Research for city practice

Food systems are exceeding planetary boundaries and endanger both human and planetary health. Transforming these systems requires stakeholder engagement and constructive dialogue for acknowledging the diversity of views and values from different actors within the food system. Serious games have proven effective in fostering collaboration and exploring social-ecological dynamics, yet a holistic food system game linking planetary and human health remains absent. This paper presents the CiFoS Game, a serious game designed to explore food system transformation strategies, showing both the individual and collective impacts of diets, production choices and circularity principles on environment and human health. Co-designed with university students, food system experts, and game designers, the game was tested in multiple pilot sessions in different contexts. Throughout its development, multiple dynamics were added in a step-by-step process to enhance complexity, while improving and aligning already existing dynamics along the way. Results highlight its potential to facilitate learning and support discussions, connecting dietary and production choices to food sustainability challenges. By engaging stakeholders in interactive explorations of food system transformations, the CiFoS game can serve as a boundary crossing tool to foster dialogue, create common understanding and support collaboration towards sustainable food futures for human and planetary health.

Food regime theory provides a framework of continued and recurring interest to geographical perspectives in charting the contours connecting agri‐food and capitalist political economy. Drawing principally on Marxian regulation theory, the analytical framework of food regime theory outlines three periodised regimes from the starting point of 1870 to the present day. Yet there remains ongoing and unresolved debate as to how we characterise the contemporary third regime – and whether it is a regime on its own specific terms or merely an enduring hangover from the second. I argue that an underacknowledged dimension of attempts to characterise the third regime lies in the conjoined relationship between human and planetary health, which the diagnosis of the Anthropocene encourages us to recognise amid tumultuous global environmental change. Given food regime theory's evasive relationship with ecological dynamics within its explanatory framework, I suggest that a “planetary” retheorisation of its central contributions is increasingly prescient. In considering the growing tensions and contradictions afflicting the contemporary regime, and using soy as a working example, I work through three central arguments. First, that a planetary retheorisation serves to reveal the way in which planetary dynamics shape social life, enabling – albeit never wholly determining – food regimes. Second, that what and how people eat in their dietary practices are of planetary significance, which has been to some degree marginalised within the production‐centric analyses of food regime theory. Third, that the conceptual Anthropocene highlights how planetary and human health are intricately and inextricably connected, which food regime theory must better account for. I conclude by proposing that the explanatory potential of the contemporary third regime is being stretched, with contested trajectories and nascent contours raising questions around how we might understand quite what we are living through today.

An alarming progression of human-centred and environmental concerns has marked the Anthropocene, including climatic changes and the inextricably linked deterioration of human mental health. Expanding on the 2015 Rockefeller Foundation-Lancet Commission on Planetary Health, we propose that mental health be explicitly included within the planetary health approach. This inclusion acknowledges the importance of population mental health as part of planetary health and addresses the symbiotic deterioration of global mental health and environmental health. As part of this approach, we conceptualise several types of interventions, including symbiocentric and transformative mental health interventions, with the latter combining active environmentalism with the aim of simultaneously improving mental health and wellbeing. We further identify several areas of opportunity in which transformative interventions could be translated to practice and implemented across a range of settings, including workplaces, educational contexts, and organised sport. Making a call to action, we highlight the urgency of shifting from individualised to collective environmental responsibility, including collective transformative reflection, with different stakeholders coming together to scale up transformative interventions and working towards true planetary (mental) health. Finally, we give recommendations to promote symbiocentric and transformative interventions in policy and reform.

Vol. 126, No. 10 ErratumOpen AccessErratum: “Down to Earth: The Emerging Field of Planetary Health”is correction ofDown to Earth: The Emerging Field of Planetary Health Nate Seltenrich Nate Seltenrich Search for more papers by this author Published:4 October 2018CID: 109001https://doi.org/10.1289/EHP4460Cited by:1AboutSectionsPDF ToolsDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InReddit This article included three incomplete or outdated affiliations. Howard Frumkin is now head of the Our Planet, Our Health program at the Wellcome Trust. He no longer chairs the funding committee for Our Planet, Our Health; no longer serves on the steering committee of the Planetary Health Alliance; and no longer works at the University of Washington. Michael Myers is the managing director for policy at the Rockefeller Foundation. Sam Myers is director of the Planetary Health Alliance.In addition, the article stated that the Wellcome Trust has never funded or joined the Planetary Health Alliance. However, it should be noted that the Wellcome Trust did support travel for several attendees at the 2017 and 2018 meetings of the Planetary Health Alliance.Finally, “planetary health” is a much older term than indicated in the article. The nongovernmental organization Friends of the Earth (FOE) was perhaps the first to use the term in its current context, stating in 1980 that “FOE therefore believes that health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—that personal health involves planetary health” (Friends of the Earth 1980).EHP regrets these errors.ReferenceFriends of the Earth.1980. News from FOE: health care. Alternatives 9(2):2. Google ScholarFiguresReferencesRelatedDetailsCited by Oyilieze Akanwa A and Joe-Ikechebelu N (2019) The Developing World’s Contribution to Global Warming and the Resulting Consequences of Climate Change in These Regions: A Nigerian Case Study Global Warming and Climate Change [Working Title], 10.5772/intechopen.85052 Related articlesDown to Earth: The Emerging Field of Planetary Health12 July 2018Environmental Health Perspectives Vol. 126, No. 10 October 2018Metrics About Article Metrics Publication History Manuscript received10 September 2018Manuscript accepted12 September 2018Originally published4 October 2018 Financial disclosuresPDF download License information EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted. Note to readers with disabilities EHP strives to ensure that all journal content is accessible to all readers. However, some figures and Supplemental Material published in EHP articles may not conform to 508 standards due to the complexity of the information being presented. If you need assistance accessing journal content, please contact [email protected]. Our staff will work with you to assess and meet your accessibility needs within 3 working days.

The digital determinants of health have recently attracted attention in the medical and public health literature, but the environmental aspects of these determinants have rarely been considered. This Perspectives article calls for applying a planetary health lens to the digital determinants of health, with a focus on the impacts of novel generative AI technologies on the natural world. The argument is founded on the principle that human and planetary health are intertwined and that digital technologies such as generative AI affect the health of both humans and the other living things in ecosystems. The article discusses proposals of how generative AI tools can contribute to action on the climate, loss of biodiversity and pollution crises but also highlights how the expansion of generative AI infrastructure and operation has exacerbated the problems of e-waste, greenhouse gas emissions and major burdens on energy and water resources. It is argued that for progress to be made in improving human and planetary health, those working in health promotion and other public health domains must acknowledge that human and planetary health are interdependent, so that we can refer to the ‘digital determinants of human and planetary health’. The article highlights this interdependence and the importance of fighting for multispecies justice and the rights of nature to promote the mutual flourishing of humans and the natural world. Actions are proposed that can be taken at the organization and community level to make visible and counter the impacts of generative AI on human and planetary health.

COVID-19 Health Technology Governance, Epistemic Competence, and the Future of Knowledge in an Uncertain World.

From the Editor's Desk: Systems Science 2010-2020, and Post-COVID-19.

Planetary health definitions are clear about advancing human well-being, aiming for the highest standard of health worldwide. Planetary health recognizes human health is dependent on natural systems; however, framing human health as the central consideration of planetary health may risk rendering invisible the non-human species that are central to the viability of ecosystem services and human survival. This review seeks to discover and describe opportunities for advancing discourses on planetary health justice through exploration of the interspecies justice literature. This rapid review of forty-three articles asks the following: how does health arise in interspecies justice literature and how can interspecies justice advance broader conceptualizations of justice in planetary health? Results suggest opportunities for epistemological expansion within planetary health to include consideration of other species, ecosystems, and relationships between them. Examining what health is for more-than-humans, reflecting on how we understand these interdependencies, and advocating for decolonizing planetary health study and practice are critical to growing planetary health justice.

Human activities on earth result in global disturbances of natural systems that manifest as natural resource exploitation, pollution, climate change and biodiversity loss which negatively impact human health in turn. In response, the concept of Planetary Health (PH) has emerged, recognizing the need for a systemic understanding of interconnectedness between human health and that of the natural systems on which it depends. Cities constitute a relevant ground for health interventions as they are currently home to more than half of the world’s population and paradoxically also among the most vulnerable locations for the impact of human-induced PH pressures.Despite its growing scientific prominence, the field of PH lacks in action-based research. Therefore, this review seeks to map the existing evidence of approaches that operationalize the planetary health concept, and its application across urban contexts. It illuminates entry points and provides guidance for PH researchers, educators, local governments and urban planners in the pursuit of operationalizing PH in urban areas.A literature search for peer-reviewed publications was conducted across 7 databases (N=7843), using the keyword “Planetary Health.” Using the PRISMA-ScR extension guidelines a team of 3 researchers identified 35 articles for the final synthesis.The included studies consist of various types of research investigating how the concept of PH can be operationalized in urban areas. Some approaches are associated with PHs conceptual foundations in the form of frameworks, literacy/ education models and practices, as well as the formulation of measurement and evaluation methods. Then there are applied approaches, consisting of interdisciplinary PH research-projects, diverse case studies and papers that examine PH’s application potential within policy.Among the heterogenous application of the concept across a diversity of contexts, the review identified several best practices, draws out present conceptual and research limitations, as well as challenges and opportunities for embedding the concept across diverse disciplines and as part of various urban interventions.

Issues The interconnected emergencies, such as climate change, biodiversity loss and increase of both communicable and non-communicable diseases are linked to planetary health concept. The Nature Step to Health Program 2022-2032 combines the public health and environmental goals towards a more sustainable way of life at the local level with an education and communication campaigns in the City of Lahti and Päijät-Häme region. Problems The program emphasizes the interconnectedness of human health with the balance of natural systems. Public health, climate change, and biodiversity loss are all interlinked, with unsustainable lifestyles negatively impacting both human health and the environment. Conversely, sustainable choices tend to benefit both environmental and public health. Results The program sets five key goals and four cross-cutting tasks that promote the achievement of all objectives concurrently. The key focus is on practical actions that have a measurable impact on public health, biodiversity, climate change mitigation, and adaptation. The program enhances understanding of the interdependence between human health and environmental conditions, fosters collaboration across health and environmental sectors, and accelerates concrete steps toward planetary health e.g. more mobility, plant-based meals, healthy living environment and nature connections. Lessons The collaboration is strengthened through research, joint efforts, communication, and education by: 1. Advancing planetary health research and using evidence-based knowledge to enhance actions and practices. 2. Enhancing communication, counseling and guidance through various channels to raise awareness of planetary health practices. 3. Integrating systematically planetary health into professional education, training and further education. 4. Integrating the program into regional, city and municipal strategies, programs and plans. Key messages • Increased understanding of the links between human health and environmental well-being and strengthened inter-sectoral cooperation. • Accelerated actions for planetary health and enhanced policy influence to support sustainable health and environment.

A call for planetary health case studies

Actor network theory to map planetary health interconnections: a clinical case study

Planetary Health: From the Wellspring of Holistic Medicine to Personal and Public Health Imperative

The term planetary health, popularized in the 1980s and 1990s, was born out of necessity; although the term was used by many diverse groups, it was consistently used to underscore that human health is coupled to the health of natural systems within the Earth’s biosphere. The interrelated challenges of climate change, massive biodiversity losses, environmental degradation, grotesque socioeconomic inequalities, conflicts, and a crisis of non-communicable diseases are, mildly stated, daunting. Despite ‘doomsday’ scenarios, there is plenty of room for hope and optimism in planetary health. All over planet Earth, humans are making efforts at the macro, meso and micro scales to promote the health of civilization with the ingredients of hope—agency and pathway thinking; we propose that planetary health requires a greater commitment to understanding hope at the personal and collective levels. Prioritizing hope as an asset in planetary health necessitates deeper knowledge and discourse concerning the barriers to hope and the ways in which hope and the utopian impulse are corrupted; in particular, it requires examining the ways in which hope is leveraged by advantaged groups and political actors to maintain the status quo, or even promote retrograde visions completely at odds with planetary health. Viewing the Earth as a superorganism, with humans as the collective ‘nervous system’, may help with an understanding of the ways in which experience and emotions lead to behavioral responses that may, or may not be, in the best interest of planetary health. We argue that the success of planetary health solutions is predicated on a more sophisticated understanding of the psychology of prevention and intervention at all scales.

Just eight years from now, in 2030, the world will once again review our progress toward the United Nations Sustainable Development Goals (SDGs), a bold set of 17 interconnected goals with 169 targets, agreed upon by the 191 United Nations (UN) members, centered around creating a more equitable world for all. The SDGs were originally published in 2015 on the seventieth anniversary of the UN to set out a “supremely ambitious and transformational vision…a world free of poverty, hunger, disease and want, where all life can thrive” [1]. The SDGs were developed with a full recognition that humanity’s needs are deeply connected and not siloed. Despite this recognition, we continue to approach humanity’s needs in ways that belie the interconnectedness of those needs; we continue to work in ways that do not fully acknowledge that basic development needs such as housing, water, food, gender equality, food insecurity, poverty alleviation, and the environment are interconnected. We believe this is unacceptable because it fragments the discourse around the fullness of what humanity itself needs to thrive.The world of research is just as fragmented as the world of programs and policies around the SDGs. Development aid and government investments in sectoral programs are normally examined for their impacts on narrow outcomes. For example, few programs in nonhealth sectors are assessed for their influence on human health outcomes. While annual global development aid reached $161.2 billion in 2020 [2], economic and agricultural development programs rarely evaluate their health impacts [3, 4]. More importantly, most poverty alleviation and food security programs are not developed with improving health or health equity as a key objective, and as a result, improvements in health are not optimized with traditional development approaches. Additional research examining the linkage between poverty alleviation, improved food security, gender equality, planetary health, and human health could further encourage large global health and development actors to invest in more interdisciplinary approaches.Systemic racism as well as ethnic, gender, and other forms of discrimination negatively affect progress toward achieving the SDGs. Minoritized racial and ethnic groups are generally further behind advantaged racial and ethnic groups in poverty, economic growth, and access to clean water and food, all of which adversely affect health and well-being. Those who live in poverty typically have less access to food, less access to clean water and sanitation, and more exposure to pollution than those who have a higher income [5]. Physical and psychological health disparities are further exacerbated by racial disparities related to environmental injustice and climate change [6]. Despite a call by several UN human rights groups, the SDGs are silent on the eradication of systemic racism and racial, ethnic, and many other forms of discrimination, which constitute global barriers to human development and the fulfillment of human rights throughout the life span.Prior to the COVID-19 pandemic, many countries around the world had made substantial progress toward ending poverty in all its forms (SDG 1). While 36% of the world’s population lived in extreme poverty in 1990, by 2015 this had fallen to 10%. Due to the COVID-19 pandemic, however, it is estimated that an additional half a billion people have been pushed or pushed further into poverty [7]. The effects of infectious diseases like COVID-19 on economic outcomes serve as yet another illustration of the strong positive correlation established between health and wealth over decades of economics research. Moreover, a vibrant literature in economics has demonstrated a strong bidirectional relationship between health and economic outcomes in both low- and high-income countries [8]. This research has demonstrated that there are large returns to investing in health and that programs that protect or improve economic outcomes—such as social protection programs—result in significant health improvements as well. Moreover, in the field of economics, the past two decades have witnessed a revolution in scientific methods for learning how to end poverty and improve well-being in low- and middle-income countries. Randomized trials of interventions and policies have become far more common and have opened new possibilities for understanding how to achieve SDG 1, and also with important impacts on SDG 3 (“Good health and well-being”) [9]. However, most of the economic research on poverty alleviation and health in low- and middle-income countries typically appears in journals that are not widely read by health scientists or by stakeholders in the countries where the research takes place. Through the section on SDG 1, Advances in Global Health aims to provide new opportunities for dissemination of research on the linkages between poverty and health.Food insecurity and poor diets (SDG 2) compromise nutrition and health outcomes in profound ways. Global and national models suggest that malnutrition and poor diets are the leading contributors to the burden of disease around the world [10]. These impacts operate through multiple pathways. For instance, maternal and child undernutrition contribute to almost half of all child deaths each year in the developing world, and 11% of the global burden of disease, including noncommunicable disease, is linked to poor diets [11]. These poor health outcomes, in turn, can affect other SDGs through increased health expenditures, loss of wages when people are too sick to work, or care burdens that often fall disproportionately on women. The connections between food insecurity, diets, nutrition, and health are strong, mutually reinforcing, and rooted in social and economic inequities. Often, the intergenerational transmission of food insecurity and poor nutrition prevents families and communities from escaping these vicious cycles. And yet too much research on food security and nutrition is out of the view of those working on achieving health goals, because it sits in literatures in agriculture, food policy, nutrition, and economics, and lacks a transdisciplinary and trans-SDG emphasis.Gender issues and global health challenges are diverse, emanating out of a complex global context, including a multiplicity of social and cultural contexts. SDG 5 is committed to gender equality, with several targets geared toward ending discrimination against women and improving their opportunities, especially in economics, leadership, and reproductive health. Gender equality is important to advancing global health for several reasons [12, 13]. Without attention to gender equality, females will continue to suffer from reproductive health challenges such as high rates of teenage pregnancies, infertility, and maternal mortality and increased risk of sexually transmitted infections including HIV. Beyond reproductive health, gender matters in the field of gender-based violence, access to health-care services, gender-disaggregated data, and much more [14, 15, 16]. These, in turn, invite us to interrogate the gender-biased norms and gender responsiveness of health policies, financing, and the entire political economy. Engendered by different crises and challenges, these matters play out differently in unique cultural and social environments.Since the 1950s and 1960s, humans have been transforming and disrupting most of our planet’s natural systems at a much-accelerated pace, from the deep oceans to the upper atmosphere, causing loss of biodiversity, overexploitation of fisheries, rising carbon dioxide in the atmosphere, acidification of oceans, and loss of tropical forests. Those disruptions interact with each other in complex ways to alter the fundamental conditions for human health and well-being and, ultimately, affect nearly every dimension of human health [17]. Planetary health focuses on understanding and quantifying the human health impacts of these global environmental disruptions and on developing solutions that will allow humanity and the natural systems we depend on to thrive now and in the future [18]. Our vision is to encourage the preservation and sustainability of natural systems for the benefit of human health (SDG 3), aligned with SDGs 13 (Climate Action), 14 (Life below Water), and 15 (Life on Land) through the study and characterization of the inextricably linked dependencies between human health and the health of natural systems.Inequities in the representation of scientists from low- and middle-income countries as well as minority groups in most countries has plagued academic research. For example, in a systematic review of health research in sub-Saharan Africa between 2014 and 2016, 14% of papers had no local coauthors (i.e., from the country where the research took place), and representation of local coauthors as first author was also low (23%) when the research involved researchers from the United States, Canada, or Europe [19]. This is consistent with extensive global health literature [20, 21]. Even higher rates of nonrepresentation of local coauthors are reported in economics research that takes place in low- and middle-income countries. A recent review discovered that only 23% of first authors were from the country of the study’s focus [22, 23]. Research funding and publication fees contribute to such inequities and are some of the barriers that need to be addressed to improve equity in the recognition of research. We believe that supporting the SDGs cannot be separated from addressing these significant inequities in research dissemination.Advances in Global Health is a peer-reviewed, open-access research journal that is committed to decolonizing and democratizing global health. This entails purposefully giving prominence to knowledge and knowledge production from low- and middle-income countries as well as racial and ethnic minority communities within all countries. In so doing, Advances in Global Health is committed to the following: (1) having an editorial board that is representative of relevant disciplines and inclusive of scholars from low- and middle-income countries; (2) publishing knowledge from low- and middle-income countries; (3) focusing on issues that are pertinent to low- and middle-income countries; and (4) securing representation of lead authors from low- and middle-income countries. The journal is dedicated to transdisciplinarity and inclusivity; seeks to fully engage researchers from low- and middle-income countries in all aspects of the journal; and specifically encourages contributions led by authors situated in these regions. Furthermore, we have chosen to use an open-access format to ensure that the journal content is freely available to researchers, policy makers, and the general community free of charge. For at least through the end of 2023, publication is free of charge; in subsequent years, the publication charge will be reduced or free for authors from low- and middle-income countries.Thematically, Advances in Global Health is focused on advancing health equity throughout the world by publishing research aligned with the SDGs. Advances in Global Health centers health as its focus and promotes an interdisciplinary approach to studying the bidirectional relationship between health outcomes and other key sectors—for example, ending poverty and promoting food security, gender equality, and planetary health. These sections emphasize individual disciplinary approaches to the SDGs as outlined in each section’s aims and scope, forming the core areas of research inquiry and editorial activity of the journal (Figure 1). However, the journal specifically welcomes and encourages research that is interdisciplinary or transdisciplinary in nature and that cuts across multiple SDGs, to avoid research fragmentation and generate a commonplace for integrative science. Finally, as an underlying theme of the journal connected with each of the sections, we will promote scholarly activity that addresses racism and other forms of discrimination, including the rights of Indigenous people.In summary, the Editorial Board, UC Press, and the UC Global Health Institute are firmly committed to having Advances in Global Health be a leading academic journal to share cutting-edge transdisciplinary research and commentaries aiming at improving health equity worldwide. Advances’ editorial policies will actively address research publishing inequities in low- and middle-income countries to effectively promote free sharing of knowledge around the globe.AGL is sponsored by Emerge, the Emerging Diseases Epidemiology Research Training grant D43 TW007393 awarded by the Fogarty International Center of the US National Institutes of Health.The authors declare that they have no competing interests.