17.1: Introduction

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In an era of rapid social and ecological change, the interfaces of health, human security, and global environmental change warrant particular attention. Accordingly, this chapter foregrounds the notion of health security in relation to social-ecological change. The World Health Organization constitution states that “the health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co-operation of individuals and states” (WHO, 1948, p. 1). Health security therefore exists at the interface of the health and security sectors, and is typically thought of as the activities required to mitigate risk or respond to acute events that endanger population-level health across international boundaries.

This conventional definition of health security therefore privileges concerns of disease outbreaks of epidemic proportions with risks of international transmission, deliberate acts of bioterrorism, and responses to disease in contexts characterized by war or violent conflict. Global health security is arguably more important now than ever before. For example, an influenza pandemic could affect up to 1.5 billion people, be responsible for up to 150 million deaths, and produce USD $3 trillion in economic damages (Hoffman, 2010). While the acute public health and emergency management response is laudable to respond to such direct biophysical threats, one topic that has received limited attention in human and health security discourses is the role of global environmental change.

Leveraging from more traditional definitions of health security, this chapter conceptualizes how global environmental change can impact health security, and builds upon other chapters in this volume that engage with threats to human security (Chapter 5), climate change (Chapter 9), resource scarcity (Chapter 10), human rights (Chapter 15) and global environmental governance (Chapter 20). First, we provide definitions for key terms, highlighting the historical context that led to emergence of health security. Second, we establish the importance of social-ecological systems as an essential component in considering the interface of health security and global environmental change. Third, we profile some of the greatest ecological challenges facing the planet in the 21^st century in relation to their implications for health security, and demonstrate the relevance of these challenges through several applied case studies. Finally, we present and discuss the implications of a broader definition of health security, its relationship to globalized equity and ecological considerations, addressing time and scale considerations that span the local to the global, and which point to emerging priorities for public health practice, research and policy moving forward. Our chapter foregrounds essential theoretical and practical considerations to drive future innovation on health security in an era of environmental change. While this chapter is not intended to be an exhaustive review of the concept of health security or the myriad social-ecological challenges facing the human population, we anticipate it will be helpful for audiences from health and non-health sectors in clarifying key terminology, and establishing connections between seemingly unconnected health issues as security challenges.