Introduction to the Winter 2025 ESS Lecture Series

Welcome and Acknowledgment

• Deborah Ross introduces herself as the outreach and communications director at the College of Sustainability, Dalhousie University.

• She acknowledges being on traditional Mi'kmaq territory, emphasizing the importance of land acknowledgments beyond mere formality.

• Ross highlights her commitment to amplifying Indigenous perspectives in discussions about climate crises.

Speaker Introduction

• Dr. Nicole Red is introduced as a member of the Dene Kue First Nation with extensive experience working with Indigenous communities globally.

• She holds significant academic positions, including research chair and Director of Indigenous Planetary Health at Western University.

• Dr. Red's work focuses on integrating Indigenous perspectives into health research and practice.

Dr. Nicole Red's Presentation: Determinants of Planetary Health

Contextual Background

• Dr. Red expresses gratitude for the warm welcome and shares her excitement about visiting Halifax for the first time.

• She plans to discuss determinants of planetary health through a sustainability lens within healthcare contexts.

Importance of Land Acknowledgment

• Dr. Red emphasizes grounding oneself in identity when entering new territories, highlighting accountability to ancestral knowledge.

• She explains that understanding one's geographic location is crucial for recognizing relationality in their work.

The Role of Storytelling

• Dr. Red discusses how her lived experiences are shaped by stories from her region, which serve as a method for community operation.

• She stresses honoring ancestors when sharing knowledge derived from Indigenous teachings.

Indigenous Perspectives on Relationships

Interconnectedness and Natural Law

• The concept of relationships within communities is rooted in acknowledging interconnectedness among people, land, and nature.

• Traditional knowledges stem from an understanding of natural law, which governs all aspects of existence.

Shift in Worldview

• Dr. Red contrasts historical circular worldviews with contemporary synthetic ones, indicating challenges faced today due to this shift.

Understanding Planetary Health

Introduction to Planetary Health

• The term "Planetary Health" is critical in addressing global health issues and has gained traction over the past decade, particularly through the work of the Planetary Health Alliance.

• The concept is relatively new in academic discourse, marking its 10-year anniversary with a focus on redefining its anthropocentric origins.

Redefining Planetary Health

• A new definition emphasizes that planetary health is a solutions-oriented transdisciplinary field aimed at understanding human impacts on Earth's systems and their effects on all life forms.

• There is often confusion between "Planetary Health" and "One Health," with the latter focusing primarily on zoonotic diseases and animal-human interactions.

Distinctions Between One Health and Planetary Health

• One Health emerged from veterinary studies concerning infectious diseases but has expanded to include ecosystem considerations; however, it remains more focused than planetary health.

• While both concepts intersect, planetary health encompasses broader social structures, economic systems, and justice issues beyond just human-animal disease transmission.

Indigenous Perspectives on Planetary Health

• From an indigenous viewpoint, planetary health reflects long-standing understandings of interconnectedness between people and the planet, contrasting with Western constructs that often separate these elements.

• Indigenous communities have their own terminologies for similar concepts (e.g., Mother Earth's health), which can be translated into Western frameworks for policy discussions.

Worldviews Impacting Research and Solutions

• The use of planetary health as a framework allows for strategic alignment with indigenous perspectives in policy-making while acknowledging different cultural contexts.

• Historical anthropocentrism shapes research questions and solutions; there’s a need to shift towards an ecocentric worldview prevalent in many indigenous cultures.

Equity Considerations in Planetary Health

• Discussions around equity are becoming more common but face political pushback; this includes interspecies equity—not just human-centric approaches to health.

• Social determinants of health traditionally center humans but must expand to consider broader ecological factors affecting overall well-being.

Conclusion: Expanding Understanding of Social Determinants

• Recognizing how various societal factors influence individual health outcomes is crucial; this includes education levels, income disparities, food security, etc.

Exploring the Interconnectedness of Health and Mother Earth

Centering Mother Earth in Health Discussions

• The discussion begins with the idea that where one lives can significantly impact health outcomes. The focus shifts to centering Mother Earth in health considerations, emphasizing her wellbeing as a crucial factor.

• An indigenous perspective is introduced, highlighting the importance of viewing all beings on the planet as relatives and considering what affects Mother Earth's health. Ten determinants impacting planetary health are mentioned but not detailed here, as they are available in open-access papers.

Human Relationship with Nature

• A key determinant identified is human interconnectedness within nature. The speaker argues that ecological decline reflects an impaired relationship between humans and nature, suggesting that we are inherently part of it.

• Evidence points to a loss of an ecologically bound identity in modern society, leading to a fragmented sense of self that detaches humans from their role within larger ecosystems. This disconnect fosters predatory behaviors towards the earth.

Anthropocentric Worldview and Its Consequences

• The emergence of an anthropocentric worldview promotes a sense of entitlement over land and resources without responsibility or care for the environment, perpetuating harm to the planet.

• The modern scientific paradigm is critiqued for its Euro-Western centricity, which often prioritizes human benefit even when studying other species or systems, limiting its effectiveness in addressing complex ecological issues.

Limitations of Modern Scientific Approaches

• Modern science is described as linear and reductionistic, which may work well for specific medical inquiries but fails when applied to complex planetary systems involving diverse human interactions over time.

• Historical interests in Western science have focused primarily on benefiting humans rather than understanding broader ecological relationships or complexities inherent in natural systems. This has led to underappreciated connections with systems-based thinking approaches emerging since the 1970s.

Indigenous Science: A Holistic Approach

• Indigenous scientific methods are characterized by being contextual, holistic, nonlinear, relational, and timeless—utilizing collective observations to explain natural phenomena through both real and metaphorical narratives. This approach contrasts sharply with conventional scientific methodologies that often fail to address complex problems effectively.

• A critical assertion made is that one cannot solve complex problems using the same worldview that created them; this highlights the need for new perspectives rooted in indigenous knowledge systems when tackling sustainability challenges within healthcare contexts specifically discussed later on.

Sustainability Gaps in Healthcare

• There’s an acknowledgment of significant gaps regarding sustainability discussions within healthcare—a field needing more attention concerning environmental impacts and practices aligned with indigenous perspectives on health and wellbeing.

• Introduction to "Donut Economics" by Kate Raworth illustrates a framework aiming for balance between social foundations (like access to water and food equity) while respecting Earth's limits—emphasizing sustainable living without overshooting planetary boundaries already breached by humanity's actions today.

Sustainable Development Goals and Healthcare's Environmental Impact

Understanding Sustainable Development Goals (SDGs)

• The concept of a "safe space" for humans emphasizes the need to meet social foundations within ecological limits, highlighting the importance of sustainable development.

• The SDGs are often presented linearly from 1 to 17, which can mislead people into thinking all goals hold equal weight; some are foundational for others.

• A revised model, referred to as the "donut model," prioritizes key environmental SDGs, indicating that without these, other goals cannot be achieved.

Implications in Healthcare

• An example is shared about Maria, a cancer patient who requested tracking of medical supplies used during her breast reconstruction surgery, illustrating waste issues in healthcare.

• The sheer volume of waste generated by surgeries globally raises concerns about environmental sustainability in healthcare practices.

Climate Change and Health Connections

• Climate change impacts health through various channels such as extreme weather events and water shortages; these connections are increasingly recognized.

• A figure developed by Courtney Howard outlines how ecological determinants affect health systems and potential health impacts like heat stress and increased infectious diseases.

Healthcare's Carbon Footprint

• Globally, healthcare accounts for approximately 5% of greenhouse gas emissions, making it one of the largest contributors to climate change.

• Canada ranks among the top polluters in healthcare emissions at around 5%, trailing only behind the United States at 10%.

Need for Policy Changes

• Despite being significant contributors to pollution, Canadian healthcare has not implemented substantial measures to reduce its environmental impact compared to other countries.

• There is a lack of comprehensive studies on Canada's healthcare emissions; however, parallels with data from the US and UK suggest that most emissions stem from medical devices and pharmaceuticals.

Understanding Healthcare Emissions and Indigenous Perspectives

The Exclusion of Healthcare from Emission Reports

• Historically, healthcare has been excluded from national emissions reports despite being significant contributors. Recent changes show countries beginning to include healthcare data in their emissions reporting.

• The assumption that healthcare should not be counted due to its role in helping humans is being challenged, emphasizing the need for accountability across all sectors.

Gaps in Knowledge and Opportunities

• There are substantial gaps in understanding how the healthcare sector can achieve net-zero emissions, indicating a need for innovative thinking and solutions.

• Identifying potential strategies similar to other industries is crucial for addressing these gaps while leveraging opportunities for improvement.

Indigenous Perspectives on Health

• The concept of "Patient Planetary Health co-benefit prescribing" integrates land and environmental considerations into health practices within Indigenous communities. This approach emphasizes the interconnectedness of human health and the planet's well-being.

• Traditional medicine systems often require a balance between harvesting natural resources and ensuring sustainability, highlighting the importance of ecological awareness in health practices.

Translating Indigenous Concepts to Western Healthcare

• Efforts are underway to adapt Indigenous perspectives on health into Western medical practices by considering both patient needs and environmental impacts during prescribing decisions. This includes evaluating climate change mitigation alongside health benefits.

• Policymakers are more likely to act when human health components are included, making it essential to connect environmental initiatives with public health outcomes effectively.

Examples of Co-Benefit Prescribing

• Asthma inhalers serve as an example where environmental impact can be considered; traditional metered-dose inhalers have high greenhouse gas emissions compared to dry powder inhalers, which offer similar clinical benefits with minimal environmental impact. Understanding this can lead to better prescribing choices that consider both patient care and planetary health.

• Anesthetic gases also present an opportunity for improved practices; certain anesthetics contribute significantly more greenhouse gases than others, yet many healthcare providers remain unaware of these differences, underscoring a gap in education regarding environmentally friendly alternatives.

Impact of Nitric Oxide and Waste in Healthcare

The Longevity of Laughing Gas Molecules

• Laughing gas molecules remain in the atmosphere for an average of 121 years before being removed or destroyed, raising questions about awareness among dental professionals regarding its environmental impact.

• One pound of nitric oxide has a warming effect that is 265 times greater than that of one pound of carbon dioxide, highlighting the potency of certain gases used in healthcare.

Questioning Healthcare Practices

• There are potent substances used in healthcare that often go unquestioned, despite the existence of clinically equivalent alternatives. This indicates a need for education and policy change to explore low-hanging fruit opportunities for improvement.

Circular Economy in Healthcare

• Discussions around a circular economy in healthcare suggest reusing medical equipment, reminiscent of past practices where sterilization allowed for reuse rather than disposal.

• Current practices often involve discarding items post-procedure, contributing significantly to waste without evidence supporting disposables as safer against infections.

Challenging Established Norms

• The speaker encourages questioning long-standing practices within any field, emphasizing the importance of evidence-based approaches to challenge norms and explore alternatives.

Sustainability Initiatives

• The concept of circular economy is gaining traction particularly in Europe but remains underexplored in North America. Questions arise about how to maintain sustainability within healthcare systems while ensuring quality care metrics include environmental considerations.

Climate Resilience and Health Systems

Integrating Environmental Sustainability

• Climate resilience must be integrated into health systems to withstand climate events while also centering environmental sustainability as a key metric alongside traditional measures like efficiency and equity.

Global Commitments and Local Actions

• At COP 26, countries including Canada committed to developing low-carbon sustainable health systems; however, progress has been stagnant since signing these agreements.

Emerging Roles in Healthcare Sustainability

• Some Canadian hospital systems are beginning to hire sustainability officers focused on both financial and environmental sustainability within healthcare settings.

Aligning Science with Sustainable Development

Decade for Sustainable Development Goals

• The United Nations' decade for sciences aimed at sustainable development seeks better alignment between basic sciences and pressing global crises such as climate change and pandemics.

Broadening Inquiry Beyond Traditional Knowledge

• There is concern over narrowing inquiry questions within academic spaces which may exclude diverse forms of knowledge, particularly indigenous perspectives essential for understanding equity issues.

Scientific Hegemony's Impact on Innovation

• A recent paper suggests that scientific hegemony has led to less disruptive innovations over time due to restrictive structures within institutions limiting broader inquiries.

Intellectual Advances and Sustainability in Research

Decline in Disruptiveness

• The speaker notes a lack of intellectual advances in recent years, linking this decline to a restricted use of previous knowledge. This perspective aligns with the "shoulders of giants" view, emphasizing the importance of building on past ideas.

• It is crucial to ask disruptive questions for meaningful change, particularly in sustainability efforts within fields like healthcare, where traditional policies often resist innovation.

Importance of Forming Narratives

• The speaker stresses that forming narratives around sustainability is essential. They encourage individuals to ask challenging questions about current practices that may not support long-term viability.

• Highlighting the Welcome Trust's commitment to spend $10 billion on research over ten years, they note its focus on health and sustainability and its collaboration with UK government organizations to create environmentally friendly research guidelines.

Sustainability in Academic Labs

• The speaker expresses concern that most university labs lack sustainability plans, indicating a general reluctance to question established practices.

• The Welcome Trust has initiated discussions on developing reporting guidelines for research funders and institutions aiming for sustainable health research practices.

Student-Led Initiatives

• Many changes towards sustainability have been driven by students. A notable example is the Academic Health Institutions Declaration on Planetary Health signed by most medical school deans across Canada.

• This declaration represents significant institutional commitments aimed at aligning medical education with planetary health principles—a shift not seen a decade ago.

Global Examples and Framework Development

• The success of student-led initiatives has inspired other universities globally, such as Sun University in Malaysia, which mandates cross-curricular integration of planetary health concepts for all students.

• Various frameworks have emerged from these movements, including the Planetary Health Education Framework encouraging organizations to integrate environmental principles into their operations.

Governance and Legal Perspectives

• Key determinants of planetary health include self-community relationships and governance laws that reflect societal norms regarding lifestyle choices and environmental priorities.

• Some countries recognize entities like Mother Earth within their constitutions, showcasing how indigenous perspectives influence legal frameworks related to environmental rights.

Understanding Institutional Change Through Indigenous Knowledge

The Need for Multiple Ways of Knowing

• Discussion on the importance of integrating multiple ways of knowing into institutional and organizational change, moving away from a singular perspective.

• Emphasis on transitioning from hierarchical practices to communities of practice, fostering reconnection with land and place.

• Highlighting the shift from deficit-based dialogues to strength-based dialogues, promoting inclusivity over hegemony.

Integrating Compassion in Knowledge

• The critical role of compassion alongside knowledge in operationalizing indigenous perspectives within various fields.

• Importance of reflection to understand one's position within larger systems and the need for adaptability at different levels (micro, meso, macro).

Planetary Health Initiatives

• Introduction to the student-driven initiative "Planetary Health Report Card," allowing students to evaluate their institutions' commitment to planetary health practices.

• Mention of the "Pledge for Planetary Health," initiated by medical professionals and advocating for similar pledges across all fields.

The Planetary Health Pledge

• Description of adapting the Hippocratic Oath into a planetary health pledge that emphasizes service to humanity and environmental protection.

• Key components include practicing with conscience, advocating for equity and justice, and addressing social determinants affecting health.

Commitment to Future Generations

• The pledge includes commitments towards sharing knowledge for societal benefit while promoting transdisciplinary actions for community health.

• Repeated affirmations in the pledge emphasize personal accountability in embodying planetary health principles.

Reflection on Sustainability Critiques

• Acknowledgment that discussions around sustainability often face criticism; further exploration is needed regarding these critiques.

Sustainability in Healthcare: A Nature-Centered Approach

Critique of Current Sustainability Movements

• The speaker critiques global sustainability movements, including those in Canada, for being overly technocratic and mechanistic, lacking a connection to the planet.

• A review of 26 environmental sustainability frameworks in healthcare revealed that none mentioned "nature," with only one reference to biodiversity, highlighting a disconnect from ecological considerations.

Importance of Nature-Centered Solutions

• Emphasizes the necessity of nature-centered solutions for successful sustainability efforts, advocating for an eco-centric focus that appreciates diverse ways of knowing.

• Introduces the concept of epistemological pluralism, which recognizes multiple valuable perspectives in research and practice contexts to enhance integrative studies.

Indigenous Perspectives on Knowledge

• References MCMA Elder Albert Marshall's idea of "two-eyed seeing," which embodies integrating indigenous and Western knowledge systems as a means to enrich understanding.

• Calls for shifting discussions from binary oppositions (e.g., animal vs. human) towards focusing on relationships between entities, reflecting indigenous community perspectives.

Personal Connection to Climate Issues

• Shares personal experiences related to wildfires in the Northwest Territories, where significant evacuations occurred due to climate impacts on communities and healthcare systems.

• Highlights the lack of preparedness within healthcare systems for climate-related emergencies, stressing the need for effective mitigation and adaptation plans.

The Role of Humanity in Ecological Systems

• Quotes an indigenous advocate emphasizing that while Mother Earth can heal herself, she requires human interaction and care; our actions significantly impact ecological health.

• Discusses how certain medicinal plants depend on human harvesting practices for growth, illustrating humanity's integral role within natural ecosystems.

Closing Thoughts and Cultural Reflections

• Concludes with gratitude expressed through cultural language ("Mai Cho"), emphasizing respect and honor within indigenous communities regarding their relationship with nature.

• Reflects on the significance behind names like "big lake" or "big river," suggesting they represent honor rather than mere size—an important cultural perspective.

Understanding Planetary Health and Individualism

The Concept of Individualism in Society

• The speaker discusses the notion of individualism, suggesting it has always existed but is now more openly expressed.

• They argue that while societal changes are evident, the underlying individualistic tendencies have been emboldened rather than newly created.

Suffering as a Catalyst for Change

• The speaker highlights indigenous knowledge, emphasizing that suffering can drive communities to unite and instigate change.

• Recent climate events, such as devastating fires in California, illustrate how suffering may compel collective action and awareness.

Resilience Amidst Political Challenges

• Acknowledging upcoming political difficulties, the speaker stresses the importance of not allowing external forces to define personal or community identity.

• They advocate for recognizing small victories and maintaining resilience during challenging times to foster connections.

Examples of Circular Healthcare Models

Innovations in Sustainable Healthcare Systems

• The UK is highlighted as a leader in adopting circular economy principles within its healthcare system, focusing on environmental sustainability.

• Legislative policies have prompted UK health systems to hold suppliers accountable for environmental practices related to pharmaceuticals.

Strategic Negotiations with Suppliers

• The UK's bulk purchasing strategy allows them to negotiate environmental controls with pharmaceutical companies effectively.

Global Leaders in Sustainability

• Singapore is also recognized for advancing sustainability initiatives within its healthcare system alongside Malaysia's emerging efforts.

The Impact of Fear vs. Love on Solutions

Emotional Responses to Climate Issues

• The speaker reflects on an encounter with a TikTok influencer discussing climate anxiety and fear prevalent among youth today.

Indigenous Perspectives on Action

• In contrast to fear-driven responses, indigenous communities often approach climate issues from a place of grief and love for the land.

Encouraging Purposeful Engagement

• The speaker urges young people to connect deeply with their motivations regarding climate action, advocating for solutions rooted in love rather than fear.

Bioethics and Planetary Health: Navigating Complex Decisions

The Intersection of Patient Care and Environmental Ethics

• The speaker emphasizes that solutions driven by fear and anxiety may not be sustainable, suggesting a need for more thoughtful approaches to advance work in healthcare.

• A recent publication submitted to The Lancet addresses the bioethics of planetary health, highlighting the ethical implications when patient care conflicts with environmental concerns.

• An example is presented where a cancer patient requires radioactive materials that harm the earth, raising questions about prioritizing patient needs versus environmental health.

• Current projects from institutions like Oxford and Italy are exploring how to ethically triage medical care during environmental crises, such as medicine shortages due to disasters.

• Historical context is provided regarding treatments derived from endangered species, questioning whether it is justifiable to sacrifice natural resources for immediate medical benefits.

Seeking Frameworks for Ethical Decision-Making

• There is a call for better frameworks in bioethics that balance patient care with planetary health considerations, especially as climate change impacts healthcare delivery.

• A study conducted with physicians in the Northwest Territories revealed many had not previously considered these ethical dilemmas but expressed a desire for guidelines on prioritizing between patients and the planet.

• Physicians generally favored putting patients first but acknowledged complexities when faced with specific scenarios requiring deeper ethical reflection.

• The speaker advocates for interdisciplinary conversations to develop societal-level frameworks addressing these emerging ethical issues related to healthcare and environmental sustainability.

Indigenous Rights and Resource Extraction Ethics

• Ethical dilemmas also arise concerning resource extraction from indigenous territories for technologies like electric batteries, prompting discussions on sacrificing indigenous rights for broader societal benefits.

• The speaker identifies a significant gap in incorporating ethical dimensions into discussions about climate change and health, emphasizing the need for this integration moving forward.

Love, Connection to Land, and Indigenous Perspectives

• A question arises about literature connecting love and connection to land; while some work exists indirectly referencing this theme, explicit writings are still forthcoming from the speaker's research efforts.

• Indigenous authors often frame love as integral within their communities but may not directly link it to decision-making processes influenced by fear or love-based motivations.

Engaging Traditional Science Departments

• The importance of systems thinking in scientific disciplines is highlighted; advice is sought on integrating diverse ways of knowing into traditional science education settings.

• The speaker mentions their book includes chapters across various scientific disciplines aimed at fostering interdisciplinary understanding among students studying physics and other sciences.

Indigenous Perspectives in Science and Mathematics

Representation of Indigenous Scholars

• The speaker highlights the scarcity of indigenous authors contributing to discussions on indigenous science, emphasizing the need for diverse perspectives within scientific contexts.

• There are very few indigenous individuals in academic faculties, particularly within science departments; the speaker knows only two indigenous mathematicians who have made significant contributions to indigenous mathematics.

Gaps in Indigenous Scientific Representation

• The speaker mentions awareness of one indigenous chemist but notes a lack of knowledge regarding any indigenous physicists, suggesting that there may be more undiscovered talent in this field.

• Despite gaps in representation, the speaker asserts that indigenous knowledge systems are rich with understandings related to physics and other sciences, indicating a deep connection between traditional knowledge and modern scientific principles.