Transdisciplinary Research Priorities for Human and Planetary Health in the Context of the 2030 Agenda for Sustainable Development

Planetary health and its relevance in the modern era: A topical review

Planetary health is a relatively new concept that has gained traction in recent years due to the urgent need to address the health of our planet and its inhabitants. It refers to the interdependent health of both humans and the environment, recognizing that the two are inseparable and that the health of one is intricately linked to the health of the other. This article aims to advocate changes in how health care for both the environment and humans is envisaged, and aligned with sustainable development goals using ethically sound, solution-oriented, and practical approaches to education. Rapid industrialization, urbanization, and population growth led to environmental degradation and climate change in this era. These factors have profound implications for human health, with the World Health Organization estimating that 23% of global deaths are linked to environmental factors. Climate change and extreme weather events are exacerbating existing health problems. Air pollution, water pollution, and toxic chemicals are additional environmental factors that add to it and lead to health issues, including non-communicable diseases and death. A collaborative and interdisciplinary approach is needed to address planetary health challenges, including working across sectors and investing in research to understand better the complex interactions between human health and the environment. By promoting sustainable development and protecting the planet's health and inhabitants, we can ensure a healthy future for generations.

Climate Change Adaptation Methods for Public Health Prevention in Australia: an Integrative Review

PURPOSE OF REVIEW

Climate change poses a serious threat to human health and well-being. Australia is not immune to the public health impacts and continues to be underprepared, putting the population health at risk. However, there is a dearth in knowledge about how the Australian public health system will address the impacts of climate change.

RECENT FINDINGS

This integrative review synthesises tools, frameworks, and guidance material suitable for climate change adaptation from a preventive public health perspective. The literature search was conducted in electronic databases MEDLINE, PubMed, CINAHL, and Web of Science. Of 4507 articles identified, 19 articles met the inclusion criteria that focused on operational methods in public health and excluded the clinical context and reactive disaster response approaches. This review revealed that Australia is ill-prepared to manage climate change adverse health impacts due to ineffective adaptation strategies. The review highlights that Australia urgently requires effective adaptation strategies such as undertaking a National Adaptation Plan process and an improved understanding in managing complex health risks. Taking this action will strengthen the public health system and build health resilience especially for vulnerable populations. These findings will help understand and develop of the necessary adaptive strategies in Australia.

Incorporating biodiversity responses to land use change scenarios for preventing emerging zoonotic diseases in areas of unknown host-pathogen interactions

The need to reconcile food production, the safeguarding of nature, and the protection of public health is imperative in a world of continuing global change, particularly in the context of risks of emerging zoonotic disease (EZD). In this paper, we explored potential land use strategies to reduce EZD risks using a landscape approach. We focused on strategies for cases where the dynamics of pathogen transmission among species were poorly known and the ideas of "land-use induced spillover" and "landscape immunity" could be used very broadly. We first modeled three different land-use change scenarios in a region of transition between the Cerrado and the Atlantic Forest biodiversity hotspots. The land-use strategies used to build our scenarios reflected different proportions of native vegetation cover, as a proxy of habitat availability. We then evaluated the effects of the proportion of native vegetation cover on the occupancy probability of a group of mammal species and analyzed how the different land-use scenarios might affect the distribution of species in the landscape and thus the risk of EZD. We demonstrate that these approaches can help identify potential future EZD risks, and can thus be used as decision-making tools by stakeholders, with direct implications for improving both environmental and socio-economic outcomes.

Planetary Health: Preparing Nursing Students for the Future

BACKGROUND

Climate change around the globe is impacting human and planetary health at unprecedented rates. Nurses are well positioned to act as climate leaders, given their critical role globally.

PROBLEM

Current and future nurses must work to mitigate climate-related health effects. It is necessary that a planetary health approach is integrated into nursing education.

APPROACH

Curricular modifications, using the Planetary Health Education Framework, are presented, which will promote awareness and understanding of climate health among future nurses. The framework is grounded in equity, which is well suited to nursing education, and can be readily adapted into current nursing curricula.

OUTCOMES

Recommendations for nursing education are presented within the 5 domains of the framework.

CONCLUSIONS

Future nurses are called on to be exemplary planetary health communicators, educators, advocates, and leaders. The Planetary Health Education Framework promotes nursing leadership in practice and in advocating for a climate-resistant future.

Mathematical Model of the Spread of Hantavirus Infection

A mathematical epidemiological model incorporating the mobility of rodents and human groups among zones of less or major contact between them is presented. The hantavirus infection dynamics is expressed using a model type SEIR (Susceptible-Exposed-Infectious-Removed), which incorporates the displacement of the rodent and the human, between the urban and rural sector, the latter being subdivided in populated and non-populated. The results show the impact that rodent or human displacement may have on the propagation of hantavirus infection. Human mobility is more significant than rodents in increasing the number of hantavirus infection cases. The results found may be used as a reference by the health authorities to develop more specific campaigns on the territorial dynamics of the rodent, attend to the mobility of humans in these territories, mainly agricultural and forestry workers, and strengthen control-prevention actions in the community, to prevent future outbreaks that are fatal.

Extramural US Federal Research Grants For Health Outcomes Associated With Climate Change Inadequate, Too Narrow In Focus

Climate change causes and exacerbates disease, creates and worsens health disparities, disrupts health care delivery, and imposes a significant disease burden in the US and globally. Critical knowledge gaps hinder an evidence-based response and are perpetuated by scarce federal research funds. We identified and described extramural US federal research funding (that is, grants provided to organizations and institutions outside of federal agencies) that both addressed health outcomes associated with climate change and was awarded between 2010 and 2020. During this eleven-year period, 102 grants met our criteria, totaling approximately $58.7 million, or approximately $5.3 million per year (2020 adjusted US dollars). Federal investments in climate change and health research during this period failed to address the breadth of climate-sensitive exposures, health outcomes, and impacts on vulnerable populations. Moving forward, in addition to increasing investment in climate and health research across all known hazards, critical attention should be placed on vulnerable populations and health equity. To achieve this, increased federal research coordination and cooperation are needed, as well as a mechanism to track this funding.

Determinants of Food Waste in Cluj-Napoca (Romania): A Community-Based System Dynamics Approach

This study identifies the most relevant causes of food waste according to the perceptions of key stakeholders in Cluj-Napoca, Romania. Community-Based System Dynamics (CBSD), a qualitative approach, was used to reveal the determinants of food waste. CBSD was intended to encourage the system thinking of participants in the field of food waste. Consequently, CBSD helped us map and visualize the role of each identified cause in the system and the nature of their interactions. For the present study, four categories of stakeholders were involved: consumers, public administration, food waste business, and the NGO sector involved in food waste reduction. The result of each modeling session was a loop diagram of the main food waste determinants. A common perception reflected within each stakeholder group was that food waste could be minimized through upstream actions. The participants highlighted pro-environmental knowledge, awareness, and values as the prerequisites for fighting food waste. It was found that the lack of education and awareness of food waste directly impacted food waste generation. In addition, the role of education was underlined by participants as a contributor to changing individual and household practices, such as overbuying. The lack of connection between consumers and the food production process, coupled with consumerist practices and the rejection of 'ugly food', contributed to the decrease in the overall value people attributed to food. Governmental intervention, through legislation, was indicated by the CBSD participants as being key to increasing societal awareness and shaping the behavior of food chain actors. We concluded that food waste is a 'wicked problem' and the interlocking of the economic, social, political, and environmental spheres and the multitude of stakeholders' interests, values, and perceptions should be considered in designing sustainable solutions to combat food waste. Finally, this research testifies to the importance of engaging with diverse panels of stakeholders who, through the multitude of opinions and perspectives on the causes of food waste, can further create knowledge about the most appropriate ways to combat the food waste phenomenon.

From reflection diaries to practical guidance for transdisciplinary research: learnings from a Kenyan air pollution project

Transdisciplinary research (TDR) approaches have been cited as essential for overcoming the intractable sustainability challenges that the world is currently facing, including air pollution, water management and climate change. However, such approaches can be difficult to undertake in practice and can consequently fail to add value. Therefore, examples of what works in practice (and what does not) are helpful to guide future research. In this study, we used a conceptual TDR framework as the basis to examine and evaluate the strengths and weaknesses of our approach in a project exploring air pollution in an informal settlement in Nairobi, Kenya. Reflection diaries exploring experiences of participation in the project were undertaken by the project team (comprising academic and community partners) at multiple time points throughout the project. These reflection diaries played an important role in evaluation and for providing space for team learning. Diaries were thematically coded according to the TDR framework to explore aspects of the project that worked well, and areas which presented challenges. We draw upon our reflections, and the extant literature, to make practical recommendations for researchers undertaking TDR projects in future. Recommendations focus on three key project stages (pre-funding, funded period, post-funding) and include; building the team in a way that includes all key stakeholders in relevant and appropriate roles, giving everyone sufficient time to work on the project, and ensuring regular and open communication. Building these recommendations into the design and delivery of transdisciplinary sustainability science projects will support progress towards achieving the Sustainable Development Goals (SDGs).

Supplementary Information

The online version contains supplementary material available at 10.1007/s11625-023-01317-0.

Worldwide Surveillance Actions and Initiatives of Drinking Water Quality: A Scoping Review

This study identified and mapped worldwide surveillance actions and initiatives of drinking water quality implemented by government agencies and public health services. The scoping review was conducted between July 2021 and August 2022 based on the Joanna Briggs Institute method. The search was performed in relevant databases and gray literature; 49 studies were retrieved. Quantitative variables were presented as absolute and relative frequencies, while qualitative variables were analyzed using the IRaMuTeQ software. The actions developed worldwide and their impacts and results generated four thematic classes: (1) assessment of coverage, accessibility, quantity, and drinking water quality in routine and emergency situations; (2) analysis of physical-chemical and microbiological parameters in public supply networks or alternative water supply solutions; (3) identification of household water contamination, communication, and education with the community; (4) and investigation of water-borne disease outbreaks. Preliminary results were shared with stakeholders to favor knowledge dissemination.

Planetary health and health education in Brazil: Facing inequalities

Brazil has the world's fifth-largest population and seventh-largest economy. However, it also has many inequalities, especially in health education, which impacts health sector services. Thus, this article aims to describe the situation of planetary health and health education in Brazil, identifying how current policies support the cause of planetary health. This study had a qualitative approach characterised as exploratory research based on an integrative review and documentary research. The results show that, in recent decades, there have been positive improvements to achieve collective and planetary health, which advocates empathy and pro-environmental and humanitarian attitudes. However, the pursuit of planetary health in Brazil is being influenced by various challenges, ranging from the need for a sound policy framework to provisions of education and training on planetary health. Based on the need to address these deficiencies, the paper suggests some measures which should be considered as part of efforts to realise the potential of planetary health in the fifth largest country in the world.

Planetary Health and Health Education in Brazil: Towards Better Trained Future Health Professionals

Brazil is Latin America's largest country and has a strong economy, but it is also characterised by many inequalities. These are very conspicuous in the health sector, particularly in health education, which is expected to modernise according to the planetary health (PH) perspective. This paper describes the health education scenario in Brazil and undertakes an analysis of the postgraduate health programmes and policies in place, identifying the extent to which these support the cause of PH. To achieve this goal, this paper deploys a bibliometric analysis to gain a better understanding of the research streams related to higher education and PH. In addition, it presents and discusses selected case studies in the field and cross-checks documents from the Brazilian Ministry of Education against five domains of PH in education. The results indicate that despite some progress to date and the fact that some programmes are in place, there is a perceived need for policies and efforts from education organisations towards connecting PH principles in the education of current and future health professionals.

Selected Research Issues of Urban Public Health

Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.

Setting the European environment and health research agenda -under-researched areas and solution-oriented research

BACKGROUND

The aim of the EU-funded HERA (health and environment research agenda) project is to set priorities for the future European research agenda in the environment, climate and health nexus. We report results from a European researcher's perspective and identify research areas that have been inadequately investigated to date.

METHODS

An online survey was completed by European researchers to assess, evaluate and visualise research gaps. These research gaps were identified for 21 predefined areas within 3 main categories: i) classical environment and health paradigm; ii) problem or sector-based research areas and approaches and iii) holistic research areas and concepts. All research gaps were then evaluated by expert groups with the pre-defined criteria and systematically summarized. For areas identified within the survey as under-reported, additional input was sought from a range of key selected experts. The EU project database Cordis was utilized to verify that these areas were under-researched.

RESULTS

Between May and July 2019, 318 respondents from 38 countries reported 624 research gaps. The main areas for attention identified were: urban environments; chemicals; and climate change, (combined n = 313 gaps). Biodiversity loss and health; transport, mobility, sustainable solutions and health; energy transition and health; waste and the circular economy and health; ethics and philosophy and health were areas that were acknowledged as under-researched (combined n = 27 gaps). These under-researched areas were identified as having certain commonalities, they: i) mostly fell in the category "problem or sector based approaches"; ii) they are essential for developing and implementing solutions; and iii) require trans-disciplinary and cross-sectoral collaboration.

CONCLUSIONS

Currently attention is given to topical and highly researched areas in environmental health. In contrast, this paper identifies key topics and approaches that are under-researched, yet, are critical for the implementation of the EU Green Deal, related strategies and action plans, and require further investigation and investment. The findings reveal the imperative to foster solutions-oriented, trans-disciplinary and participatory research and its implementation through changes in research funding and research structures.

Research Priorities of Applying Low-Cost PM2.5 Sensors in Southeast Asian Countries

The low-cost and easy-to-use nature of rapidly developed PM_2.5 sensors provide an opportunity to bring breakthroughs in PM_2.5 research to resource-limited countries in Southeast Asia (SEA). This review provides an evaluation of the currently available literature and identifies research priorities in applying low-cost sensors (LCS) in PM_2.5 environmental and health research in SEA. The research priority is an outcome of a series of participatory workshops under the umbrella of the International Global Atmospheric Chemistry Project–Monsoon Asia and Oceania Networking Group (IGAC–MANGO). A literature review and research prioritization are conducted with a transdisciplinary perspective of providing useful scientific evidence in assisting authorities in formulating targeted strategies to reduce severe PM_2.5 pollution and health risks in this region. The PM_2.5 research gaps that could be filled by LCS application are identified in five categories: source evaluation, especially for the distinctive sources in the SEA countries; hot spot investigation; peak exposure assessment; exposure–health evaluation on acute health impacts; and short-term standards. The affordability of LCS, methodology transferability, international collaboration, and stakeholder engagement are keys to success in such transdisciplinary PM_2.5 research. Unique contributions to the international science community and challenges with LCS application in PM_2.5 research in SEA are also discussed.

Building Resilient Cities: Climate Change and Health Interlinkages in the Planning of Public Spaces

Greenhouse gases emissions resulting from the combustion of fossil fuels are worsening air quality and affecting the climate system. While climate change impacts on meteorological variables affects air quality by altering the concentration and distribution of pollutants, air pollution significantly influences the climate, leading to negative impacts on human health. Due to the combination of high temperatures, air pollution, and high population density, cities are particularly vulnerable to climate change impacts. The planning and design of public spaces aimed at climate change mitigation and adaptation can result in multiple co-benefits for human health, while reducing social inequalities. To address the major research gaps in the communication between health and planning experts, and the lack of capacity among public sectors and policy makers, it is necessary to promote capacity building and knowledge sharing between the planning and health sectors. The purpose of this article is to develop preliminary recommendations for a process that allows a comprehensive assessment of the interlinkages between climate and health, social, environmental, and economic vulnerabilities, and the quality of the urban spaces, to support local governments, policymakers, and education institutions in making informed decisions for public spaces. The methods applied were a literature review and interviews with experts.

Searching for the Antioxidant, Anti-Inflammatory, and Neuroprotective Potential of Natural Food and Nutritional Supplements for Ocular Health in the Mediterranean Population

Adherence to a healthy diet offers a valuable intervention to compete against the increasing cases of ocular diseases worldwide, such as dry eye disorders, myopia progression, cataracts, glaucoma, diabetic retinopathy, or age macular degeneration. Certain amounts of micronutrients must be daily provided for proper functioning of the visual system, such as vitamins, carotenoids, trace metals and omega-3 fatty acids. Among natural foods, the following have to be considered for boosting eye/vision health: fish, meat, eggs, nuts, legumes, citrus fruits, nuts, leafy green vegetables, orange-colored fruits/vegetables, olives-olive oil, and dairy products. Nutritional supplements have received much attention as potential tools for managing chronic-degenerative ocular diseases. A systematic search of PubMed, Web of Science, hand-searched publications and historical archives were performed by the professionals involved in this study, to include peer-reviewed articles in which natural food, nutrient content, and its potential relationship with ocular health. Five ophthalmologists and two researchers collected the characteristics, quality and suitability of the above studies. Finally, 177 publications from 1983 to 2021 were enclosed, mainly related to natural food, Mediterranean diet (MedDiet) and nutraceutic supplementation. For the first time, original studies with broccoli and tigernut (chufa de Valencia) regarding the ocular surface dysfunction, macular degeneration, diabetic retinopathy and glaucoma were enclosed. These can add value to the diet, counteract nutritional defects, and help in the early stages, as well as in the course of ophthalmic pathologies. The main purpose of this review, enclosed in the Special Issue "Health Benefits and Nutritional Quality of Fruits, Nuts and Vegetables," is to identify directions for further research on the role of diet and nutrition in the eyes and vision, and the potential antioxidant, anti-inflammatory and neuroprotective effects of natural food (broccoli, saffron, tigernuts and walnuts), the Mediterranean Diet, and nutraceutic supplements that may supply a promising and highly affordable scenario for patients at risk of vision loss. This review work was designed and carried out by a multidisciplinary group involved in ophthalmology and ophthalmic research and especially in nutritional ophthalmology.

A Systems Understanding Underpins Actions at the Climate and Health Nexus

Multiple sectors—health and non-health—can determine the health and well-being of people and the condition of the socio-ecological environment on which it depends. At the climate and human health nexus, a systems-based understanding of climate change and health should inform all stages of the policy process from problem conceptualization to design, implementation, and evaluation. Such an understanding should guide countries, their partners, and donors to incorporate health in strategic climate actions based on how health is affected by, and plays a role in, the dynamic interactions across economic, environmental, and societal domains. A systems-based approach to sustainable development has been widely promoted but operationalizing it for project level and policy development and implementation has not been well articulated. Such an approach is especially valuable for informing how to address climate change and health together through policy actions which can achieve multiple, mutually reinforcing goals. This commentary article describes strategic steps including the complementary use of health impact assessment, quantification of health impacts, and linking climate and health actions to national and global policy processes to apply a systems-based approach for developing climate mitigation and adaptation actions with human health benefits.