One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario

BMC Public Health

Karen Morrison²  Dean Middleton¹  Zee Leung¹ 

[1] Public Health Ontario, Toronto, Canada;Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Canada

关键词: Cross-sectoral partnerships;    Sustainability;    Governance;    EcoHealth;    One Health;    Public health practice;   

Others  :  1163617
DOI  :  10.1186/1471-2458-12-358

 received in 2012-01-24, accepted in 2012-05-16,  发布年份 2012

【 摘 要 】

Background

There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.

The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences.

Methods

Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns.

Results

Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields.

Conclusions

Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This study also highlights the critical role of governance and partnerships in facilitating a holistic approach to health. Further research on governance and partnership models, as well as systems-based organizational working practices, is needed to close the gap between One Health and EcoHealth theory and public health practice.

【 授权许可】

   
2012 Leung et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Veterinarians without Borders/Vétérinaires sans Frontières: One Health for One World: A Compendium of Case Studies. Veterinarians without Borders/Vétérinaires sans Frontières, Guelph; 2010.
• [2]: One Health Initiative. , :. [http://www.onehealthinitiative.com/mission.php]
• [3]Zinsstag J, Schelling E, Waltner-Toews D, Tanner M: From “one medicine” to “one health” and systemic approaches to health and well-being. Prev Vet Med 2010, 101(3–4):148-156.
• [4]: One World One Health. , :. [http://www.oneworldonehealth.org/]
• [5]Baker S: Sustainable Development. Routledge, New York; 2006.
• [6]Great Lakes Research Advisory Board: The ecosystem approach: scope and implications of an ecosystem approach to transboundary problems in the Great Lakes Basin. , ; 1978.
• [7]Olsson P, Folke C: Adaptive Comanagement for Building Resilience in Social–Ecological Systems. Environ Manage 2004, 34(1):75-90.
• [8]Waltner-Toews D, Kay J: The evolution of an ecosystem approach: the diamond schematic and an adaptive methodology for ecosystem sustainability and health. Ecol Soc 2005, 10(1):38.
• [9]Charron DF: Chapter 1: Ecohealth: Origins and Approach. In Ecohealth Research in Practice: Innovative Applications of an Ecosystem Approach to Health. Edited by Charron DF. Springer, New York; 2012:1-32.
• [10]: Ecosystems and Human Health. , :. [http://www.idrc.ca/EN/Programs/Agriculture_and_the_Environment/Ecosystem_Approaches_to_Human_Health/Pages/default.aspx]
• [11]Public Health Agency of Canada: One World One Health: from ideas to action. Report of the Expert Consultation. , ; . [http://www.phac-aspc.gc.ca/publicat/2009/er-rc/pdf/er-rc-eng.pdf]
• [12]FAO OIE WHO UNSIC UNICEF the World Bank: Contributing to One World, One Health - A Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems Interface. , ; . [http://un-influenza.org/files/OWOH_14Oct08.pdf]
• [13]Webb JC, Mergler D, Parkes MW, Saint-Charles J, Spiegel J, Waltner-Toews D, Yassi A, Woolard RF: Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health. Can J Public Health 2010, 101(6):439-441.
• [14]Rittel HW, Webber M: Dilemmas in a General Theory of Planning. Policy Sciences 1973, 4:155-169.
• [15]Ontario Ministry of Health and Long-Term Care Public Health Division: Ontario Public Health Standards. , Toronto; 2008.
• [16]: Health Protection and Promotion Act. , :. [http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_90h07_e.htm]
• [17]: Ontario Public Health Libraries Association. , :. [http://www.ophla.ca/customsearch.htm]
• [18]: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference. , New York; . 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. [http://www.who.int/governance/eb/who_constitution_en.pdf]
• [19]Waltner-Toews D, Kay JJ, Neudoerffer C, Gitau T: Perspective changes everything: managing ecosystems from the inside out. Front Ecol Environ 2003, 1:23-30.
• [20]Parkes MW, Morrison KE, Bunch MJ, Hallström LK, Neudoerffer RC, Venema HD, Waltner-Toews D: Towards integrated governance for water, health and social–ecological systems: The watershed governance prism. Glob Environ Change 2010, 20(4):693-704.
• [21]Centre for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases Division of High-Consequence Pathogens and Pathology: Operationalizing “One Health ”: A Policy Perspective - Taking Stock and Shaping an Implementation Roadmap. , ; . [http://www.cdc.gov/onehealth/pdf/atlanta/meeting-overview.pdf]
• [22]National Collaborating Centre for Healthy Public Policy Integrated Governance and Healthy Public Policy: Two Canadian Examples. , ; . [http://www.ncchpp.ca/docs/Integrated_governance_AN.pdf]
• [23]Ryan GE, Bernard HR: Data Management and Analysis Methods. In Handbook of Qualitative Research. 2nd edition. Edited by Denzin NK, Lincoln YS. Sage Publications, Thousand Oaks; 2000:769-802.