Introducing Ecosystem Health into
Undergraduate Medical Education
David J. Rapport
Douglas L. Jones
Christopher M. Anjema
John R. Bend
The concept of health is ancient. While the notion of health intuitively may apply to the well-being of any complex system (e.g., the economy, a community, the oceans, a coral reef, the planet; Somerville 1995), for much of history its context has been limited to the physical condition of the individual (at first humans and later other biota—both plants and animals). In more recent times, the concept has won acceptance as a descriptor of the complete mental, physical, and emotional state of the individual and as a descriptor of the condition of populations (e.g., flocks, herds, human societies). The World Health Organization (WHO) in its constitution defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity” (WHO 1948). Today, the health concept has taken another leap in its formal application—being applied by ecologists, resource managers, and medical practitioners to whole ecosystems—complex organizations comprising vast numbers of species. With every shift of level, the concept of health evolves and acquires new levels of meaning (Rapport et al. 1999a).
At the level of the whole ecosystem (landscape, region), the notion of “health” is a potentially powerful integrative concept—referring to the well-functioning of complex systems comprising intimate interrelationships among humans and other species, and among life forms and their abiotic environment. A trademark of this complexity is the dependence of all life forms on functions governed by the ecosystem as a whole. Whole-system properties such as nutrient cycling, hydrological cycles, pollination, and primary productivity have a pervasive influence on all life forms that comprise a given ecosystem.