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Introduction

Ecosystems form the foundation upon which society can survive and thrive, providing food, water, air, materials, and recreation. These connections between people and their environments are under stress from human-driven climate change, pollution, resource exploitation, and other actions that may have implications for public health. The integral connection between nature and human health is recognized and has been explored through different bodies of work, including many existing intellectual frameworks such as One Health,¹ Planetary Health,² ecosystem services, nature-based solutions, and others. Each of these frameworks has helped connect different elements related to the resilience of public health and ecological health systems. However, because of the breadth of this issue, many implications regarding public health are not well characterized. This has created a gap in understanding the interconnections between public health and ecosystem health systems and how ecosystem resiliency may affect public health.

WORKSHOP OBJECTIVES

To inform the development of a research agenda aimed at bridging the knowledge-to-action gap related to integrating public and ecological health to foster resilience, the National Academies of Sciences, Engineering, and Medicine (the National Academies) formed a planning committee to organize a workshop that brought together interdisciplinary researchers and practitioners from the public health, natural resource management, and environmental protection communities to exchange knowledge, discuss critical gaps in understanding and practice, and identify promising research that

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¹ The One Health High-Level Expert Panel defines One Health is “One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of humans, animals, plants and ecosystems. It recognizes the health of humans, domestic and wild animals, plants and the wider environment (including ecosystems) are closely linked and interdependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development.” See https://www.fao.org/3/cc2289en/cc2289en.pdf (accessed March 30, 2023).

² The Planetary Health Alliance defines Planetary Health as “a solutions-oriented, transdisciplinary field and social movement focused on analyzing and addressing the impacts of human disruptions to Earth’s natural systems on human health and all life on Earth.” See https://www.planetaryhealthalliance.org/planetary-health (accessed December 30, 2022).

could support the development of domestic and international policy and practice.³ The workshop explored the following areas:

• Current intellectual frameworks for integrating public health, natural resource management, and environmental protection research, policies, and practices to foster resilience in complex, interconnected systems, synergies among these frameworks, and consideration of how they may continue to evolve to reflect emerging understanding and priorities.
• Recent research results and emerging areas for future research advances, including research related to characterizing and quantifying the public health effects associated with conservation, natural resource management, and other environmental and land-use practices; metrics that incorporate public and ecological health outcomes, including consideration of equity; how financing influences public and ecological health outcomes; and public health and conservation communication.
• Efforts to integrate public and ecological health considerations in policy and practice, what has worked, and where have there been challenges.
• Identification of key elements of a knowledge-to-action research agenda for integrating public and ecological health to foster resilience in these interconnected systems.
• Discussion of how a research agenda could be advanced, including opportunities to build better connections between research communities, and between practitioner and policy maker or decision-maker communities, in advancing research and practice.

Day 1 of the workshop, held virtually on September 19, 2022, addressed the following question: What has been learned about how to integrate public health and nature into research, policy, and practice to foster resilience? Days 2 and 3, held virtually and in person at the National Academies in Washington, DC, on September 29 and 30, 2022, explored advancement opportunities in transdisciplinary and community-engaged scholarship to improve integration of public health and nature and inform policy and practice (Day 2), and opportunities to bridge the knowledge-to-action gap with strategies to translate knowledge into policy and practice (Day 3).

ORGANIZATION OF THE WORKSHOP PROCEEDINGS

In accordance with the policies of the National Academies, the workshop did not attempt to establish any conclusions or recommendations about needs and future directions, focusing instead on information presented, questions raised, and improvements suggested by individual workshop participants. Chapter 2 discusses the existing knowledge base regarding connections between nature and public health. Chapter 3 discusses how the interconnections between public health and nature are valued. Chapters 4, 5, and 6 discuss the challenges, gaps, and opportunities for moving from knowledge to action. Chapters 7 and 8 summarize the workshop’s discussions on crafting a research agenda to address existing knowledge gaps to inform action. Chapters 9 and 10 discuss approaches for overcoming the barriers to knowledge generation, integrating public health and nature, and informing policy and practice. Chapter 11 summarizes key points raised during the workshop, discusses the Biden-Harris Administration’s whole-of-government approach to valuing the connections between human and

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³ The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements and opinions expressed are those of individual presenters and participants and do not necessarily represent the view of all workshop participants, the planning committee, or the National Academies of Sciences, Engineering, and Medicine.

ecosystem health, and recounts the workshop’s final discussion on moving the field forward. Appendix A includes the statement of task, Appendix B provides biographical sketches of the planning committee members, and Appendix C includes the workshop agenda.

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