Abstract
Humanity is both an animal species that evolved within and is dependent upon natural ecosystems and a social animal that exists within the social systems we have created. Our health is dependent upon both these systems — natural and social — functioning well, and indeed upon their interactions. Yet our approach to improving the health of the population over the past few decades has been largely, if not exclusively, focused on the social determinants of health. A recent Canadian Public Health Association (CPHA) Discussion Document and the technical report on which it is based seek to strike a more balanced approach. First, they document the dramatic and rapid global ecological changes that humans have created and argue that they are a significant threat to the health of the population in the 21st century. Second, they identify the underlying social, cultural and economic forces that are driving these changes. Third, they argue that we need to take an eco-social approach in population health promotion, recognizing the interactions between the ecological and social determinants of health. Such an approach could be considered to be ’Population health promotion 2.0’, and it has profound implications for the practice of public health.
Key words: Health promotion, ecosystem, ecological and environmental phenomena, social determinants of health
Résumé
L’humanité est à la fois une espèce animale qui a évolué dans des écosystèmes naturels et qui en dépend et un animal social qui vit dans des systèmes sociaux que nous avons créés. Notre santé dépend du bon fonctionnement de ces systèmes naturels et sociaux et de leur interaction. Pourtant, notre démarche pour améliorer la santé de la population des dernières décennies a été axée largement, voire exclusivement, sur les déterminants sociaux de la santé.
Un récent document de travail de l’Association canadienne de santé publique et le rapport technique sur lequel il est fondé tentent de trouver une démarche mieux équilibrée. D’abord, ils documentent les changements écologiques dramatiques et rapides que les hommes ont suscités et affirment qu’ils sont une importante menace pour la santé de la population au 21e siècle. Ensuite, ils cernent les forces sociales, culturelles et économiques sous-jacentes qui suscitent ces changements. Enfin, ils avancent que nous devons adopter une démarche écosociale dans la promotion de la santé de la population en reconnaissant les interactions entre ses déterminants écologiques et sociaux. Une telle démarche pourrait être considérée comme la „promotion de la santé de la population 2.0” et aurait de profondes répercussions sur la pratique de la santé publique.
Mots Clés: promotion de la santé, écosystème, phénomènes écologiques et environnementaux, déterminants sociaux de la santé
Footnotes
Conflict of Interest: None, but was lead author and editor for the Canadian Public Health Association reports discussed in this commentary.
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