Health and the Environment Shall we change the subject?

1. Health and the Environment Shall we change the subject? Nick Fox University of Sheffield

2. Introduction • How health and environment interact. • Anthropocentrism vs. anti-humanism. • An anti-humanist approach to health and the environment. • Changing the subject.

3. Approaches to ‘Health and the Environment’ • Human health is threatened by environmental factors e.g. climate change. • Improving the environment can enhance human health. • Improvements in health threaten the environment (e.g. population growth, economic development). • Initiatives can reduce the environmental impact of health care. • Gaia-inspired conceptions of humans as part of a self-regulating environmental system.

4. Contradictory forces? • Are human health and environmental health potentially antagonistic? • How can human health and environmental health be complementary? • Should human or environmental health have priority?

5. Anthropocentrism • Gives priority to human bodies, human subjects and human experience. • Reflected in: • Humanism • Romanticism • Individualism • Popular politics

6. Anthropocentrism and health • Most health care and medical theory is inevitably anthropocentric. • Health has become a ‘good’ that is almost unquestionable. • Public health has the capacity to avoid anthropocentrism, by focusing on networks and interactions rather than bodies.

7. Anthropocentrism, health and the environment • With human health privileged, then the environment becomes the context within which health is threatened or enhanced. • Examples: • Improving the built environment. • Addressing environment risks e.g. pollution, UV radiation. • Health and safety, health protection, HPA.

8. An alternative approach • Anti-humanism: a philosophical or ontological position that intentionally overturns the priority or privilege accorded to humans. • Focuses on the non-human, the inanimate, and social formations. • Humans are no longer sole agents (‘inorganic life’). • ‘Health’ is understood relationally, as a capacity of a body to engage with its environment.

9. An anti-humanist method • Focus not on bodies or subjects, but on assemblages (networks) of relations between bodies, things, ideas and social institutions. • Look at how these relations affect or are affected, rather than at ‘agency’ and social actors. • This is how we ‘change the (human) subject’.

10. An anti-humanist approach to health and environment 1 • Humans are not prior or privileged. • Focus on assemblages of organic and inorganic: bodies, things, social formations. • ‘Environment’ is no longer separate from bodies: the latter are part of an assemblage that is ‘environment’.

11. An anti-humanist approach to health and environment 2 • Trace how relations in the assemblage affect and are affected by each other. • Look at the capacities produced in bodies and things by these affects. • ‘Health’ is not a body attribute, but an evaluation of capacity: what a body can do.) • Understand poor health outcomes by assessing assemblages.

12. Example 1: city transport housing – work places – shops – services - workers – (capitalist) economic system - wages – transport infrastructure – fossil fuels – renewable fuels – pollution - public transport - private transport – etc. • A sustainable city transport policy can optimise the affective flows in this assemblage. • ‘Health’ emerges as a ‘by-product’ of the capacities produced by sustainable transport.

13. Example 2: water management population – agriculture - industry – water sources – climate – investment – water use and recycling technologies - water and sewage infrastructure – economic development – cultural water use beliefs – micro-organisms – etc. • Analysing the interactions in this assemblage can optimise water management. • Sustainable water management policy enhances capacities (e.g. access to affordable clean water, sewage management) = ‘health’.

14. Example 3: global warming humans – industry - fossil fuels – sunlight – atmosphere - weather systems – politics - economics - cultural formations • Balancing the production and capture of atmospheric carbon can stabilise global temperatures , and thus reduce ecosystem variability. • A stable ecosystem will enhance human opportunities and hence health.

15. Conclusions • Environment is an assemblage. • Humans are an element in this assemblage. • Elements in the assemblage affect each other. • Engineering assemblages can produce capacities that enhance health. • Change the subject from ‘human health’ to ‘environmental assemblages and affects’. • This suggests a distinctive, environmental approach to public health.

16. Health and the Environment Shall we change the subject? Nick Fox University of Sheffield