Health Of Populations and Ecosystems (HOPE)

UK social science has led the way in establishing that people's health and lifestyles are shaped by their environments - by their family and community networks, their living and working conditions and the wider socioeconomic and cultural environment. This 'social determinants of health' (SDH) framework underpins global, national and local strategies to improve population health and reduce health inequalities.

However, the SDH framework rests on a very constrained view of the environment. In particular, the biophysical environment - the Earth's life supporting systems such as its soil and water systems, climate and biodiversity - is almost wholly absent, as it is from the wider swathes of social science research on health. The stability of the biophysical environment is implicitly assumed and therefore unacknowledged. In the face of accelerating global environmental change, and its increasingly adverse direct and indirect threats to human health, the SDH framework is becoming outmoded. The major driver of future population health will be environmental change. Future health inequalities, too, will be environmentally-driven and temporal; the disadvantaged majority are those yet to be born. Approaches to public health need to change radically and rapidly in response to these emerging challenges.

To achieve this transformation, new frameworks for population research and policy are urgently required. These need to encompass an understanding of the dynamics of the biophysical environment and how it affects, and is affected by, the social determinants of health that have, to date, been the focus of social science research.

In this project, we will exploit synergies in health and ecosystem research to catalyse the integration of the biophysical environment into population health research and policy. We will take two approaches to achieve this transformation.

Firstly, working closely with leaders from the policy and research communities, we will critically assess widely-used SDH and ecosystem health frameworks. We will focus on their conceptual building blocks (e.g. 'health', 'determinants' 'drivers'), causal structures and spatial/temporal scales. Our objective is to combine these frameworks to develop a new integrative framework, which is evidence-based and policy relevant and can therefore be used to inform new cross-sectoral policies linking public health and environmental sustainability.

Secondly, we will use individual behaviours as 'entry points' for policies to promote these twin policy goals. We will undertake exploratory research investigating the co-occurrence of health and environmental behaviours through a scoping review of existing studies and an analysis of the UK Household Longitudinal Study. We will supplement this with a further exploratory study focused on the ethical claims of future generations on whom the health threats of environmental change will disproportionately fall. We will commission a suite of questions in the ONS Opinions and Lifestyle Survey investigating the weight that people give to policies that promote their health relative to the health of future generations (their children and grandchildren).

The project will be informed by groups of research and policy leaders, drawn from senior representatives of key local organisations (e.g. Directors of Public Health), national bodies (e.g. Natural England, Natural Capital Committee, National Institute of Health Research, National Institute of Health and Clinical Excellence) and international programmes (e.g. WHO). Outputs from the project will be shared with the research leaders and policy leaders groups, and disseminated to the stakeholder community at national and regional level through an ambitious and innovative engagement programme.

Impact is integral to the transformative aim of the project: to initiate a transformation of research and policy at the intersection of population health and the biophysical environment.

To support these impacts, the project includes a proactive outreach programme, designed to highlight the biophysical environment as a fundamental determinant of health, and one critically affected by environmental and health-related behaviours. The main focus of the impact activities will be non-academic and, specifically, the UK policy community.

The impact activities will be coordinated on a day-to-day basis by Saskia Walcott and Susannah Randall, of Walcott Communications, who have extensive expertise in communicating social and health research to wider audiences. This includes working with the Wellcome Trust and the ESRC.

We will deliver a programme of presentations at health conferences/events at national and regional level (e.g. Midlands and south of England) to take advantage of the major policy shift of NHS responsibility to local authorities in April 2013. We will make use of the press and social media, together with mobile displays, articles in professional magazines and a commissioned film, to ensure two-way knowledge transfer with practitioners and other stakeholders groups and - importantly - win public support for joint approaches to population-ecosystem health to promote the health of future generations. These will be targeted at socio-demographic and policy groups with heightened sensitivity to children's health futures, and faciliated by the project's research and policy leaders groups.

Finally, we will exploit the academic relevance of the work by publishing in a broad range of peer-reviewed papers aimed at social and health scientists (e.g. British Medical Journal, Sociology of Health and Illness, Social Science and Medicine, Health Policy) and ecosystem scientists (Ecosystem Services, Environmental Health, Environmental Health Perspectives, EcoHealth), as well as taking opportunities to present our work at relevant international conferences.