SNAPP: Ecological levers for health: Advancing a priority agenda for disease ecology and planetary health in the 21st century

Our children's and grandchildren's health depends on wise stewardship of natural ecosystems. But even as evidence amasses for links between human health and environmental change, we lack actionable solutions. The UN’s Sustainable Development Goals and a new scientific movement, “Planetary Health,” are drawing attention to these issues and raising questions about how habitable climate, clean water, fiber, fuel, and natural products, among other services and subsidies, relates to human health. Whereas past efforts have promoted the concept, objective scientific evaluation is lacking. Here, we aim to identify ecological “levers for health.” That is, actionable ecological/environmental drivers that lead to win-win outcomes for people and nature. For instance, some of us analyzed historical global health outcomes of various strategies for controlling human schistosomiasis, finding that ecological levers have been more effective than direct health interventions (Sokolow et al. in press [1]). To expand this effort, we propose to convene several working groups to analyze existing data on additional disease-environment systems (a goal to identify up to 10) for which evidence exists and opportunities are present to intervene through “ecological levers for health” at a local or regional level. We will also put these concrete examples in context and synthesize how they can advance a “Planetary Health” agenda for the 21st century. Lastly, a key ingredient to moving this field forward is to identify common metrics to report outcomes for health, society, and the environment. We will bring together a cross-disciplinary team to develop candidate metrics to measure health, environment, and economic outcomes in common or comparable currency.