Introduction

Health is an extremely difficult concept to define. It relies on an intricate web of

determinates that vary across individuals, communities, and nations. Hundreds of health models

have been developed to try and encapsulate the meaning of health and it’s safe to say no model

can completely fit for every person or circumstance. For example, the biological model views

health as merely the absence of disease. It does not take into account the relationship between

illness and larger socioeconomic or culture factors like poverty and personal wellbeing

(Warwick-Booth, Cross, and Lowcock, 2012). This approach can be helpful in a modern health

care setting but the absence of disease, while important to heath, should not be the only thing

considered. In this paper I will be using a more positive, holistic approach to view what health is.

I will be defining health according to a social model summarized succinctly by the World Health

Organization (1948) definition stating that health is "a state of complete physical, mental, and

social well-being and not merely the absence of disease or infirmity". This framework recognizes

a wide range of factors like social, political, and environmental all influence health, which is

necessary when looking at the relationship between health and the ecosystem. The relationship

between health and ecosystems goes beyond the dominant biomedical or epidemiological

attitudes towards health and therefore our definition should be socially and broadly defined to

include external factors.

Human health cannot be looked at in isolation. The health of an individual is directly

related to the quality of ecosystem in which they live. I’m defining ecosystem as “a functional

unit that encompasses the dynamics among plants, animals (including humans), microorganisms,

and their physical surroundings” (Charron, 2011, p6). In order for individuals to be healthy, they

need to be living in a healthy, stable ecosystem. An ecosystem consists of the interactions

between the natural world, the built environment and the social environment. In this paper, I will

be using the WHO’s (nd) definition of environment, as it relates to health, as “all the physical,

chemical, and biological factors external to a person, and all the related behaviors”.

When looking at the relationship between health and ecosystems, it’s helpful to keep the

“Ecosystem Approach to Health” model in mind. An ecosystem approach acknowledges that the

health and wellbeing are “the result of complex and dynamic interactions between determinants

and between people, social, economic conditions, and environments” (Charron, 2011, p7). This

shows that economy, the environment, and community factors all affect the health of the

ecosystem, thus affecting the health of individuals. In the real world, limited focus to just one of

these factors can create an imbalanced and unsustainable community (Lebel 2003). However,

due to the limited space available in this essay, I will only be focusing on the relationship

between health and the physical environmental aspect of ecosystem. A person’s environment is

directly related to their health. Case studies show that poverty and discrimination force people

into deteriorating environments that are harmful to their wellbeing (Charron, 2011, p3). In this

essay, I will be showing the relationship between the environment and health by outlining

several different ways the environment is a determinate of health. These ways include the

importance of access to clean water and proper sanitation, the effects of poor air quality on

health, and global scale environment. There are many more that could be discussed, but again

due to length, this essay will only focus on these three and relevant issues that arise within each.

Water and Sanitation

Water is one of the most essential substances on earth to facilitate life. All humans must

have access to water to survive. Apart from drinking, water is necessary for cooking, cleaning,
agriculture, and more. Consuming water and completing necessary duties such as bathing or

washing provides easy access for contamination due to both pathogens, defined as living agents

of disease and geogens, non living agents of disease (Anthamatten and Hazel, 2011). Low-

income countries often have the issue of poor sanitation in the ecosystem, which allows the

drinking water to be contaminated by excreted waste and expose the population to many

different pathogens that cause ill health. As cited by Anthamatten and Hazel (2011, p23),

according to the WHO, “diarrheal diseases—88 percent of which are attributable to poor

sanitation and hygiene—lead to 1.8 million deaths per year.” Environmental hygiene is very

important for the health of a community.

Geogens can be another source of environmental disruption on health. They take the form

of naturally occurring substances or synthetic chemicals. For example, the natural geogen

arsenic is extremely toxic when ingested so many countries have regulations in place to monitor

levels. Elevated arsenic levels can be found in several different places but so far nowhere has

seen a larger arsenic health problem than Bangladesh. Smith, Lingas, and Rahman (2001) of the

WHO estimated that “between 35 and 77 million people were at risk for arsenic poisoning in

2000.” Exposure came from a 1970s health initiative created by the United Nations’ Children’s

Fund and Bangladeshi government agencies with the goal of providing communities access to

clean groundwater through a tube system. While this program effectively provided 95 percent of

the Bangladeshi population access to water, it was soon realized that the majority of this

groundwater was contaminated with dangerously high levels of arsenic (Anthamatten and Hazel,

2011). It’s difficult to pin down the exact number of individuals affected by this tragedy, but it is

certain that the health of the Bangladeshi population will be negatively impacted for decades.
(Smith, Lingas, and Rahman, 2001). Health is impacted in the form of new chronic alignments,

but also a social mistrust of government campaigns and generational trauma.

Many pathogens have a life cycle that depends on a separate species, or a vector, to

transmit the pathogen between varieties of hosts. These diseases also often have a very specific

relationship with the environment, as specific conditions are necessary for transmission and

breeding (Anthamatten and Hazel, 2011). One of the most common examples is a mosquito

carrying malaria. It’s commonly known that the geography of an area can greatly change the

prevalence because standing water in the ecosystem leads to higher rates of malaria. When

trying to decrease malaria rates, it’s often advised to manage bodies of water, cover or fill areas

that accumulate water, and plant shade trees around bodies of water (Okella-Onen, Mboera, and

Mugisha, 2012). However it should be noted that, the physical environment is not the only thing

that contributes to an individuals’ risk of contracting malaria. Other factors, such as the

frequency at which they use nets or insecticide, age, gender, and occupation are all also

significant. High malaria areas are associated with lack of resources can create instability in the

community. It’s necessary to consider both the physical and social environment in order to

understand the full effects of most diseases even though this essay is focused on the effects of the

natural world.

Air Quality and Pollution

Although it is difficult to determine the exact health effects of poor air quality, it is

known that a variety of pollutants have negative effects on health. Long-term exposure to

pollution creates several chronic aliments such as cancer and a variety of respiratory problems.

Anthamatten and Hazel (2011), showed that Fuentes-Leonarte et al. concluded “indoor air
pollution in the poorer countries is one of the principal causes of death in the world” while

another study claims that outdoor pollution is likely accountable for 1.4 percent of all mortality,

definition, and 2 percent of all cardiopulmonary. It’s clear that pollution is a worldwide

determinate of health and major changes will need to occur to reduce this risk. Researchers

(Künzli et al, 2000) in Austria, France and Switzerland found their air pollutants caused 6

percent of mortality and over half were directly caused by vehicle emissions. They found that

traffic-related pollution was shockingly responsible for “more than 25,000 new cases of chronic

bronchitis (adults); more than 290,000 episodes of bronchitis (children); more than 0.5 million

asthma attacks; and more than 16 million person-days of restricted activity” (Künzli et al. 2000

p795). Research has consistently proved a link between mortality and pollution, however

pollution is unevenly distributed. Varying ecosystems have varying impacts on human health due

to differing amounts and types of particles present in the air. Urban areas are more likely to

“experience adverse health impacts from air pollutants, owing to high concentrations of traffic,

and industrial and domestic pollutants” (Anthamatten and Hazel, 2011 p58). The physical

geography of a city can also put it at greater risk for increased pollution rates. This is evident in

Mexico City, because the entire city is located down in a basin surrounded by higher ground,

which forces the pollution to sit above like a foggy haze (Anthamatten and Hazel, 2011). Mental

wellbeing is also affected in high pollution areas: depression, anxiety and Alzheimer’s disease

have all been linked to air pollution.

Global Warming

Earth’s climate system is an integral part of every ecosystem and the health of

populations depends on the stability and functioning of this process. Human activity has
amplified the greenhouse effect, which has placed a large amount of strain of the climate system

(McMichael, 2004). Global climate change has the power to create widespread health impacts

now and in the immediate future. The past two sections were more focused on micobiological

risks to health by local exposures, however the scale of effects of global climate change is much

greater and will create huge environmental hazards to human health (McMichael, 2004) These

major changes include “stratospheric ozone depletion, biodiversity loss, worldwide land

degradation, freshwater depletion, and others such as the disruption of the elemental cycles of

nitrogen and sulphur, and the global dissemination of persistent organic pollutants” (McMichael,

2004, p2) All of these changes have severe repercussions for human health, agriculture, society,

and economy.

It’s predicted that global warming will affect water systems by increasing global water

temperatures and an increase in flooding that will stress aquatic systems. An increase in flooding

or heavy rainfall could also lead to an increase of water thriving pathogens and vector disease

due to an increased water contamination and standing water, and a decrease in sanitation

(Anthamatten and Hazel, 2011). There will also be an increase in extreme weather events and

extremes like hurricanes, droughts, and harsh winters and deadly summers. The extreme warmer

temperatures are predicted to bring an increase in gastrointestinal disease due to food poisoning

and water scarcity (Anthamatten and Hazel, 2011). Changes in air flow and quality will lead to

an increase of air pollutants and respiratory issues. These effects will also create a decrease in

mental and social wellbeing in communities due to the strain of the declining food production,

trauma from natural disasters, and economic fallout.

Environmental Justice
 It’s extremely important to raise the issue of environmental injustices when discussing

environmental ecosystems as a determinate of health. The environment is strongly intertwined

with social differences. Walker (2011, p17) describes this relationship as how for “some people

and some social groups the environment is an in as intrinsic part of living a room life of

prosperity, health and well-being, while for others the environment is a source of threat.” The

environmental justice movement recognizes people of color and low-income communities are

disproportionally affected by external threats of the ecosystem. Health needs to be considered

within the context of the individuals and community.

Conclusion

An individual’s ecosystem is composed of many different components. In this essay, I

analyzed the environmental aspect as it relates to human health. When looking at the ecosystem

as a determinate of health, it’s necessary to view health in a positive, holistic manner.

Environmental factors can increase disease present in communities and lead to societal or

economic instabilities as well as creating a decrease in mental wellness.

Works Cited

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Routledge


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International Developmental Research Centre

Kunzli, N., et al. 2000. Public-health impact of outdoor and traffic-related air pollution: a
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Lebel, J., 2003. Health: An Ecosystem Approach. Ottawa: International Developmental Research

Centre

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