What is public health? To some, it is about the infrastructure for
health -- drains, water, food, housing. These require engineering
and expert management. To others, it's about the State using
medicine or health education to prevent the public harming itself
through poor lifestyles. This book, part historical, part
prospective, argues that public health needs an overhaul. It should
return to and modernize itself around ecological principles.
Ecological public health thinking addresses what are described as
four levels of existence: the material, biological, social and
cognitive worlds. The long tradition of public health has always
been reactive, responding to and transforming the relationship
between people, their circumstances and the biological world of
nature and bodies. The authors show how twenty-first century public
health is being shaped by a number of long-term transitions, some
long recognized, others not. These transitions are demographic,
epidemiological, urban, energy, economic, nutrition, biological,
cultural and democracy itself. Facing them all is required if the
health of people and the planet are to be integrated.Ecological
public health thinking, the authors argue, has been marginalized
partly because it has lacked clear analysis, and partly because of
the scale and complexity of the issues which need to be addressed.
Public health thinking has partly lost its way because it has been
subsumed into the problems rather than championing solutions. Often
linked to the State, it has adapted to consumerism rather than
championing citizenship. Returning to ecological public health
requires stronger and more daring combinations of interdisciplinary
work, movements and professions, and a reinvigoration of
institutional purpose.
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