Special Topics: Planetary Health


Course Number
CHL8001H F3
Series
8000 (Special Topics)
Format
Seminar
Course Instructor(s)
Paula K.A. Braitstein, Ashley Aimone

Context: The world is changing fast. Globally, forests are disappearing, oceans are emptying, and droughts and floods are becoming more common, and more severe. Ever more people are moving to cities, many lying in coastal regions expected to be flooded over the next several decades due to rising ocean levels. It is estimated that at least a billion people may become malnourished by 2050 as a result of the desertification and food shortages expected to result from global climate change, mostly in low-income settings. World food production needs to double within the next 50 years but is threatened by an inadequate supply of fresh water, degraded soil, threats to fish and other ocean stocks. The 2015 high-level commission of the Rockefeller Foundation and The Lancet has drawn attention to the fact that the public health community in general is woefully unprepared for tackling the challenges of a dramatically changing environment on human health, including impacts on nutrition, food security, and access to freshwater.[1]

Course Goal: This 6-week, quarter credit is a second pilot which will provide students with a big picture perspective of planetary health, research, policy and practice issues related to it, and the implications and opportunities related to planetary health for public and population health globally. A key theme throughout will be consideration of health and social equity issues and the differential impacts of climate and other environmental changes on populations in light of these issues.

Prerequisite/Co-Requisites: As a course in the Dalla Lana School of Public Health (DLSPH), it is highly recommended that students have:

  1. At least one epidemiology course covering the building blocks of an epidemiological study i.e. population, exposure, outcome, covariates +/-intervention, analysis, and different epidemiological designs e.g. cross-sectional survey, cohort study. For DLSPH students, this will likely be CHL5401F Introduction to Epidemiology or something from undergraduate studies if a first year student.

Enrolment: As the course aims to advance competencies in the field of epidemiology, it will be of interest to:

  • Masters and PhD students in the Dalla Lana School of Public Health (who will be given preference).
  • MSc and PhD students affiliated with the School of the Environment or in the Institute of Medical Sciences with backgrounds in environmental sciences and health, or toxicology; and
  • Masters and PhD students in related areas, fields or disciplines such as geography and planning, engineering, or policy studies with sufficient background to contribute to and benefit from the course.

If in doubt, please check with the lead instructor. Proposed complement for this pilot course is 8-18 students.

Course Format

There will be 6 classes of 3 hours each. Each class will break for 15 minutes in the middle. We will use a combination of lectures, videos, reading, reflection, discussion, and small group work. Students are expected to spend approximately one day per week including class time related to the class. NEW in 2017 is a pilot offering of the course in parallel at Moi University in Eldoret, Kenya. The first half of each class in Toronto will overlap with the second half of the class in Eldoret via videoconferencing. This will enable co-instruction, cross-cultural discussion and perspectives, and the opportunity for collaborative class assignments.

Course Objectives – Relevant competencies to build during course

By the end of this course students will be able to:

  • Broadly understand the concept of planetary health, its distinguishing characteristics relative to eco-health, the ecological determinants of health, and OneHealth.
  • Articulate the nature of the Anthropocene and discuss current trends in knowledge and thinking about the impacts on human societies.
  • Identify key human health effects and indicators across the lifespan related to planetary health and climate change.
  • Identify key sources of data on climate change, desertification, human health and development, nationally and globally.
  • Identify key sources of data on planetary surveillance systems.
  • Understand key methodological challenges and limitations in studying planetary health.
  • Start thinking about research ideas in this field.
  • Start thinking about implications for policy and practice in this field.
  • Formulate advocacy perspectives from research evidence.

 

Proposed Schedule and Seminar Topics (subject to change and availability of speakers)

 

Week 1 – September 13, 2017. What is planetary health?

Part 1: Introductions, Course overview, objectives and expectations. What is planetary health? What is its relationship to eco-health, OneHealth, environmental health and how do they all fit together?

Part 2: What are the Sustainable Development Goals and what is sustainable development?

Required Reading:

  • The Rockefeller-Lancet Commission paper on Planetary Health (pages 1-11 up to Population growth, consumption, and technology – drivers of environmental change). Whitmee et al. “Safeguarding human health in the Anthropocene epoch: report of The Rockefeller Foundation-Lancet commission on planetary health”
  • “The trajectory of the Anthropocene: The Great Acceleration” The Anthropocene Review pages 1-18. 2015.
  • Chapter 1 from Jeff Sachs Sustainable Development book
  • Affiliated website http://www.thelancet.com/infographics/planetary-health;

Recommended Reading:

  • Millennium Ecosystem Assessment Synthesis
  • Chapter Five “History’s Biggest Fraud” of the book Sapiens by Yuval Noah Harari

Assignments – a) The reading; b) Write a 1-page reflection. Consider the following questions: Are we a parasite/invasive species on the planet? Can we become symbiotic? Is it too late to change? How? Why?

Week 2 – September 20, 2017. What are the major drivers and population health impacts of climate and environmental change (CEC)?

Part 1: Discussion of reflections from week 1. What are the key messages from the Lancet commission paper on the major drivers of CEC? Presentation on human migration by Prof. Andrea Cortinois.

Part 2: What are the major population health impacts of CEC?

Recommended Reading: Solly Benatar, “Politics, Power, Poverty and Global Health: Systems and Frames”, Int J Health Policy Manag 2016, 5(10): 599-604; Canadian Public Health Association Discussion Paper “Global Change and Public Health: Addressing the Ecological Determinants of Health”

Assignments: a} The reading. b} Class in Toronto, and the class in Eldoret, work together to identify the major drivers and population health impacts of CEC in Canada and Kenya, respectively.

Week 3 – September 27, 2017. What are the research paradigms and sources of data available to study planetary health and how can they be most appropriately used?

Part 1: Presentation by Prof. David Fisman on modelling infectious diseases. Presentation of class assignments from week 2. Describe and discuss a variety of research approaches to investigation of planetary health issues (ecological analysis, Big Data, community-based participatory research, etc.). Discuss methodologic issues including design and measurement, handling uncertainty and change.

Part 2: Description of data sources related to climate and environmental change and their human health impacts. What are the integrated surveillance systems that collect rigorous health, socioeconomic, and environmental data for defined populations over a prolonged period of time (e.g. Public Health Observatories)?

Invited resource people: Prof. David Fisman, Kate Lillepold

Assignments: a} The reading. b} Each student will be assigned a different published manuscript with a set of structured questions about their methods to answer.

Week 4 – October 4, 2017. What are potential responses and opportunities to build resilience and regenerative sustainability, regionally, nationally and globally?  

Part 1 – Presentation by Prof. Blake Poland on regenerative sustainability, panarchy, and community resilience.

Part 2 – General discussion of last week’s assignment. Discussion of final individual project and ideas.

Key resource person: Prof. Blake Poland

Required Readings:

Recommended Readings:

Assignments: a} The reading. b} Begin working on potential research question for final assignment.

Week 5 – October 11, 2017. What is Food Sovereignty? Why is it important in the context of planetary health? Where does ‘water’ fit?   

Part 1 – Presentations by Prof.’ Cortinois, Cole, and Aimone

Part 2 – General discussion about issues raised during the presentations, and about the final assignments.

Key resource people: Prof. Andrea Cortinois, Prof. Donald Cole

Required Readings:

  • Torrez, F. (2011). “La Via Campesina: Peasant-led agrarian reform and food sovereignty.” Development 54: 49-54.
  • Weiler, A., C. Hergesheimer, B. Brisbois, H. Wittman, A. Yassi and J. Spiegel (2014). “Food sovereignty, food security and health equity: a meta-narrative mapping exercise.” Health Policy and Planning: 1-15.
  • UN Water, World Water Development Report 2015: “Water for a Sustainable World” – Part 1, Chapters 1-3: Water and the 3 dimensions of sustainable development”; and Part 2, Chapter 7: Food and Agriculture

Recommended Reading:

  • Andree, P., J. Ayres, M. Bosia and M.-J. Massicotte (2014). Globalization and Food Sovereignty: Global and Local Change in the New Politics of Food. Toronto, Canada, University of Toronto Press.
  • Bellamy, A. and A. Ioris (2017). “Addressing the knowledge gaps in agroecology and identifying guiding principles for transforming conventional agri-food systems.” Sustainability 9(330).
  • Water Grabbing – An Atlas of Water – peruse the website (http://watergrabbing.com/atlas.html), and read Part 1 from the atlas: “A World of Water”
  • UN Water Policy Brief, Climate Change Adaptation and the Pivotal Role of Water

Week 6 – October 18, 2017. Summary, student presentations, feedback and wrap-up

Part 1: Students presentations and general discussions.

Part 2: Wrap up and evaluations.

Key resource people: A panel of experts from both University of Toronto and Moi University will listen to student presentations and provide feedback from their different perspectives.

Format of Instruction

Sessions will comprise different mixes of interactive discussion, presentations, and review of tasks by faculty, guests and students. A more detailed schedule with specific resources is being provided and will be posted on Blackboard. It may be updated during the course, depending on changes in guest or instructor availability. We will also provide more detailed outlines for individual sessions, including readings and background preparation, on Blackboard each week.

Students in Toronto will be encouraged to attend selected seminars of the Environment & Health Seminar Series sponsored by the School of the Environment, the Environment & Health Collaborative Program  Usually from 16:10-18:00 Thursday afternoons, Rm. 1170, 40 St. George Street, Bahen Centre for Information Technology.

Assessment

A separate document with detailed instructions on assignments will be available as a handout and on Blackboard and/or Google Collaborate by the first class.

  1. Participation in course sessions, as graded by the instructor based on student preparation (news & events, readings), engagement in discussions, and contribution to the learning of all group members – 10% (holistic assessment)
  2. 1 page reflection and class blog from Week 1. 10% (holistic assessment)
  3. Class project of population health impacts in Canada, and Kenya, respectively. 10% (analytic assessment: 5% for relevance, 5% for equity considerations)
  4. Answers to structured questions on published paper. 20% (completeness and accuracy)
  5. One in-class presentation on the last day of students research ideas and proposed methods for final write-up. 20% (analytic assessment: 10% quality of presentation, 10% for completeness, feasibility, approach)
  6. Students will prepare a research protocol, public health advocacy framework, intersectoral program or policy proposal on a related topic. The proposal (5 – 6 pages, single spaced, 12 point font, not including references and appendices) will focus on the context and problem; research questions; study design; sources of data; and intended outputs and impacts. Each student will hand in their completed document by October 31. 30% (analytic assessment: 15% for completeness and relevance to course, and 15% for rationale, broad aim, hypothesis, sources of data, primary exposures, primary outcomes, methods, and potential limitations; program or policy proposal to include: problem statement, program or policy proposed, target population, intended impact, limitations).

Related Course Offerings

  • Building Community Resilience (GGR434 and CHL5126)
  • Environmental Epidemiology (CHL 5416)
  • Ecological Public Health Graduate Course CHL5809H –cross-listed with HST407H1F 20179 – Health Studies, University College undergraduate course: Ecological Public Health
  • Directed Reading: Population Health Intervention Research (CHL 7001H)
  • Directed Reading Course in Planetary/Global Health Ethics (CHL 7001H)