Published October 12, 2013 · Estimated reading time: 2 minutes · Filed under

Ecological public health: the 21st century’s big idea? (2012) by Tim Lang and Geof Rayner is a superb essay in the BMJ I read today and thought I’d share here. Three things really make it worth a read. First, it really lays out the necessity of better models for understanding public health issues and implementing public health policies. Particularly, the authors identify the “diminution of perspective” as an issue plaguing modern approaches to public health. Essentially, there is so much focus on technocratic solutions and approaches at the personal scale, that we are in a sense losing sight of the big picture and the larger context in which people’s health is embedded. Second, the article identifies the different approaches to public health clearly and beautifully, as you can see in this table. They discuss each of these approaches and their historical context in detail.

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Five Models of Public Health (Click for larger view)

Third, the article makes a compelling case for adopting ecological approaches to public health in the 21st century. The ecological model of public health is described as an integration of historical approaches to public health (i.e. sanitary environmental approaches) and modern approaches to public health (i.e. techno-economic). In the paragraph quoted below they really lay out the benefits of the ecological public health model (accompanied by a shoutout to Darwin/Wallace):

A strength of the ecological public health model is that it draws upon and integrates parts of the other models). Secondly, it articulates modern thinking about complexity and system dynamics, addressing, for example, questions of non-linearity, variations in scale, feedback, and other emergent qualities of nature, biology, and human behaviour. In the UK, we see some of such thinking in the government chief scientist’s Foresight programme. Thirdly, ecological public health seeks to build knowledge as a continual intellectual engagement. This means more than just evidence, and includes the open pursuit of social values, highlighting the role of interest groups, and debate across society not just within restricted scientific circles. Think Darwin and Wallace, Beveridge or Roosevelt: big thinking about the nature of life, good societies, order and change. Fourthly, it incorporates an evolutionary perspective, from matters like nutritional mismatch to questions of biological feedback. Fifthly, this is an overtly interdisciplinary and multi-actor model. It celebrates that public health requires action on multiple fronts and embraces the argument familiar in the 19th century that public health action requires a public health movement.

Great, brief article. Definitely worth a read.

Cited

Lang T, & Rayner G (2012). Ecological public health: the 21st century’s big idea? An essay by Tim Lang and Geof Rayner. BMJ (Clinical research ed.), 345 PMID: 22915666

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Permanent linkMarzieh Ghiasi


2 responses so far

  1. Just noticed this. Glad you liked it. Now read the book!

    Reply

    Marzieh Ghiasi Reply:

    Thanks for a great article! The book’s been on my to-read list for a long time, I certainly will. 🙂

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