Online Program

Oral

Today there is an ecological turn under way in the study of how health manifests itself in both the social environment and the natural environment. A social ecology perspective transforms the individualistic view of health that has largely predominated in medicine, health systems and health law in the past. Human beings experience the benefits of good health and face the risk of illness and disease as members of interlinked social and biotic communities. In partial recognition of this, public health research and practice today are focusing on the notion of choice architecture to influence individual health-related behavior. That shows contextual or ecological recognition, but it is not enough. We need, through the influence of normative vision in ethics, the law, and governance, to choose a health architecture for whole communities that is effective, equitable, and sustainable. There is a growing awareness within public health of environmental factors systemically defined. Consider for example the health effects of global climate change, a process that involves much more than atmospheric carbon dioxide “pollution.” Research on the role of the microbiome in human health, and the rapidly growing understanding of the human genome and eipgenome are reconceptualizing our understanding of the biology of the human organism. As the understanding of health moves away from an individualistic perspective in which both the social-cultural environment and the biotic environment are understood as an instrumental backdrop for human health, public health values, ethical concepts, and legal norms will be affected. Coming to the fore is a different, relational perspective in which social and natural factors are interrelated in an ecological web of constitutive factors from which human behavior and health emerge. A focus of this special session will be on the way the ecological perspective on health leads to a the convergence among bioethics, public health ethics and law, and environmental ethics. Ecological public health shifts the stage and field of justice, ethical agency and responsibility. If the conditions that undermine human and ecological health are interdependent, and if the conditions that promote health are systemic, institutional, and fundamentally global in scale, then an ethical response to these conditions cannot be focused on individual behaviors operating on local or small regional scales. Ethical theory is only beginning to develop systematic and global accounts of justice, cosmopolitan rights, and intergenerational obligations. Governance and law are also struggling and in need of guidance in this regard. The field and profession of public health must be at the forefront of this learning dialogue. Public health ethics—in tandem with bioethics, health law, and environmental ethics—can contribute to and draw from this emerging new ecological perspective on health.

Session Objectives: Participants will be able to discuss and explain an ecological approach to building the public health capacities of communities, integrating health and social care systems, and assuring equitable access to a full continuum of services and supports to all Americans from cradle to grave. Participants will be able to identify and assess the key barriers to implementation of integrated care systems and equitable access to care. Participants will be able to analyze ethical issues of global health and justice, and balancing of rights and care in civil society within contexts of community, culture and scarce resources.

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH)