The term planetary health, and what falls within that field, provokes strong and interesting debate. Where consensus can be found is in the notion that planetary health is cross-disciplinary – involving academics from different disciplines working collaboratively on a common problem – complex and interconnected. It needs input from many academic disciplines, and many academics, each of whom needs to look outside of their own immediate area of research to wider issues that intersect, require trade-offs and involve compromises. This will enable the field to move towards being truly interdisciplinary. Only then will the right action be identified and taken.

For this reason, the planetary health programme at the Oxford Martin School recently convened the first of what is hoped to be a series of seminars open to all members of the university – regardless of faculty, discipline or field – who are intrigued by the concept of planetary health and keen to discover what their research may have to offer.

At the inaugural meeting, invited researchers from University of Oxford’s Climate Econometrics, the Environmental Change Institute, Primary Care Health Sciences, the Smith School of Enterprise and the Environment, the Future of Humanity Institute and Faculty of History joined the Oxford Martin School-based staff of The Rockefeller Foundation Economic Council on Planetary Health Secretariat to hear about the project’s progress so far, plans for the future and opportunities for collaboration.

Discussions highlighted the importance of working across different levels of magnitude – with the macro-level needing to be informed by an accumulation and magnification of (more) micro-level studies whose synthesis will inform the bigger picture. A presently incomplete picture, with diverse data sets, must not be allowed to impede progress towards a better future. Sectors, as well as geographic locations, need to be considered on a global level. The shipping sector, for instance, may be a better target for focus than the US or China, in efforts to limit ocean pollution; multinationals can have a huge impact on consumer behaviour and behavioural change. A focus on the mining sector may help to understand what is driving the desire for the mined minerals and how this may be tackled. Planetary health needs to identify root causes, not just diagnose and treat symptoms.

Degraded land from mining, Poland (Mariusz Prusaczyk)

The discussions also raised questions about how the cause and symptoms should be identified: we are good at defining planetary ill-health, but less clear on what the practical vision of a healthy planet might be. If countries are to be asked to remain inside their planetary boundaries, planetary health must address what their transport systems, agricultural lands, energy grids and cities look like when they do.

How well do we understand the limits of the human body, and the extent to which our current lifestyles push these in negative as well as positive directions (as obesity and the rise in non-communicable diseases suggest they do)? What are the measures of good health beyond just the World Health Organization’s “absence of disease or infirmity”? What are the social determinants of this and do we sufficiently understand how a better environmental can drive good health as much we understand how the current one drives ill-health?

On the one hand, it is common sense to say air pollution is unhealthy, just as we know smoking is unhealthy, but without scientific evidence of levels of harm and a corresponding understanding of how healthy we might be without exposure to such risk factors, policy-makers will be loath to limit revenue and GDP-generating activities. Such quantified understanding will be particularly important if we are to “lock in” good practice to new technologies, urban developments and progress within the timeframes needed to keep our planet within manageable levels of environmental change.

We may overshoot planetary boundaries while we do so, but how far can we overshoot and still be able to (ever) recover? If there has to be trade-offs between population numbers, (average) length of life and current lifestyles – if the planet cannot support 12 billion people all living on average to 100 with an ecological footprint equivalent to the average North American – we must decide what we sacrifice and how: energy consumption, plastic use, a second child, the last 10 years of the current lifespan, or all four for some, none for others as inequality takes on new dimensions. Should we, and if so, how, incentivise people to make their own lives as healthy as possible, and tax into submission those who “choose” not to?

The key to all this is a better understanding of the casual chains that drive behaviours leading to degraded environments and their impacts on human health. The challenge is that these are not simple causal chains, but interconnected causal pathways that weave through complex systems. Each researcher might position their work along a single path, or at a single node of the network, but a planetary health researcher needs to see the entire system, and understand how every other causal chain affects theirs. This is no easy task, requiring academics to step outside of their own discipline into fields, methodologies and approaches with which they are less familiar as they inch towards an understanding of areas they have not considered before.

The solution may be as much about network analysis as it is about the epidemiology of malaria or the physics of diesel combustion, but more likely it is about all three (and dozens more). The answers to planetary health’s questions may lie at the end of research projects that are only now beginning, requiring today’s academics to work on current best estimates rather than certainties.

There is, nonetheless consensus around the idea that “if you’re not sick, you’re healthy” is as old-fashioned an idea for the planet as it is for the body. Better and more accurate early diagnosis of problems is needed so that they can be addressed swiftly and upstream, when doing so is easier. Prevention is better than cure, risk management is better approached through adaptation and mitigation than recovery. The researchers present saw this going beyond sustainability to something more wide-ranging, while also advising caution that the field may be looking too holistically before the specifics have been pinned down; incomplete understanding may shift problems elsewhere rather than solve them entirely. But planetary health research has to start somewhere. There may not be hard boundaries yet, but this should not be a barrier to practical suggestions on how to limit harm we can certainly see, if not yet fully quantify.

The debates are clearly far from over and offer plenty of scope for future discussions. If solutions are to be found, they will be composite approaches from different academic disciplines working together, creating an innovating and forward-looking interdisciplinary space from which equally innovative solutions can emerge. More researchers are welcome to join in as we take this forward.

By Jennifer Cole, Public Health Policy Advisor, Secretariat of the Rockefeller Economic Council on Planetary Health, University of Oxford; Connor Rochford, Blavatnik School of Government, University of Oxford; and Esther Schroeder, Worcester College, University of Oxford.

The opinions in this blog are those of authors alone, and do not represent the view of the entire Rockefeller Foundation Economic Council on Planetary Health.

There is no doubt that current agriculture and food systems are significant drivers of planetary ill-health. Impacts include land degradation from poor production practices, high levels of species extinction, unhealthy diets driving rising levels of obesity, diabetes and other non-communicable diseases, and nearly 25% of global greenhouse gases from land use change, agriculture and deforestation.

The annual EAT Forum held in June 2018 in Stockholm generated plenty of discussion on how to fix “the broken food system”. The host, Sweden, offered some innovative approaches to reducing the impacts of current food systems. For example, a recent Climate Change Act commits the Nordic country to zero emissions by 2045. In addition, the Swedish Green Party (a member of the current ruling coalition) is considering a tax on the intensive meat industry and there is also discussion on copying French legislation on banning the disposal of edible food. Senior Swedish officials anticipate that animal-based investments may become the stranded assets of the future – just as with fossil fuel-based energy businesses – with a predicted mass shift to plant based-diets. Highly successful crowd-based funding of new food markets shows the interest in change among consumption and investors.

A group of experts, advisers and investors were challenged to put their money where their mouth is. Insurance companies, fund managers, pension funds, banks and foundations are all finding ways to shift investments towards more sustainable and less damaging agriculture. Several groups are focussed on better knowledge of investments and are setting up scorecards of impacts in relation to biodiversity loss, emissions and waste management as well as benchmarking good practice. Far-sighted leadership of investors and behavioural nudges and changes have made a difference, such as the fast emergence of the Green Bonds market. But, better data for better decision-making is needed – such data will need to sit alongside engaging narratives for change and framed by values.

Investment, innovation and wider system transformation in agriculture and land use, however, still lags behind other areas such as energy despite its centrality to current and future planetary health. While latest estimates show that $250 billion was invested in renewable energy last year, it was reported that only $10 billion flowed to land-based investments. But hopefully that imbalance will start to change as groups like the Food & Land Use Coalition, chaired by Unilever CEO Paul Polman and a member of The Rockefeller Foundation Economic Council on Planetary Heath, encourage business to help drive changes in land use and food production to reduce environmental destruction.

According to the International Renewable Energy Agency (IRENA), disruption and transformation of the energy sector is well underway driven by decarbonisation, digitalisation and decentralisation as mainstream renewable technologies can be expected to provide average costs at the lower end of the fossil fuel cost range by 2020. The notion of zero coal and low-emissions transport and energy systems emerged just a short 5 or 6 years ago, but in Stockholm – in response to the challenges of the food system – the concept of low or zero meat diets was considered.

Just as the future of coal has been discussed, now is the time for a discussion on the future of meat, particularly intensive meat production and consumption (with all the disruptions, political, economic and social that may emerge). Technologies are emerging and new dietary norms could emerge faster than expected.

There was a consensus at the EAT Forum that society, economies and leaders have a binary choice between a bleak future of resource constraints and global warming, or to take advantage of the opportunities for transforming a new way of managing our food systems. There is a sense of optimism that this is achievable with the right combination of vision, leadership, investment, knowledge generation, partnership and collective action.

By Sam Bickersteth, Executive Director, The Rockefeller Foundation Economic Council on Planetary Health