Review

Thinking globally

HEALTH ECOLOGY: health, culture and human-environment interaction
M Honari & T Boleyn (eds)
Routledge, 1999

This is a book that is truly holistic in its approach and scale – and so rather overwhelming to read, even while it is a hugely valuable resource. As an edited collection, the chapters draw on local, regional, national and international perspectives and examples, with significant health policy figures such as Ilona Kickbusch and Nancy Milio contributing their analyses.

The particular strength of the book, and of the human ecological perspective it puts forward, is its genuine multi-disciplinarity, drawing on sociology, anthropology and geography, as well as public health and social policy. The chapters use examples from all over the world, and reinforce the global inter-relatedness of health status – reminding me of Michael Wilson’s dictum that ‘there is no health for me without my brother (sic). There is no health for Britain without Bangladesh’. As Zena Daysh says in the foreword, ‘health is a global affair – who would think of a state of health separated from the holistic sense that everything connects with everything?’

It is the recounting of these connections and their impact on peoples’ health which forms the content of the book. There is a wealth of information and ideas here, making a compelling argument for the need to create a healthy environment to advance global health. But there is a tension at times between the holistic philosophy which informs the ecological perspective of the editors, and the greater pragmatism of some contributions, detailing policies which hardly seem radical enough to bring about the visionary change required. Perhaps what is lacking here are activist approaches to health ecology, where the value of grassroots campaigns and popular understandings of what is needed to improve health might be recognised.

But this is a valuable resource to inform thinking on sustainable development, and for examining the reality of social justice and ‘healthy environments’. This is useful at the local level – what is going on in our own areas? where is health in LA21 planning? – as well as for thinking about global health impact assessments, our actions and behaviours, and the policies of our governments.