Health and the Environment Shall we change the subject?

Nick FoxUniversity of Sheffield

Introduction

• How health and environment interact.

• Anthropocentrism vs. anti-humanism.• An anti-humanist approach to health

and the environment.• Changing the subject.

Approaches to ‘Health and the Environment’

1. Human health is threatened by environmental factors e.g. climate change.

2. Improving the environment can enhance human health.

3. Improvements in health threaten the environment (e.g. population growth, economic development).

4. Initiatives can reduce the environmental impact of health care.

5. Gaia-inspired conceptions of humans as part of a self-regulating environmental system.

Contradictory forces?

• Are human health and environmental health potentially antagonistic?

• How can human health and environmental health be complementary?

• Should human or environmental health have priority?

Anthropocentrism

• Gives priority to human bodies, human subjects and human experience.

• Reflected in:• Humanism• Romanticism• Individualism• Popular politics

Anthropocentrism and health • Most health care and medical theory is

inevitably anthropocentric.• Health has become a ‘good’ that is

almost unquestionable.• Public health has the capacity to avoid

anthropocentrism, by focusing on networks and interactions rather than bodies.

Anthropocentrism, health and the environment • With human health privileged, then the

environment becomes the context within which health is threatened or enhanced.

• Examples: • Improving the built environment.• Addressing environment risks e.g. pollution, UV

radiation.• Health and safety, health protection, HPA.

An alternative approach• Anti-humanism: a philosophical or ontological

position that intentionally overturns the priority or privilege accorded to humans.

• Focuses on the non-human, the inanimate, and social formations.

• Humans are no longer sole agents (‘inorganic life’).

• ‘Health’ is understood relationally, as a capacity of a body to engage with its environment.

An anti-humanist method

• Focus not on bodies or subjects, but on assemblages (networks) of relations between bodies, things, ideas and social institutions.

• Look at how these relations affect or are affected, rather than at ‘agency’ and social actors.

• This is how we ‘change the (human) subject’.

An anti-humanist approach to health and environment 1• Humans are not prior or privileged.• Focus on assemblages of organic

and inorganic: bodies, things, social formations.

• ‘Environment’ is no longer separate from bodies: the latter are part of an assemblage that is ‘environment’.

An anti-humanist approach to health and environment 2• Trace how relations in the assemblage affect

and are affected by each other.• Look at the capacities produced in bodies

and things by these affects.• ‘Health’ is not a body attribute, but an

evaluation of capacity: what a body can do.)• Understand poor health outcomes by

assessing assemblages.

Example 1: city transport

housing – work places – shops – services - workers – (capitalist) economic system - wages

– transport infrastructure – fossil fuels – renewable fuels – pollution - public transport -

private transport – etc.• A sustainable city transport policy can optimise

the affective flows in this assemblage.• ‘Health’ emerges as a ‘by-product’ of the

capacities produced by sustainable transport.

Example 2: water management

population – agriculture - industry – water sources – climate – investment – water use and recycling

technologies - water and sewage infrastructure – economic development – cultural water use beliefs –

micro-organisms – etc.• Analysing the interactions in this assemblage can

optimise water management.• Sustainable water management policy enhances

capacities (e.g. access to affordable clean water, sewage management) = ‘health’.

Example 3: global warming

humans – industry - fossil fuels – sunlight – atmosphere - weather systems – politics -

economics - cultural formations• Balancing the production and capture of

atmospheric carbon can stabilise global temperatures , and thus reduce ecosystem variability.

• A stable ecosystem will enhance human opportunities and hence health.

Conclusions• Environment is an assemblage.• Humans are an element in this assemblage.• Elements in the assemblage affect each other.• Engineering assemblages can produce

capacities that enhance health.• Change the subject from ‘human health’ to

‘environmental assemblages and affects’. • This suggests a distinctive, environmental

approach to public health.

Health and the Environment Shall we change the subject?

Nick FoxUniversity of Sheffield