Medicine in the Anthropocene at the Planetary Health Alliance Annual Meeting

This past weekend, I presented a poster of my doctoral research at the Planetary Health Alliance’s Inaugural Annual Meeting in Boston. Planetary health is a growing field[1] focused on “the health of the human civilization and the state of the natural systems on which it depends.”[2] The new paradigm draws on research from conservation medicine, ecological health, the one health movement, geo health, and studies of the Anthropocene to develop strategies for living healthily within the earth’s biophysical limits. As Samuel Myers, Senior Research Scientist at Harvard’s T.H. Chan School of Public Health and Director of the Planetary Health Alliance noted in his opening remarks, achieving planetary health will require a fundamental rethinking of the relationship between the human species and the earth’s environmental systems. This kind of change not only demands action at the level of public health policy, but must also use the power of social movements to change our culture from one that perpetuates ecological destruction to one that improves human health and ecosystem integrity in tandem. Natalie Linou, Policy Specialist at the United Nations Development Programme, captured the new field well when she described planetary health as an opportunity to connect the narratives surrounding social justice, environmental justice, and health equity.

My poster, titled “Human Health and Long-Term Social-Ecological Systems Change: Emerging Alternatives for Health in the Anthropocene”, introduced the theoretical framework that guides my doctoral research. Central to my approach is the notion that the age of economic growth is coming to an end, and that climate change, environmental destruction, and declining energy and material resources will transform the structure of health systems in the future. To deal with the mounting constraints that will limit the size and scope of formalized healthcare models, health and care activities will need to be increasingly grounded in systems of family and community reciprocity. In other words, we need to find ways to make it easier for people to look after one another, often on a voluntary, reciprocal basis. In an individualized capitalist society, the barriers to this kind of approach are high, but in a context of declining resources and energy use, the tables could turn quickly. To explore some of the alternatives that already exist in this space, my fieldwork will investigate social innovations including the Family Care System in Geel, Belgium, Care Farms in the Netherlands, and Community-Based Care in the Transition Movement.

The poster itself was a bit unusual. I recently defended my PhD dissertation proposal and finished up a pile of grading for my teaching assistantship. When it came time to prepare my poster, I felt like I needed a break from sitting in front of screens all day. I decided to make my poster out of fabric so that I could spend a few days making something with my hands. I figured out how to print onto canvas and embroidered details on all the diagrams. The crafted approach to an academic poster also reflects the kinds of social innovations that my research highlights as emerging alternatives for health in the Anthropocene. These are strategies that can operate in a context of significantly reduced materials and energy use. They are place-based and community-centric, and offer strong meaning frameworks for those who participate. Throughout the weekend, I had many conversations with researchers and practitioners affiliated with the Planetary Health Alliance who see the value in asking big anthropological questions about the future of health on our changing planet.

[1] The Planetary Health movement is supported by research institutions around the world including the Consortium for Advanced Research Training in Africa, the University of Edinburg, the London School of Hygiene and Medicine, the Oxford Martin School, the Cornell Atkinson Centre for a Sustainable Future, and the Health Network of the Future Earth initiative.

[2] The Lancet Planetary Health, 2017. “Welcome to The Lancet Planetary Health.” The Lancet Planetary Health 1 (1): p. e1.

Two Rivers

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My research is about how moving deeper into the Anthropocene will transform human health systems. It is also about practices (some long-standing, others newly emerging) that could offer practical alternative trajectories for health systems coming to terms with the ecological and social dynamics of a novel geological epoch. The Anthropocene is already marked by global warming, altered weather patterns, environmental decimation, energy and resource shortages, financial crises, and massive movements of populations, not only of humans, but of birds, wolves, ocean mammals, monarch butterflies, and disease vectors. Since 1950, the scale of growth in humanity’s economic sphere has burned enough fossil fuels to begin changing the patterns of the Earth’s seasons, of its landscapes, and of the less visible biophysical cycles that sustain life on this planet.

The growth of the economy has also fueled the expansion of human society. We now have more people, more cities, more roads, more electricity, more complicated technologies, more pharmaceutical drugs, and more scientific knowledge than at any other point in the long life of the Earth. We also have fewer species, less tropical rainforest, melting polar ice caps, and a smaller number of languages. The parts of the world that are not incorporated into an international division of labour are diminishing and the number of people with access to digital technologies is rising. In the Anthropocene, human economic, social, and political activities will determine the course of ecological change. It is an era of unprecedented global connectivity and social complexity. It is also a time of great fragility and vulnerability to crisis and nonlinear change. Together we each face global risks (climate change, nuclear disasters, pandemics), but lack the collective identifications and institutional mechanisms for a global-scale response.

Health systems in the Anthropocene are floating down two rivers. One is wide and rushing. It is the strong current of high technology, of novel gene therapies, nanomedicine, robotic surgical techniques, wearable tech, and pharmaceutical drugs. It is the medicine of an industrial capitalist, highly complex society; it cures individuals, extends the lifespan, and enshrines health as a human right. The other river is slow and deep. It is the age-old, innate human capacity to imbue life with meaning, to care for each other, and to heal with the pharmacopoeias of nature and human consciousness. It is the medicine of place-bound communities in a resource constrained world; it is embodied, ritualistic, invested with cultural significance, and is community-centric rather than individualized. In the Anthropocene, the two rivers meet.

Some references:

Baer, H. A., Singer, M., Susser, I. 2013. Medical Anthropology and the World System: Second Edition. Westport, CT: Praeger.

Beck, U. 2016. The Metamorphosis of the World. Cambridge: Polity Press.

Bednarz, D., Beavis, A. 2012. “Neoliberalism, degrowth and the fate of health systems.” Resilience.org. http://www.resilience.org/stories/2012-09-14/neoliberalism-degrowth-and-fate-health-systems

D’Alisa, G., Demaria, F., Kallis, G. 2014. Degrowth: A Vocabulary for a New Era. New York: Routledge.

Farmer, P.E. 1999. “Pathologies of power: Rethinking health and human rights. ” American Journal of Public Health 89(10): 1-11.

Greer, J. M. 2009. The Ecotechnic Future: Envisioning a post-peak world. Gabriola Island: New Society Publishers.

Harrison, M. 2004. Disease and the Modern World: 1500 to the Present Day. Cambridge: Polity Press.

Homer-Dixon, T. 2006. The Upside of down: Catastrophe, Creativity and the Renewal of Civilization. Toronto: Vintage Canada

Ophuls, W. 2011. Plato’s Revenge: Politics in the age of ecology. Cambridge, MA: The MIT Press.

Quilley, S. 2012. “System Innovation and a New ‘Great Transformation’: Re-Embedding Economic Life in the Context of ‘De-Growth.’” Journal of Social Entrepreneurship 3 (2): 206–29.

Quilley, S. 2015. “Navigating the anthropocene: Environmental politics and complexity in an era of limits.” In Economics for the Anthropocene.

Rockström, J., et al., 2009. “A safe operating space for humanity.” Nature. 461:472-475.

Singer, M. 2014. “Transcending ‘Ordinary Times Rules’ in Environmental Health: The Critical Challenge for Medical Anthropology.” Medical Anthropology 33(5): 367-372.

Steffen, W., Broadgate, W., Deutsch, L., Gaffney, O., Ludwig, C. 2015. “The Trajectory of the Anthropocene: The Great Acceleration.” The Anthropocene Review January.

Turner, V. 1977. The Ritual Process: Structure and Anti-Structure. New York: Cornell University Press.

Zalasiewicz, J., Williams, M., Steffen, W., Crutzen, P. 2010. “The New World of the Anthropocene.” Environmental Science & Technology 44 (7): 2228–2231.

This blog was also published on http://medicineintheanthropocene.tumblr.com

Medicine in the Anthropocene

medanthropocene

The world has entered a new geological epoch in which society is a dominant force of ecological change. Moving deeper into the Anthropocene will accelerate the metamorphosis of human health systems.

I study how medical systems are transforming in response to profound reorientations of global socio-ecological systems. My research looks beyond incremental changes to existing health care models toward more radical health system innovations. Around the world, people are searching for ways to secure long-term human and environmental wellbeing amid ecological crises and social upheavals accompanying the end of economic growth as an organizing principle for society. This blog is a place to collect ideas, stories, and emerging practices for medicine in the Anthropocene. In sharing early iterations of my research questions, theoretical orientation, and practical ideas for positive health system transitions, it is also a form of autoethnography tracking the research process.

I also post on medicineintheanthropocene.tumblr.com and Navigators of the Anthropocene.