at the local government and community level,” they wrote.
Moving the urban green space for health agenda forward will require a coordinated approach involving government, lobbyists, researchers and law-makers.
It is also important to rectify the inequitable distribution of green space within cities, they wrote.
Further reading: Urban green space provision: the case for policy‐based solutions to support human health, in The Medical Journal of Australia
2. Community engagement and co-design
Dr Ro MacFarlane, from the University of Canberra, highlighted the importance of working with local communities on co-designing the world we want to live in.
This entails co-creating visions, aligning values, identifying what’s going to work, problem-solving, and investing in solutions at the local level, she said.
At the same time, it is also important to have input into the international and wider dialogue on protecting the environment and biodiversity.
MacFarlane said that we tend to deal with the issues of biodiversity, health, climate, food and water in silos, but need to try and think in “multiple bins at the same time”.
Tara Ingerson, who works on the State of the Environment SA report at Environment Protection Authority SA, also highlighted the importance of community engagement.
She said that if the community is on board with respecting and protecting the environment, it will help drive the changes required.
She said we need to “drive home” the benefits from protecting the environment, as many people in the community, as well as government officials and politicians, ask “what’s in it for me?”
Ingerson said a key message that arose from consultations with Aboriginal and Torres Strait Islander communities in SA is that if “you care for Country, Country will care for you”.
This is a “massive message” that we need to learn from and integrate back into the way we report and protect the environment, she said.
3. Relationships matter
Building relationships, which requires time, is necessary to translate research into policy, the meeting heard.
Networks and research collaborations, such as the HEAL Network, are valuable for translating research into policy, according to Professor Xiaoqi Feng, University of New South Wales.
Feng told the meeting that it is important to actively work with multiple sectors, including industry stakeholders and government departments. She also recommended making submissions to inquiries and consultations.
Policymakers are interested in the evidence, how interventions can benefit health, as well as how much they will cost.
Feng told the forum that it’s important to monitor impact over time to determine why policies were or weren’t implemented.
Associate Professor Carmel Williams, Director of the Centre for Health in All Policies Research Translation, told the forum that big research institutions and universities expect researchers to deliver impacts.
But they are not resourcing them to invest in the time required to engage and build relationships with policymakers, she said.
Williams said research institutes and universities need to start recognising the time it takes to build trusting relationships and create incentives to do so within the ecosystem of the academic community.
4. OneHealth approach is vital
Addressing antimicrobial resistance requires a OneHealth approach that integrates human health, animal health and environmental sustainability, according to Dr Sopheak Hem, Research Fellow at Cooperative Research Centre for Solving Antimicrobial Resistance in Agribusiness, Food, and Environments (CRC SAAFE) at University of South Australia.
Some of the challenges for responding to antimicrobial resistance include a lack of awareness among stakeholders, the perception that it is not a priority, cost and concerns about who will pay for it, Hem said.
She stressed that collaboration and problem solving are key, and told the meeting that practical, affordable and scalable solutions are required to address antimicrobial resistance.
To make real change, we need to be able to speak in the same language, ensuring that the right messages are delivered to the right audience in the way that resonates with them, she said.
Dr Adriana Milazzo, Senior Lecturer in the School of Public Health at The University of Adelaide, also highlighted the importance of OneHealth approaches in relation to urban planning and human health.
“I don’t think we can think about healthy environments unless we think about OneHealth,” she said.
Milazzo emphasised the importance of collaboration across sectors, and establishing and maintaining relationships with industry, policymakers and other key stakeholders.
5. More evidence needed about “hot spot” concerns
While recycled water offers several environmental, social and economic benefits, it can also increase health risks due to the wide range of pathogens in sewage, according to Dr Ben Van den Akker, Enterprise Fellow within STEM at University of South Australia.
He told the meeting that there is a good understanding of many of the pathogens in sewage, including campylobacteria and rotavirus, and Australia has good systems for assessing the risk of pathogens we have information about.
However, there are many emerging hazards that we don’t know enough about, including novel pathogens, microplastics and antimicrobial resistance.
Several interconnected environments are contributing to the rise of antimicrobial resistance (AMR), including overuse and misuse of antibiotics, he said.
Some agricultural practices and some processes involved in wastewater treatment plants have been “flagged as a potential hot spot for AMR”, Van den Akker said.
“We know that they’re there, but we don’t have sufficient information or knowledge to assess their risk.”
More research is required to gain a better understanding of antimicrobial resistance in recycled water, how it can inform the risk assessment framework and its risk relative to other hazards or contaminants.
6. Potential benefits from recycled water
Dr Ngai Ning Cheng from SA Water told the meeting that while challenges and risks exist, there are many opportunities to increase the harvest and use of storm water, which offer environmental, social and economic benefits.
Cheng said some of the challenges include vandalism of infrastructure, theft of copper pipes and in some locations, insufficient demand.
However, in some areas of Adelaide, recycled stormwater use can be increased where there is demand and using existing infrastructure.
For example, the Glenelg wastewater treatment plant, in western Adelaide, has a large area for storage, which could be used for irrigation of public spaces, recreational areas and industry.
Over 60 schools in South Australia use recycled storm water for alternative water use to drinking water, according to Cheng. We could also look at using recycled storm water for irrigating school sport fields, he said.
Urban wetlands are another example where stormwater can be harvested and stored, as well as being a nice outdoor area for community members.
Frameworks, such as the Nature Positive Plans, enable consideration of co-benefits of water management, including flood mitigation and carbon dioxide storage.
But, it is important to evaluate different systems with different criteria such as lifestyle course, ecosystem services and social equality. Different options are also required for highly dense metropolitan areas and regional areas.
Regulations vary across different jurisdictions in Australia, he said.
While economic regulators try and stay away from the risk and benefits of water and wastewater management, they play a big role in ensuring customers don’t pay more than they need to get supply, according to Professor Lin Crase, Professor of Economics and Dean of Programs within University of South Australia Business.
Customers need to be willing to pay for environmental improvements such as using reclaimed water, which is quite costly to produce, according to Crase. However, economic regulation of water is not managed the same in each state and territory.
7. Celebrate achievements
Professor Kirstin Ross, course coordinator for the Graduate Diploma in Environmental Health Practice and Master of Environmental Health at Flinders University, told the meeting that when she feels frustrated her research isn’t translating fast enough into policy, she tries to remind herself that “good research does eventually translate”.
The extra years in life expectancy over the past century are evidence that research has translated into policy and outcomes.
“Lots of research culminates in good changes to policy,” she said. “It is easy to forget to celebrate the huge achievements in human health.”
The event also included discussions on housing energy efficiency requirements in the Building Code of Australia.
Caption for feature image
SA-based HEAL investigators in attendance at the meeting and two HEAL investigators from interstate. L-R: Christie Byrne, UniSA; Yonatal Tefera, The University of Adelaide; Ro MacFarlane, University of Canberra; Xiaoqi Feng, University of NSW; Craig Williams, UniSA; Carmel Williams, SAHMRI; Sopheak Hem, UniSA; Kirstin Ross, Flinders University; and Mira Cooper, UniSA.
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