One planet regions: planetary health at the local level

One of the key lessons that can be learnt from the history of public health is that many major public health advances—from clean drinking water to tobacco control—have been led at the local level. As we enter the Anthropocene, and strive to embrace an ecosocial approach that can address the implications for population health of the global ecological changes humans are creating,1Hancock T Capon A Dietrich U Patrick R Governance for health in the Anthropocene.Int J Health Gov. 2016; 21: 245-262Crossref Scopus (8) Google Scholar once again much of the leadership and action will need to occur at the local level. This position does not deny the need for global-level action to address boundary-spanning issues such as climate change, ozone depletion, or persistent organic pollutants (three examples for which international agreements have recently been made). Unfortunately, such global-level action is usually time-consuming and fraught with difficulties. Meanwhile, local governments have often shown more commitment and been quicker to act.2Pancost R Cities lead on climate change.Nat Geosci. 2016; 9: 264-266Crossref Scopus (15) Google Scholar Earth's human population is now mostly urban, with almost 55% of people living in cities, a proportion expected to grow to 66% by 2050.3United Nations, Department of Economic and Social Affairs, Population DivisionWorld urbanization prospects: the 2014 revision (ST/ESA/SER.A/366). United Nations, Department of Economic and Social Affairs, Population Division, New York2015Google Scholar Cities produce about 80% of global gross domestic product,4UN HabitatUrbanization and development: emerging futures (world cities report 2016). UN Habitat, Nairobi2016Crossref Google Scholar and are responsible for more than 75% of natural resource consumption, 60–80% of energy consumption, and 75% of global carbon emissions.5Steiner A Foreword.in: Swilling M Robinson B Marvin S Hodson M. City-level decoupling: urban resource flows and the governance of infrastructure transitions. summary for policy makers. UNEP, Nairobi2013Crossref Google Scholar It can, therefore, be argued that the battle for planetary health will be won or lost in the world's cities. One way to understand the scale of human impact on the Earth is the ecological footprint (EF).6Wackernagel M Rees W Our ecological footprint: reducing human impact on the earth. New Society Publishers, Gabriola Island, BC; Philadelphia, PA1996Google Scholar Globally, the EF exceeded the Earth's biocapacity (put simply, the Earth's capacity to produce resources and ecological services) in about 1970, and as of 2012 had grown to 1·6 times that figure, even though in that period biocapacity itself grew slightly due to increased agricultural productivity.7WWF InternationalLiving planet report 2016.in: Risk and resilience in a new era. WWF International, Gland, Switzerland2016Google Scholar Moreover, high-income countries (HICs) required 6·2 global hectares per person in 2012, which was 3·6 times the available biocapacity of 1·7 global hectares per person.7WWF InternationalLiving planet report 2016.in: Risk and resilience in a new era. WWF International, Gland, Switzerland2016Google Scholar In other words, people living in HICs require, on average, 3–4 planet's worth of biocapacity to sustain present ways of living. Because this situation is unsustainable, we must learn to live on the one small planet that is our home, but in a way that also ensures a good quality of life, and a long and healthy life, for all. This predicament has led to the concept of so-called One Planet living, in which all individuals, communities, and nations have to abide by inherent resource constraints.7WWF InternationalLiving planet report 2016.in: Risk and resilience in a new era. WWF International, Gland, Switzerland2016Google Scholar, 8Bioregional, One planet living. http://www.bioregional.com/oneplanetliving/ (accessed March 25, 2017).Google Scholar The challenge is particularly hard for people living in HICs because of the need to reduce their ecological footprint by up to 75%. However, HICs have a responsibility and ethical duty to do just this for several reasons: they have become the model to which many people in many other countries aspire, and they take far more than their fair share of the Earth's resources and have done so for many decades, if not centuries. The transformation in societies, economies, and ways of life to achieve One Planet living represents a key 21st century population health challenge. International movements are already based on local approaches to these issues, such as Healthy Cities, Sustainable Cities, and the Transition Network, but effective co-ordination between and integration of health and sustainable development is frequently not prioritised.9Patrick R Dooris M Poland B Healthy cities and the transition movement: converging towards ecological well-being?.Glob Health Promot. 2016; 23: 90-93Crossref PubMed Scopus (10) Google Scholar Because of One Planet living's concern to address both life quality and wellbeing and the EF, it offers an integrative approach with the potential to release synergies at local and regional levels. Bioregional, a UK-based charity and social enterprise working around the world with developers and municipal governments, among others, created its One Planet Living initiative in 2003.8Bioregional, One planet living. http://www.bioregional.com/oneplanetliving/ (accessed March 25, 2017).Google Scholar Its ten One Planet Principles (panel) begin with health and happiness and also address other social concerns (eg, culture and community, equity and local economy) in addition to environmental and urban planning focus areas.PanelOne Planet Principles—ten principles for local and global sustainable livingHealth and happinessEncourage active, social, meaningful lives to promote good health and wellbeing.Equity and local economyCreate safe, equitable places to live and work, which support local prosperity and international fair trade.Culture and communityNurture local identity and heritage, empowering communities and promoting a culture of sustainable living.Land and natureProtect and restore land for the benefit of people and wildlife.Sustainable waterUse water efficiently, protecting local water resources and reducing flooding and drought.Local and sustainable foodPromote sustainable humane farming and healthy diets high in local, seasonal organic food and vegetable protein.Travel and transportReduce the need to travel and encourage walking, cycling, and low carbon transport.Materials and productsUse materials from sustainable sources and promote products and services that help people reduce consumption.Zero wasteReduce consumption, and reuse and recycle to achieve zero waste and zero pollution.Zero carbon energyMake buildings and manufacturing energy efficient and supply all energy with renewables.Reproduced with permission from 8Bioregional, One planet living. http://www.bioregional.com/oneplanetliving/ (accessed March 25, 2017).Google Scholar. Health and happiness Encourage active, social, meaningful lives to promote good health and wellbeing. Equity and local economy Create safe, equitable places to live and work, which support local prosperity and international fair trade. Culture and community Nurture local identity and heritage, empowering communities and promoting a culture of sustainable living. Land and nature Protect and restore land for the benefit of people and wildlife. Sustainable water Use water efficiently, protecting local water resources and reducing flooding and drought. Local and sustainable food Promote sustainable humane farming and healthy diets high in local, seasonal organic food and vegetable protein. Travel and transport Reduce the need to travel and encourage walking, cycling, and low carbon transport. Materials and products Use materials from sustainable sources and promote products and services that help people reduce consumption. Zero waste Reduce consumption, and reuse and recycle to achieve zero waste and zero pollution. Zero carbon energy Make buildings and manufacturing energy efficient and supply all energy with renewables. Reproduced with permission from 8Bioregional, One planet living. http://www.bioregional.com/oneplanetliving/ (accessed March 25, 2017).Google Scholar. There is also a pressing need to change the way societal and community progress is measured to more accurately reflect an ecosocial approach to health. We are thus interested in applying the Happy Planet Index (HPI) at a community as well as at a national level. The HPI, an innovative measure developed by the New Economics Foundation,10New Economics Foundation The happy planet index http://happyplanetindex.org (accessed March 25, 2017).Google Scholar measures precisely what population and planetary health is interested in: life quality (life expectancy × life satisfaction × equity factor) per unit of ecological footprint. Each of the authors is working locally to convene key partners and explore what our local regions would look like if they had an EF of One Planet and a high quality of life, using the HPI at a local level to assess progress. Our intent is that planetary health understanding informs local action in the interest of the health and wellbeing of future generations, which makes it a vitally important task for public health in the 21st century. We declare no competing interests.

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