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What is Planetary Health?

#thisisplanetaryhealth

an image of vermont mountains at sunset with a globe icon superimposed over it

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The planet is alive. This ecstatic skin of the Earth that stretches but a few miles up and down is teeming with critters, plants, fungi, protists and bacteria. We don't just live on the planet, we live because of it. We're creatures, very smart apes, whose blood and breath and food exist as a result of the Earth's vast, generative biogeochemical power. No wonder, then, that planetary health may be difficult to comprehend. It's a kind of self-knowledge, and, as any teacher or parent knows, self-knowledge is hard won. But it's also existentially important.

It makes sense, then, that the University of Vermont, led by interim president Patty Prelock, is making a bold and institution-wide commitment to the difficult but hopeful work of studying and understanding the principles of planetary health-and to lead in finding solutions to protect and restore it.

Following conversations and planning over the last few years and especially this spring, the formal launch of the university's planetary health initiative will happen October 16-17, 2024. Hosted by the Osher Center for Integrative Health at the University of Vermont, the UVM Planetary Health Summit: Whole Health for People and Planet will gather researchers, educators, and clinicians across disciplines to share, discuss, and explore opportunities to find new pathways back to health for people and planet.

But you would not be alone is asking, "what, really, is planetary health? What does it have to do with me? And could you please give an example or two that brings this high-minded idea, um, back down to Earth?" UVM science writer Joshua Brown asked a range of faculty across campus these same questions. Here are some small samples from their answers, edited and condensed for length and clarity.

Sara Helms Cahan

Associate Vice President for Research
Associate Professor of Biology

The planetary health framework is trying to understand how nature affects you, how all the ways that having natural environments on this planet impact us, impact our quality of life, impact our health, impact our food, impact our ability to live and play and work and do so in a way where we can enjoy life to the fullest.

"One Health" is also a framework. It came out of veterinary schools which were seeing the same patterns of disease incidents and transmission in animals as we see in humans and recognizing that similarity. So they said, "oh, we can integrate between animal and human health." That interaction is one piece of planetary health. But planetary health, for example, is also about the interactions of the soil biodiversity on our food supply and the nutritional characteristics of fruits and vegetables. When you get an environmentally degraded field, you get crops that are lower in nutrients and thus provide lower nutrition to the people who eat them. That's another way that human health is impacted, but it doesn't have anything to do with animals and disease.

We often think about research as occurring in different disciplines. I study biology, somebody else studies history, somebody else studies water. But considering planetary health forces us to see how they are connected. And trying to solve problems of planetary health forces us to collaborate with others who do things that are different from us. You can't-alone-get at the questions raised by thinking about planetary health. The environment and human health intersect, so if you want to work in the planetary health framework, you can't just study liver disease or cancer. You have to reach out to people who study why those contaminants that lead to that cancer end up exposing people in particular settings.

The new planetary health initiative here at UVM is a catalyst that encourages people to think bigger than themselves, bigger than their disciplines, aiming to address the challenges that we are all facing that we won't otherwise be able to solve.

Brendan Fisher

Director of UVM's Environmental Program
Professor, Rubenstein School of Environment and Natural Resources

A few years ago, we gathered MDs and public health experts and hydrologists, ecologists, economists, demographers anthropologists all together in a room to ask questions of a database we assembled with 800,000 children represented across 49 of the poorest countries on Earth. This database has about 400 variables including climate, precipitation, heat stress, and environmental variables such as biodiversity, deforestation, forest cover, how many cows are on the landscape, economic data, education data of the household, how much education the household heads received, and then health data, like malaria and anemia and childhood stunting.

And the big headline results-when we controlled for everything we could and modeled in different ways-was that forest cover and healthy forest in the watershed reduced diarrheal disease, the number two cause of mortality of children under the age five on Earth; it increased dietary diversity, a key indicator in the first 60 months of life of long-term health outcomes; it reduced childhood stunting significantly; and reduced incidents of malaria. Typically it was the poorest, the most rural, and those with the least access to other goods and capital that really received the benefit of a well-functioning ecosystem. That's just one example of the links between the protection, conversion and management of ecosystems-and human health.

Walter Poleman

Senior Lecturer, Rubenstein School of Environment and Natural Resources
Director, Field Naturalist Graduate Program, Plant Biology Department

Human flourishing and ecological flourishing need to go together. Our wellbeing on all levels, whether it's healthy food, a livable climate, connection with the more-than-human world, or clean water-it all depends on intact flourishing ecosystems. If we don't have that, we are screwed. It's a huge lesson we're learning right now: our investment in the natural systems that we are a part of is essential to our own survival. A major barometer of planetary health is biodiversity. We've exceeded our planet's limits for what lets animals and plants and other organisms thrive-so the diversity of life is tanking and collapsing. You don't necessarily feel that. I was up on Jay Peak and I was thinking, "man, this is beautifully intact. It's nature everywhere." But then the wildfires were off in the distance. The forests were burning. We can get lulled into a sense that nature is intact.

The work that I do is place-based-places are geographic settings where nature and culture intertwine and unfold over time. Thought about this way, it's clear that we're in relationship with the world, and so the more we attend to the flourishing of others, of the rest of life, the more we flourish. Right now we have an endothermic relationship with the planet, sucking things out of it, rather than the synergy that can come when our own flourishing is aligned with that of the larger system. Ecosystem restoration and cultural restoration go together.

Lizzy Pope

Associate Professor, Department of Nutrition and Food Sciences
Director, Didactic Program in Dietetics

Marrying environmental health with human health is at the core of planetary heath. I feel like almost anything can relate to planetary health because most of us are trying to make the world better in some way with our work. But there are questions about equity that aren't easily answered just by looking at the two words, "planetary health." Looking into it more deeply has, in some ways, made me more puzzled.

My work focuses on looking at nutrition differently-in a way where everyone can achieve health if they choose. But health is not a mandate. Even if you choose not to pursue health or you can't pursue health, you still are given respect and care and value. In some ways, I see my work dovetailing with the principles of planetary health. In other ways, I'm concerned that "planetary health" becomes the "planetary health diet." That goal is in direct conflict with the aim of my work which is to not prescribe specific diets. Instead, I want people to eat in a way that is intuitive for their own goals and not as a response to the outside pressures of diet culture. My work is to deconstruct diet culture. Last week, I saw a big publication on planetary health diets. It was troubling. I get concerned when I see prescriptive claims: "don't eat this, don't eat that. You're killing the planet." Instead let's ask: how are companies incentivized to produce safe, wholesome food?-versus telling the individual, "Stop eating all of these things," or "Be scared of all these foods."

Christine Vatovec

Clinical Assistant Professor, Larner College of Medicine at UVM
Assistant Research Professor, Rubenstein School of Environment and Natural Resources
Research Affiliate, College of Nursing and Health Sciences

There's lots of different places thinking about the meaning and value of planetary health-Johns Hopkins, Harvard, the Planetary Health Alliance, the Rockefeller Foundation, the United Nations. All of their definitions come down to this: the health of humans is dependent upon the health of the planet. And that this is a reciprocal relationship, that the health of humans also determines the health of the planet.

That's where my perspective comes from, that reciprocal relationship-which is based in indigenous wisdom and traditional ecological knowledge. If we look to cultures that have a robust and sustainable relationship between humans and the natural environment we see the roots of the planetary health concept. The academic world is, finally, trying to catch up, bringing that perspective in and acknowledging that it's important.

Imagine a series of circles, getting bigger and bigger. Start with one person in the smallest little circle, that's the view of conventional healthcare. Then go out to environmental health, which is public health. And then move out from there into realms of global health, which is health equity around the globe for all people. Then you get to "One Health," and that's a view of the connection between humans, environment and animals, both domestic and wild.

And then planetary health is the biggest circle. You'll find different people saying different things, but to me it's a measure of how healthy the planet is-in its systems. Some environmental scientists have described nine planetary systems-climate is the most commonly talked about, but biodiversity is another. These systems determine whether the planet as a system itself can be stable. In some medical literature, people have written about the planet as the patient. If we had to take the heartbeat of the planet, how's it doing right now? How is the climate system? Ooh, we're reaching some tipping points here. How's atmospheric aerosol loading? Ooh, we're putting a lot of particulate matter into the atmosphere. So the patient, Earth, is not doing well, and what can we do to help solve that?

I study healthcare. The healthcare system causes about 8.5% of our national greenhouse gas emissions. I have come to think that if people were truly healthy-physically, mentally, and spiritually-if we had healthy community, if we had healthy relationship with the places where we live, then we would not be causing these harms to the planet. So that's my litmus test: is there anything that I am working on where the trajectory will lead to better health outcomes for people that also have a better outcome for the planet?

One example is this new collaboration between UVM, Dartmouth, and Maine Health where we are looking at climate-informed healthcare in primary care. We want to know what residents of Vermont, New Hampshire and Maine experience in terms of climate impacts on their health. Flooding, anxiety, respiratory illness-the list is long. And then how can we use that information to inform our primary care providers so that they can help people respond to their climate-related health needs in a way that doesn't further the problem by increasing carbon emissions from the healthcare system?

Polly Ericksen

Director, UVM Food Systems Research Center
Research Professor, Community Development and Applied Economics

In the 1990s, as people developed a deeper understanding of the cyclical nature of ecosystems-all the stuff that we understand now about how climate change works and how greenhouse gas emissions cause global warming-we began to think more about feedback loops. And that's an important part of what led people to think about this concept of planetary health and that human health is intrinsically linked to ecosystem health.

Studying agriculture and food systems is a really nice entry point for that because a lot of the modification that humans do of our ecosystems is to grow food. We understand that food can have both positive and negative impacts on our ecosystems, but also food is something that we engage with to be healthy ourselves. We've gained a lot of understanding in the last 20 years about how our food choices are not necessarily great for human health outcomes or for ecosystems.

When I was an environmental researcher trying to explain to epidemiologists that ecosystems were more than just a vector-they're a little more complicated than a mosquito which is a vector for dengue or malaria! And they were like, "oh, wow, that's so interesting. We're experts in understanding how diseases and hosts work with human bodies and all that stuff." And I was like, "well, think of the ecosystem as something equally complicated."

Planetary health is this broad understanding that humans have an outsized impact on the health of our planet. It's accepting accountability for that. And it's recognizing the boundaries of key services-like clean water-that we need from our planet. It's the awareness that if we degrade our environment and our climate-regulating services beyond a certain point, it's going to mean that we can't live on this planet anymore.

Here at UVM, we have a medical school and we do a lot of research on human health. If we can see more clearly how human health is connected to environmental health, and if we can try to be integrative, we'll come up with more creative, encompassing and systemic solutions. Although it's complicated to understand that everything's connected to everything, it also allows you to be more innovative about those solutions dealing with root causes, not symptoms.

Ilyse R. Morgenstein Fuerst

Director, UVM Humanities Center
Associate Professor of Religion

The UVM Humanities Center sponsors faculty directly working on issues of health and medical humanities, climate crisis, and the inequities that follow planetary health concerns. We have a theme this year-"justice/injustice"-and as part of that, we have two major events: our first is on October 8, when Vermont-based award-winning author Kekla Magoon will be on campus for a day of learning around her most recent book, Revolution in Our Time, a history of the Black Panther party and their environmental, racial, and economic activism. The second big-ticket, day-long event is planned for the week of March 17, 2025. Humanities Center board member Charles-Louis Morand-Métivier, Professor of French in UVM's School of World Languages and Cultures is spearheading bringing John P. Walsh, an expert on Francophone literature, Haiti, and environmental humanities to campus to discuss his recent book, Migration and Refuge: An Eco-Archive of Haitian Literature, 1982-2017. His work is about migration, literature, climate change, and indigenous knowledges.

The Center also has research grants out for faculty working on issues directly and indirectly related to planetary health: Thomas Borchert and Vicki Brennan, professors in religion, are Public Humanities Grant scholars this year, and they are working on a set of projects about Vermont, religion, spirituality, and land; Sarah Osten, professor of history, is the primary investigator for a Coor Collaborative Fellowship centered on migration justice, which directly attends to refugeeism, including climate refugees; Jenn Karson, a faculty member in Art & Art History is leading a multidisciplinary research grant about virtual reality and the environmental humanities.

Taylor Ricketts

Director, UVM's Gund Institute for Environment
Professor, Rubenstein School of Environment and Natural Resources

For years, I've been asked, "wait, what's planetary health?" People project themselves onto it; it can mean anything to anybody. So I've been advocating we just have a hashtag #thisisplanetaryhealth. "Hey, look that-that is what I mean by planetary health." I keep sending our planetary health group papers or news stories with nothing but that hashtag as the subject line. We're building up our understanding empirically: it's that and it's that and it's that.

I think planetary health is the realization that the natural world is important in supporting our physical and mental health and that changing the planet-global change, climate change, land use change, changing chemical flows-is changing our health in measurable, demonstrable, important ways.

I have defined health in a way that a doctor would recognize because that is what I think is powerful: to actually have "planetary health" become a mainstream concept in the medical establishment. Other people have taken planetary health to mean what I consider "sustainability." What I think is uniquely powerful is this handshake between ecology and environmental science with public health. I mean the formal profession of public health, connecting to the terms and problems that public health people already think about.

What is the influence of changing nature on changing health outcomes that we can measure and that public health people measure and worry about every day? Every time we've looked, we've found that forests improve children's health across lots of outcomes, from malaria to diarrhea to diet diversity to stunting. More forest is less disease. [See Brendan Fisher, above]. To me, that means that nature conservation is a viable, legit public health investment just like a bed net or water purification technology. It's green versus gray. And it's not a tiny effect. It's not an interesting little academic finding. The impact of conservation on health outcomes is as strong as the impact of projects that the Gates Foundation and USAID are spending billions on every year. We're missing opportunities to improve health through nature conservation.

I've spent almost twenty years estimating the economic benefits of nature to people, like the financial value of crop pollination in blueberries, or reduced damages from floods from protecting wetlands-all measured in dollars. Planetary health is a shift away from monetizing everything towards another measure of human wellbeing-that feels more authentic and personal-which is your health. There's a lot of blowback about commodifying nature, like, "oh, great, it's only important if we can make it worth a lot of money?" And many developing countries simply don't have $4 trillion. But one thing leaders are keenly interested in, always, is the health of their citizens. And so working on planetary health to me has been an evolution of the outcome variable, essentially from dollars to avoided deaths or avoided sickness. The logic is the same: nature is supporting people. And if we destroy ecosystems, they stop doing that.

My dream is that doctors and public health officials recognize nature as a huge force on people's health in all the ways that those doctors and public health officials are already defining and working on human health. It should be a mainstream driver of health, but it's not considered one. The win is if the medical establishment realizes nature is just as important as prescriptions.

Katherine Shepherd

Dean, College of Education and Social Services

Without effective education, it's hard for me to imagine healthy societies and, in turn, healthy environments. So, in important ways, planetary health is an extension of the core work of the College of Education and Social Services. How do we prepare professionals to be in a world where we understand that reciprocal relationship between health and the environment? As we think holistically about what education and social services means, we can see how planetary health is a natural fit for that. For example, we have people in social work studying climate grief, and there's a whole group that's focused on the environment and sustainability as part of social work.

Spending time in nature outdoors, being part of the environment, has been demonstrated to improve human health. The way we teach kids, and the way we deliver social and mental health services, can really contribute to that. On the other hand, thinking about children in schools, learning about the environment and climate change, we know that creates a lot of stress. So how do we educate kids in a way that builds their awareness and their desire to take action-without overwhelming them? How can professionals in counseling and social work potentially help us work through that?

Another example, at the undergrad level, we have a place-based education certificate and at the graduate level we have an Education for Sustainability graduate certificate. I'm always a believer that if you take care of the place where you are, you're going to probably have a stronger desire to take care of the whole planet. That just makes a lot of sense to me.

Solving the woes of the planet, it has to come from everywhere. It is going to be technology and education and people being willing to make lifestyle changes, people being supported to make lifestyle changes. And certainly policies too. Finding planetary health is a super complex problem. It's going to require complex solutions. And that's why, at this university, we need people, students and faculty and staff who can think across disciplines about: how do we solve this complex problem? We're not going to solve it alone.