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"Upstream is a place": Learning together about watersheds as
intersectoral settings for health
Margot W Parkes Canada Research Chair in
Health, Ecosystems & Society UNBC
PHABC Conference
4 Nov 2013
Burnaby, BC
David Bowering Chief Medical Officer of Health
Northern Health
Overview
Upstream is a Place….
‘Wicked Problems’ & Public Health
Health in social-ecological systems
Watersheds as settings for a new
generation of intersectoral action
The Environment as Context for Health
New tools, unusual allies… toward
integrated settings approaches?
A shift in thinking from ‘hazards’ to
‘home’…
difficult to clearly define;
inter-dependent & multi-causal
unintended consequences from attempts to resolve;
not stable (trying to chase a “moving target”)
no clear solution
socially complex
rarely fall under a single organisational mandate
require changes in behaviour
often characterised by chronic policy failure
e.g. obesity…
• climate change…
• aboriginal disadvantage…
• land degradation…
• and….???
Australian Public Services Commission (2007) Tackling Wicked Problems
Science and Business “as usual” don’t work…
“Wicked problems”
Wicked problems demand ‘next generation’
approaches to knowledge & action
‘Success’ with wicked problems (APSC, 2007)
o Collaborative > Authoritative > Competitive
calls for ‘transition science’, collective decisions and collaborative processes
o “Tackling Wicked Problems: Through the Transdisciplinary Imagination” (Brown 2010)
o “A timely volume that deserves a wide, global readership” (Harold Segal, 2010, Nature)
Joins calls for ‘Integration & Implementation Sciences’, ‘Transdisciplinary approaches’, ‘Knowledge
to Action’ and…. ECOHEALTH
“Upstream is a Place”
Learning together about watersheds as intersectoral settings for health
*Words beginning with eco all have origins in the greek word for house (oikos) and the latin word for household (oeco)
Economy?... Ecology…? Social-Ecological Systems?
Where is health in
this picture?
A Canadian “Milestone in Population & Public
Health Research” (IPPH/CPHA 201o)
“systems approaches to the health of people,
animals, and ecosystems in the context of
social & ecological interactions…. working
with interested parties and community
members to address issues at the interface of
health, ecosystems and society” (Webb et al 2010)
Ecosystem Approaches…
o how we begin matters…
o shift from “hazards” to “home
o A response to “wicked problems”…
Health in Social-Ecological Systems: Ecosystem Approaches to Health (EcoHealth)
Aboriginal Health & Ecohealth
“A longer historical lens recognises these
integrative approaches as (re)expressions of
ancient knowledge – rekindling holistic views
of health and wellbeing that have been
cultivated by Aboriginal peoples for
Millennia” (Parkes/NCCAH 2010)
National Collaborating Centre for Aboriginal
Health –ecohealth as an ‘emerging priority’
o Healthy Land, Healthy People…
o Connecting people, place and health/wellbeing…
nccah-ccnsa.ca
Ecohealth & Watersheds: Watersheds as‘settings’ for intersectoral health action
… The centrality of water Watersheds as:
self-organised biophysical units (aka Catchments, River Basins, cuenca hydrografica…)
social-ecological systems;
units of natural resource management, administration and (intersectoral) governance;
Meso-scale ‘settings’ to link rural & urban, sustainabilty & health, upstream/downstream effects
Fraser Basin= 80% of BC economy,
60% of Canada’s water flows north…
(See Parkes & Horwitz, 2009; Parkes et al 2008, 2010, Morrison et al 2010)
Ecohealth & Watersheds: Watersheds as‘settings’ for intersectoral health action
Watersheds as a ‘next generation’ setting for intersectoral action to improve environmental & social determinants of health, due to:
1. the hydrological imperative;
2. the importance of water to our economic, social, cultural & physical health & wellbeing;
3. the benefits of understanding impacts on ecosystems good & services within watersheds.
HIA, EIA, cost-benefit analysis, cumulative effects, ‘precaution’
(See Parkes & Horwitz, 2009; Parkes et al 2008, 2010, Morrison et al 2010)
• Northern Health (pop 300K, area = France)
• Fraser Basin Council
• Regional Drinking Water Team
• Research Collaborations (UNBC, NESH)
• Three Watershed Partners:
1. Nechako/Murray Creek: “Linking land, waterways & healthy living”
2. Kiskatinaw (City of Dawson Creek)
3. Skeena-Bulkey (Watersheds & FN Health)
‘Knowledge to action’ grant (CIHR)
“Improving social & environmental determinants of health through integrated water governance”
• Steering Committee co-chairs: UNBC-NH
How does a ‘newcomer’ to Northern BC explore this?
local partners & connections
Stuart-Nechako watershed
Fraser River Basin
Cultures and Communities
Practitioners in-the-field (health, energy, env)
Diverse academic disciplines
Sectors (health, env, agriculture, forestry, energy)
Units of Governance (local–watershed–global)
Linking
different types
of knowledge &
participation, to
facilitate
integrated
understanding
& action
Recurring (upstream, place-based) questions
Integration? Participation? Collaboration?
Adapted from Parkes et al, (2005) ‘All Hands on Deck’ EcoHealth
Knowledges – WHAT? People – WHO? Action & Learning? HOW?
Governance (as compared to government)… “The processes whereby societies and organizations make important decisions, determine whom they involve in the process, and hold decision-makers to account” (Graham et al 2003)
‘Tools for integration’ Series:
Health, Ecosystems & Community in Watersheds
o Maps & spatial information tools (Mar ‘12)
o Watersheds, Governance & Health (Oct ’12)
o ‘New’ Media & the Art of Integration (Mar ‘13)
o ‘Indicators’ & Digital Storytelling (Summer ‘13)
www.unbc.ca/parkes (3 stories by December)
Community Events
o World Water Day Gathering, Vanderhoof ’12
o Field-trips/ knowledge exchange events (‘11-’13)
o “We are all connected” (First Nations led…)
Integrating within the ‘digital toolscape’: portals, documents, archives, digital stories.
‘Knowledge to Action’ Project: Ecohealth & Watersheds
as‘settings’ for intersectoral health learning
Northern Health: Position Environment as a Context for Health
Foodsheds
Healthy
Parks/Outdoor
s
Airsheds
Schools
Workplaces
(inc. Hospitals)
Communities
Watersheds
An Integrated Settings Approach
“a fundamental shift from protection
to promoting safe and healthy environments”
“Unusual allies”
Towards an ‘integrated settings approach’
Northern Health (2012) Fig 1. Integrating Healthy & Green Settings
Working toward the ‘green edge’
of healthy settings…. Working toward the ‘green edge’
of healthy settings….
Working toward the ‘green edge’
of healthy settings…. Working toward the ‘healthy edge’
of green settings
An Integrated Settings Approach
“a fundamental shift from protection
to promoting safe and healthy environments”
“Upstream is a Place”
“Upstream is a Place”
Implications & Applications…
Changing landscapes for health in BC…
o Overcoming false dichotomies:
o Social & ecological settings for health
oHealth Impact Assessment… cumulative impact assessments…
‘Next generation’ intersectoral action?
oPublic Health & ‘wicked’ problems?
oWhat role for public health (& research)? To Lead? Convene? Facilitate? Motivate?
New allies: health, ecosystems & society
oStories, narratives, resilience…
o advancing Public Health competencies?
Doing the same things better, AND doing
better things
• Project Steering Committee: Fraser Basin Council,
Regional Drinking Water Team, City of Dawson
Creek, Nechako Environment & Water Stewardship
Society, Office of Wet’suwet’en, UNBC colleagues.
• UNBC Research Team, see: www.unbc.ca/parkes
• Canada Research Chair Program
• Canadian Institutes for Health Research
• Network for Ecosystem Sustainability & Health
• Canadian Community of Practice in Ecosystem
Approaches to Health www.copeh-canada.org
Thank you! Acknowledgements
2014 Aug 11-14, 2014, Montréal
Photo credits
Slide 4 & 7:
o http://trendsupdates.com/wwf-campaign-deforestation-and-lungs/ (forest-
lungs)
• Slide 7 & 17:
o www.idrc.ca (people)
o www.ecohealth.net (frog)
Slide 6 :
o http://www.nccah-ccnsa.ca/264/Healthy_Land__Healthy_People_-
_International_Gathering.nccah
References
Charron, D. F. (2012). EcoHealth: Origins and Approach. In Ecohealth Research in Practice: Innovative Applications of an Ecosystem Approach to Health. Springer, New York, NY, USA / IDRC. Ottawa, Canada. Available online at: http://www.idrc.ca/EN/Resources/Publications/Pages/IDRCBookDetails.aspx?PublicationID=1051.
Graham, J., Amos, B., & Plumptre, T. (2003). Principles for Good Governance in the 21st Century. Policy Brief No.15 – August 2003. Ottawa, Canada, Institute on Governance. Online at http://www.iog.ca/publications/policybrief15.pdf:
Horwitz, P., Morrison, K., Parkes, M., Patz, J., & Zinsstag, J. (2012). Integrating Health, Sustainability and Ecosystems in the Post-2015 Development Agenda. Think Piece for Health in the Post-2015 Development Agenda, http://www.worldwewant2015.org/health(http://www.worldwewant2015.org/node/300226).
Northern Health. (2012). Position on the Environment as a Context for Health. Prince George: Northern Health. Online at: http://www.northernhealth.ca/AboutUs/PositionStatementsAddressingRiskFactors.aspx
Parkes, M. W., Bienen, L., Breilh, J., Hsu, L.-N., McDonald, M., Patz, J. A., … Yassi, A. (2005). All Hands on Deck: Transdisciplinary Approaches to Emerging Infectious Disease. EcoHealth, 2, 258–272.
Parkes, M. W., & Horwitz, P. (2009). Water, Ecology and Health: Exploring ecosystems as a “settings” for promoting health and sustainability. Health Promotion International, 24, 94–102.
Parkes, M. W., Charron, D., & Sanchez, A. (2012). Better Together: Field-building Networks at the Frontiers of Ecohealth Research. In D. Charron (Ed.), Ecohealth Research in Practice: Innovative Applications of an Ecosystem Approach to Health. New York, NY, USA Springer/ DRC, Ottawa, Canada. Available online at: www.idrc.ca
Parkes, M. W., Morrison, K. E., Bunch, M. J., Hallström, L. K., Neudoerffer, R. C., Venema, H. D., & Waltner-Toews, D. (2010). Towards Integrated Governance for Water, Health and Social-Ecological Systems: The Watershed Governance Prism. Global Environmental Change, 20, 693–704.
Patz, J., Corvalan, C., Horwitz, P., & Campbell-Lendrum, D. (2012). Our Planet, Our Health, Our Future. Human health and the Rio Conventions: biological diversity, climate change and desertification. A collaboration of the World Health Organization and the Secretariats of the Convention on Biological Diversity, the United Nations Framework Convention on Climate Change and the United Nations Convention to Combat Desertification.
Webb, J., Mergler, D., Parkes, M. W., Saint-Charles, J., Spiegel, J., Waltner-Toews, D., … Woollard, R. F. (2010). Tools for Thoughtful Action: the role of ecosystem approaches to health in enhancing public health. Canadian Journal of Public Health, 101, 439–441.
