Bridging Theories, Concepts, Organisations, and Collective Knowledge for Health and Sustainability Integration

Abstract

Complex environmental health issues are examples of ‘wicked problems’ that require cross-sectoral collaboration of the public, private, not-for-profit, and academic sectors together with the communities in which they function. Although the linkages between health and sustainability have been widely acknowledged in theory, stakeholders engaged in sustainable development and health seldom collaborate in practice. Promoting environmental health has remained strongly in the domain of the health sector, despite the ambitious rhetoric of international agreements. This dissertation focuses on cross-sectoral integration of health and sustainable development practices by exploring the bridging of ‘siloed’ knowledge. The emphasis is on collective knowledge and the three characteristics of cross-sectoral partnerships that have been identified as valuable for improving decision-making processes: bridging key discourses, bringing together key groups, and generating new knowledge. Aristotle’s three intellectual virtues, epistemé, techné and phronesis, were modified to help describe these aspects of collective intelligence that could enhance the integration of approaches to health and sustainability. The theoretical foundation for this transdisciplinary research was built primarily on health promotion and sustainability governance literatures, which were examined for their overlapping and complementary aspects. Children’s environmental health was studied as a useful bridging concept and UNESCO-mandated biosphere reserves as bridging organisations for integrating health and sustainability. Activities in all Canadian and British biosphere reserves were assessed for the extent of their focus on health. In addition, by investigating four biosphere reserves as case studies, this research identified barriers to and drivers for integrating health goals into biosphere reserve activities. At the same time, the organisational understanding of matters relevant to children’s environmental health was studied to assess the potential of biosphere reserves as bridging organisations for gathering and mobilising local knowledge on these issues. The findings centre on three new perspectives for mobilising knowledge as it relates to the cross-sectoral integration of health and sustainability: (1) the bridging of health promotion and sustainability governance theories, using children’s environmental health as a bridging concept and area of application, which brings together the key discourses in a transdisciplinary manner (epistemé); (2) the value of bridging organisations offering their skills and functional platforms as mechanisms to facilitate bridging of health and sustainability in practice, by bringing together main stakeholders (techné); and (3) the importance of bridging collective knowledge and combining the theoretical, practical, and ethical aspects of the integration process, to increase the level of understanding of specific problems, in this case children’s environmental health (phronesis). Other contributions offered by this research include the discovery of similarities in health promotion and sustainability governance theories; development of a transdisciplinary ecohealth framework; recognition of biosphere reserves as bridging organisations that function as innovative community-based forums for the integration of sustainable development and public health; and findings that reveal an insufficiency of local data collection on children’s environmental health threats. All in all, the findings in this research offer a conceptual and practical frame for integrating health and sustainability by facilitating cross-sectoral collaboration.