Ecosystem Approaches to Health for a Global Sustainability Agenda

International research agendas are placing greater emphasis on the need for more sustainable development to achieve gains in global health. Research using ecosystem approaches to health, and the wider field of ecohealth, contribute to this goal, by addressing health in the context of inter-linked social and ecological systems. We review recent contributions to conceptual development of ecosystem approaches to health, with insights from their application in international development research. Various similar frameworks have emerged to apply the approach. Most predicate integration across disciplines and sectors, stakeholder participation, and an articulation of sustainability and equity to achieve relevant actions for change. Drawing on several frameworks and on case studies, a model process for application of ecosystem approaches is proposed, consisting of an iterative cycles of participatory study design, knowledge generation, intervention, and systematization of knowledge. The benefits of the research approach include innovations that improve health, evidence-based policies that reduce health risks; empowerment of marginalized groups through knowledge gained, and more effective engagement of decision makers. With improved tools to describe environmental and economic dimensions, and explicit strategies for scaling-up the use and application of research results, the field of ecohealth will help integrate both improved health and sustainability into the development agenda.     

Sustainable transportation systems performance evaluation using fuzzy logic

Sustainability has become an overarching concern for transportation policy and planning around the world. This article presents an approach for urban transport sustainability performance evaluation using fuzzy logic. This article presents a model for transport sustainability performance evaluation. Appropriate transport sustainability indicators were identified based on literature. The model addresses all major dimensions of transport sustainability such as Economic Sustainability, Social Sustainability, Environmental Sustainability and Transportation System Effectiveness. Transport sustainability index has been computed as (5.05, 6.62, 8.12) and weaker transport sustainability attributes were found. Transport sustainability index highlights the question how far toward becoming transport sustainable is an enterprise or region? While, weaker transport sustainability attributes reveals that how can an enterprise or region improve its transport sustainability effectively? Appropriate actions were initiated to improve urban transport sustainability performance. The results indicate that the model is capable of effectively assessing transport sustainability and has practical relevance. An example is also used to illustrate the approach developed. The results obtained using fuzzy approach has been validated with conventional crisp approach. 20 transport sustainability attributes out of 60 are found to be weaker and appropriate actions were derived to improve the weaker attributes.     

Assessing and comparing relative farm-level sustainability of smallholder shrimp farms in two Sri Lankan provinces using indices developed from two methodological frameworks

As shrimp farming can be an important means of income generation, particularly among Sri Lanka’s rural communities, it is important that this industry grows in a sustainable manner, starting at the farm level. The objectives of this study were to; 1) create baseline farm-level sustainability indices for smallholder shrimp farms in Sri Lanka using both content-based and system-based frameworks adapted from agriculture; 2) determine whether arranging indicators within both content- and system-based sustainability frameworks would provide additional insight into relative farm sustainability (rather than using just one framework); and 3) seek differences between the North Western Province (NWP) and the Eastern Province (EP) in sustainability index, sub-index, or indicator scores that might be used to create province-specific policies and education programs designed to potentially improve sustainable practices at the farm level. Since little has been published on the development of practical indicators and evaluation of farm-level sustainability in aquaculture, this study adapted two types of frameworks used for measuring sustainability in agriculture: content- and system-based. Using both frameworks, along with expert opinion, indicators of farm level sustainability were developed into a questionnaire and measured on 225 farms in two provinces of Sri Lanka. Indicators primarily included modifiable practices that farmers could influence to improve the chances of their farms’ survival. The farm indicators were normalized using “min-max” normalization, where scores of zero and one were assigned for the least and most sustainable options, respectively. Farm indicators in each province were then aggregated into sub-indices as well an overall aggregated sustainability index score. Similar themes were gleaned from both the content-based and system-based sustainability frameworks, and there was no significant difference between mean overall sustainability scores for the two different frameworks. Farms in the NWP scored significantly higher on the overall sustainability indices of both models despite the NWP’s history of severe disease outbreaks while the EP farms had no disease. Possible reasons for this difference were explored with an in-depth analysis of sub-indices as well as individual indicators. An overall aggregated sustainability index score was a useful baseline measure for monitoring changes in sustainability over time; however, its use was limited when attempting to identify gaps in sustainable management practices and provide practical information for farmers and stakeholders to improve farm-level sustainability. It was important to evaluate individual indicators in addition to sub-indices and overall index scores when making recommendations or identifying gaps in sustainable practices at the farm level.     

Art and anthropology for a sustainable world

Both art and anthropology, this article proposes, are future-oriented disciplines, united in the common task of fashioning a world fit for coming generations to inhabit. The first step in establishing this proposition is to show how the objectives of anthropology differ from those of ethnography. Anthropology, it is argued, establishes a relation with the world that is correspondent rather than tangential, that prioritizes difference over alterity, and that places presence before interpretative contextualization. The second step is to rethink the idea of research – to show how, as an open-ended search for truth and a practice of correspondence, research necessarily overflows the bounds of objectivity. Art and anthropology, then, and not natural science, are exemplary in the pursuit of truth as a way of knowing-in-being. The third step is to show that only if it is conceived in this way can research be conducive to the processes of renewal on which our collective futures depend. Thus research as correspondence is a condition for sustainability. But sustainability is nothing if it is not of everything. We have to begin, therefore, with the idea of everything as a plenum, in which each apparent addition is really a reworking. The article concludes with some reflections on the proposed synergy of art and anthropology for education, democracy, and citizenship.     

Ecohealth as a Field: Looking Forward

This forum paper proposes a reflection on the “field of ecohealth” and on how best to sustain a supportive environment that enables the evolution of diverse partnerships and forms of collaboration in the field. It is based on the results of a preconference workshop held in October 2012, in Kunming, China at the fourth biennial conference of the International Association for Ecology and Health. Attended by 105 persons from 38 countries, this workshop aimed to have a large-group and encompassing discussion about ecohealth as an emerging field, touching on subjects such as actors, processes, structures, standards, and resources. Notes taken were used to conduct a qualitative thematic analysis combined with a semantic network analysis. Commonalities highlighted by these discussions draw a portrait of a field in which human health, complex systems thinking, action, and ecosystem health are considered central issues. The need to reach outside of academia to government and the general public was identified as a shared goal. A disconnect between participants’ main concerns and what they perceived as the main concerns of funding agencies emerged as a primary roadblock for the future.     

A selection of safeguard subjects and state indicators for sustainability assessments

Purpose

The purpose of this work is to identify and select safeguard subjects and state indicators that are suitable for sustainability assessment in product and production development, using an interpretation of the Brundtland definition of sustainable development. The purpose is also to investigate how indicators selected in this way differ from other selections in the literature.

Methods

We use a top-down approach, which starts with reviewing the Brundtland definition of sustainability and identifying the corresponding human basic needs to be satisfied. For each basic need, we identify relevant satisfiers, and for each satisfier, a number of safeguard subjects. The safeguard subjects represent critical resources for making satisfiers available. For each safeguard subject, a number of state indicators (=endpoint category indicators) are selected that are relevant for describing impacts from product life cycles on the safeguard subject.

Results and discussion

Ecosystem services, access to water, and abiotic resources are identified as environmental safeguard subjects. Technology for transports, environment, textiles, housing, food, information, and energy, together with income, are identified as economical safeguard subjects. Human health, land availability, peace, social security, continuity, knowledge, jobs/occupation, and culture are identified as social safeguard subjects. In comparison with the other selections of safeguard subjects in literature, our safeguard subjects are structured differently and delimited in scope, but there are also many similarities. The best agreement is on environmental issues, but we classify human health as a social issue. For social issues, we identify fewer safeguard subjects and state indicators than recommendations from UNEP/SETAC. For economic issues, we diverse from current LCC and approach UNECE measures of sustainability.

Conclusions

Identification and selection of safeguard subjects and state indicators benefit from a clear definition of sustainability, needs to be satisfied, and satisfiers. The interpretation of the sustainability concept has a large influence on which safeguard subjects that are included and which indicators that are needed to describe their state. Capacity building is an important sustainability indicator, which should be developed further for use in life cycle sustainability assessment. The top-down approach offers a good arena for a further research and discussions on how to structure and focus LCSA. Our results shall be seen as one example of which safeguard subject that may be identified with the top-down approach presented here.

     

Zoonotic Emerging Infectious Disease in Selected Countries in Southeast Asia: Insights from Ecohealth

Most emerging diseases of humans originate in animals, and zoonotic emerging infectious diseases (EIDs) threaten human, animal, and environment health. We report on a scoping study to assess actors, linkages, priorities, and needs related to management of these diseases from the perspective of key stakeholders in three countries in Southeast Asia. A comprehensive interview guide was developed and in-depth interviews completed with 21 key stakeholders in Vietnam, Lao People’s Democratic Republic, and Cambodia. We found numerous relevant actors with a predominance of public sector and medical disciplines. More capacity weaknesses than strengths were reported, with risk analysis and research skills most lacking. Social network analysis of information flows showed policy-makers were regarded as mainly information recipients, research institutes as more information providers, and universities as both. Veterinary and livestock disciplines emerged as an important “boundary-spanning” organization with linkages to both human health and rural development. Avian influenza was regarded as the most important zoonotic EID, perhaps reflecting the priority-setting influence of actors outside the region. Stakeholders reported a high awareness of the ecological and socioeconomic drivers of disease emergence and a demand for disease prioritization, epidemiological skills, and economic and qualitative studies. Evaluated from an ecohealth perspective, human health is weakly integrated with socioeconomics, linkages to policy are stronger than to communities, participation occurs mainly at lower levels, and equity considerations are not fully considered. However, stakeholders have awareness of ecological and social determinants of health, and a basis exists on which transdisciplinarity, equity, and participation can be strengthened.     

Sustainability, Health and Precautionary Perspectives on Lawn Pesticides, and Alternatives

This article considers health concerns associated with lawn pesticide use and potential policy actions to address those concerns. We first briefly present the generations of pesticide technology, and then apply a sustainability lens to consider the dissipative use of persistent compounds. We enumerate uncertainties in available science and gaps in toxicity testing of pesticides, along with potential for exposure and evidence of harm from lawn pesticide exposure. We consider how a precautionary approach complements a sustainability perspective and detailed scientific findings, and then briefly present practical approaches to reducing use of lawn pesticides. Finally, we highlight factors pivotal for successful policy to limit lawn pesticide use.     

Freshwater ecosystem structure–function relationships: from theory to application

1. In this issue we aimed to answer the questions: (i) under what circumstances are functional variables better than structural ones for assessing ecosystem health? and (ii) are there good indicators of change in ecological functioning along perturbation gradients?
2. Of the numerous functional indicators tested in this issue, several show a response to anthropogenic stress and could be included in assessments of ecosystem health and integrity in running waters.
3. In three of eight studies, function showed a stronger response to anthropogenic stress than structure, whereas one study showed a response in structure and not function, and four studies showed responses in both structure and function. Thus structure alone could not detect all types of impairment and functional aspects should also be included and further developed for assessing running-water ecosystem health and integrity. Functional variables may be especially useful in situations where there is a stronger response among organisms not usually included in stream assessment (e.g. fungi and bacteria) than the commonly used invertebrate, macrophytes and fish indicators.
4. Leading research questions related to the use of functional indicators in running waters include: (i) how large is natural and operator-induced variation for functional indicators? (ii) how small of an effect size (delta) can be detected using structural versus functional indicators? and (iii) how do we efficiently improve theories as well as predictive ability for functional measures to assess the effects of anthropogenic stressors?
5. To advance the use of functional indicators in applied running-water studies, we need to supplement the approach of using large-scale datasets and correlation with ecosystem manipulations.     

Urban–rural differences in Roman Dorset,England: A bioarchaeological perspective on Roman settlements

In the Roman period, urban and rural ways of living were differentiated philosophically and legally, and this is the first regional study of these contrasting life‐ways. Focusing on frailty and mortality risk, we investigated how these differed by age, sex, and status, using coffin type as a proxy for social status. We employed skeletal data from 344 individuals: 150 rural and 194 urban (1st–5th centuries A.D.) from Dorset, England. Frailty and mortality risk were examined using indicators of stress (cribra orbitalia, porotic hyperostosis, nonspecific periostitis, and enamel hypoplastic defects), specific metabolic and infectious diseases (rickets, scurvy, and tuberculosis), and dental health (carious lesions and calculus). These variables were studied using Chi‐square, Siler model of mortality, Kaplan–Meier analysis, and the Gompertz model of adult mortality. Our study found that overall, mortality risk and survivorship did not differ between cemetery types but when the data were examined by age, mortality risk was only significantly higher for urban subadults. Demographic differences were found, with urban cemeteries having more 0–10 and >35 year olds, and for health, urban cemeteries had significantly higher frequencies of enamel hypoplastic defects, carious lesions, and rickets. Interestingly, no significant difference in status was observed between rural and urban cemeteries. The most significant finding was the influence of the skeletal and funerary data from the Poundbury sites, which had different demographic profiles, significantly higher frequencies of the indicators of stress and dental health variables. In conclusion, there are significant health, demographic, and mortality differences between rural and urban populations in Roman Britain. Am J Phys Anthropol 157:107–120, 2015. © 2015 Wiley Periodicals, Inc.     

A PCA-based method for construction of composite sustainability indicators

Purpose

Sustainable manufacturing is practiced globally as a comprehensive strategy for improving the sustainability performance of the manufacturing industry. While sustainability is characterized into such three dimensions as economic, environmental, and social, currently, there is no quantitative method yet to measure the so-called ??sustainability?? in the manufacturing industry. The objective of this research is to develop a comprehensive and effective quantitative method to measure the overall sustainability performance of manufacturing companies.

Methods

In this paper, an integrated methodology is presented for the development of composite sustainability indicators based on principal component analysis (PCA). In developing this integrated approach, both industry and academia surveys are conducted to identify what sustainability indicators are favored by the sustainable manufacturing community. A unique index is then generated to measure the overall sustainability performance of industrial practices. The methodology can be used for benchmarking the overall sustainability performance of various manufacturing companies.

Results

A case study is conducted on a total of 11 global electronic manufacturing companies. The overall sustainability performance of these companies are measured, benchmarked, and ranked. The results showed that PCA is an effective approach for constructing composite sustainability indicators across environmental, economic, and social dimensions.

Conclusions

From this research, it is found that industry and academia have different views on the sustainability measurement, evidenced by different weights put on the same indicator in industry and academia. The case study demonstrated that the methodology presented in this paper is an effective tool for comprehensive measurement of sustainability performance of manufacturing companies. Strengths and weaknesses of each company can be identified. Then, the recommended improvements can be suggested based on the study of each of the individual indicators.     

Sustainability Indicators at the Firm Level

After reviewing recent attempts to develop sustainability indicators, this article shows how the principles of productive efficiency can be used to elaborate such indicators at the firm level. The theory of productive efficiency is somewhat expanded to incorporate fundamental issues of sustainable development: environment, equity, and futurtty. Efficiency, in the expanded notion of productive efficiency, is viewed as a necessary condition for sustainability. Working with aggregate performance indicators, it is important not to lose track of the relevant basic information. Therefore, instead of elaborating one unique indicator; we propose to implement several kinds of indicators, each of which stresses one particular focus (e.g., environmental vs. social concems). The definition of sustainable development indicators is illustrated with reference to a small data set of U.S. fossil fuel-fired electric utilities. In a sustainabiltty perspective, two important aspects are stressed, namely, the use of nonmewable resources and the inclusion of employment as a variable to maximize rather than an input to minimize. The article ends with a discussion of the significance of, and limits to, the proposed indicators.     

How to monitor environmental pressures of a circular economy: An assessment of indicators

Understanding how a circular economy (CE) can reduce environmental pressures from economic activities is crucial for policy and practice. Science provides a range of indicators to monitor and assess CE activities. However, common CE activities, such as recycling and eco‐design, are contested in terms of their contribution to environmental sustainability. This article assesses whether and to what extent current approaches to assess CE activities sufficiently capture environmental pressures to monitor progress toward environmental sustainability. Based on a material flow perspective, we show that most indicators do not capture environmental pressures related to the CE activities they address. Many focus on a single CE activity or process, which does not necessarily contribute to increased environmental sustainability overall. Based on these results, we suggest complementing CE management indicators with indicators capturing basic environmental pressures related to the respective CE activity. Given the conceptual linkage between CE activities, resource extraction, and waste flows, we suggest that a resource‐based footprint approach accounting for major environmental inputs and outputs is necessary—while not sufficient—to assess the environmental sustainability of CE activities. As footprint approaches can be used across scales, they could aid the challenging process of developing indicators for monitoring progress toward an environmentally sustainable CE at the European, national, and company levels.     

Using Network Analysis to Explore if Professional Opinions on Japanese Encephalitis Risk Factors in Nepal Reflect a Socio-ecological System Perspective

Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia and a significant public health problem in Nepal. Its epidemiology is influenced by factors affecting its amplifying hosts (pigs), vectors (mosquitoes), and dead-end hosts (including people). While most control efforts target reduced susceptibility to infection either by vaccination of people or pigs or by reduced exposure to mosquitoes; the economic reality of Nepal makes it challenging to implement standard JE control measures. An ecohealth approach has been nominated as a way to assist in finding and prioritizing locally relevant strategies for JE control that may be viable, feasible, and acceptable. We sought to understand if Nepalese experts responsible for JE management conceived of its epidemiology in terms of a socio-ecological system to determine if they would consider ecohealth approaches. Network analysis suggested that they did not conceive JE risk as a product of a socio-ecological system. Traditional proximal risk factors of pigs, mosquitoes, and vaccination predominated experts’ conception of JE risk. People seeking to encourage an ecohealth approach or social change models to JE management in Nepal may benefit from adopting social marketing concepts to encourage and empower local experts to examine JE from a socio-ecological perspective.     

Measuring Sustainability Efficiency Using a Two‐Stage Data Envelopment Analysis Approach

In this article, we apply an additive two‐stage data envelopment analysis estimator on a panel of 20 countries with advanced economies for the time period 1990–2011 in order to create a composite sustainability efficiency index. We use a window‐based approach in order to study the countries over the years. The sustainability efficiency index is decomposed into production efficiency and eco‐efficiency indicators. The results reveal inequalities among the examined countries between the two stages. The eco‐efficiency stage is characterized by large inequalities among countries and significantly lower efficiency scores than the overall sustainability efficiency and the production efficiency. Finally, it is reported that a country's high production efficiency level does not ensure a high eco‐efficiency performance.     

Development of Transdisciplinarity Among Students Placed with a Sustainability for Health Research Project

Transdisciplinary education on sustainability for health has been primarily developed in high-income countries, yet the need in countries with limited research and human resource investments remains urgent. Little empiric documentation of the facilitators and barriers to transdisciplinary learning in such countries has been described. We assessed transdisciplinary learning among students of different disciplines collaborating with an Ecuadorian sustainability for health research project. Six undergraduate students from four different disciplinary backgrounds were incorporated through work–study agreements with provincial university academic supervisors. Learning was fostered and monitored through participant observations by a field supervisor. Students’ learning was evaluated through subsequent in-depth interviews and visualization methods. Academic supervisor key informant and co-investigator observations aided triangulation. Qualitative data were analyzed using indicators of transdisciplinary thinking. Principal factors facilitating transdisciplinary learning were interaction with social actors, the integration of work with other disciplines, the use of alternative research techniques and methods, and the constant support of the field supervisor. Inhibiting factors included the existence of rigid academic rules, lack of training of the academic supervisors in diverse research methods, and social pressures to implement unidisciplinary foci. At the end of their link with the project, students had developed both cognitive outcomes and attitudinal values relevant to sustainable development for health. In countries with limited investments in research and human resources development, transdisciplinary approaches with social actors and engaged researchers can sensitize new professionals training in traditional academic contexts to the ecological–social–health problems faced by poor majorities and encourage their subsequent work on sustainability for human health.     

Place,case and process: Applying ecology to sustainable development

We outline a pragmatic approach through which ecologists, by participating in interdisciplinary research, can engage with sustainable development. The approach is based on three points of intersection that facilitate the integration of ecological insights with insights from other disciplines and stakeholders. The first point of intersection, place, emphasizes the value of carefully choosing where to conduct an interdisciplinary research project. We argue that, from a sustainability perspective, research will be of most applied value if it takes place in locations that actually face urgent sustainability problems (including biodiversity decline). The second point of intersection, case, suggests that integration among different disciplines can be facilitated by choosing common study cases or units of analysis. For example, ecologists and scientists from other disciplines can focus on the same farms, villages or landscapes in their work. Sharing cases helps to create comparable data for integration, but also facilitates communication across disciplinary boundaries because it creates shared experiences in the field. The third point of intersection, process, relates to operational features of team research that improve integration across disciplines and communication with stakeholders. Key process-related features are working in a small, co-located team, planning for independent as well as joint project activities, involving some key stakeholders early on in the research process, and carefully targeting communication at different relevant audiences. In combination, an approach centred around place, case and process provides a tangible and pragmatic way for ecologists to meaningfully engage with real-world sustainability problems.     

Comparison of methods for calculation of sustainability indices for alternative sewerage systems—Theoretical and practical considerations

City planners need practical methods to assess and compare the sustainability of different alternatives for urban infrastructure. This article presents the consequences of selecting different methods to normalize the values of sustainability indicators, and the influence of selecting different indicators and different weighting techniques. Chosen indicators represent use of resources, environment, health and safety, psycho/sociological situation. Infrastructure costs are not included in the indicators, since it is more convenient to weigh them against the sustainability indices of the different systems. All indicators are aggregated into one system index. A nature-based sewerage system is compared to a conventional system. The article demonstrates that the method used to normalize the indicators, the choice of relevant indicators and the weighting technique have considerable influence on which system is found to be the more sustainable.     

Relationships among multiple aspects of agriculture's environmental impact and productivity: a meta‐analysis to guide sustainable agriculture

Given the pressures on land to produce ever more food, doing it ‘sustainably’ is growing in importance. However, ‘sustainable agriculture’ is complex to define, not least because agriculture impacts in many different ways and it is not clear how different aspects of sustainability may be in synergy or trade off against each other. We conducted a meta‐analysis to assess the relationships between multiple measures of sustainability using novel analytical methods, based around defining the efficiency frontier in the relationship between variables, as well as using correlation analysis. We define 20 grouped variables of agriculture's impact (e.g. on soil, greenhouse gas, water, biodiversity) and find evidence of both strong positive and negative correlations between them. Analysis based on the efficiency frontier suggests that trade‐offs can be ‘softened’ by exploiting the natural between‐study variation that arises from a combination of farming best practice and context. Nonetheless, the literature provides strong evidence of the relationship between yields and the negative externalities created by farming across a range of measures.