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Inter-Union CooperationsICSU Unions' Initiative "Science for Health and Well-Being"Meeting in Paris, 10-11 February, 2003
Working Paper 1: Living Environments
The mutual relationships between natural and built environments on the one hand, and health and wellbeing on the other, are increasingly seen to be critical to both the short- and long-term sustainability of the places where people live, and especially large cities and megacities. Under the broad heading of Living Environments, four more focused themes should be pursued as part of the Science for Health and Wellbeing initiative: Settlement Density, Interconnections, and Structures Concentrated human settlements, especially toward the megacity end of the urban scale, depend upon intense interconnections with distant places in order to assemble the goods, services, people, and information upon which their sustenance and viability necessarily rely. Thus settlement structure both conditions and is conditioned by the technologies that move commodities, people, and information among and within them. Transportation technologies can be facilitators of as well as obstacles to health and wellbeing in human settlements, depending on how well they are managed. Accidents related to transportation are serious causes of injury and death among certain age groups, and the frequency of accidents resulting in injury or death in different kinds and sizes of settlements deserves investigation. These events and processes are integral parts of living environments. Poor design will augment their negative health effects. Good design can minimize harmful consequences, not only as regards transportation itself but also more generally; a facet of urban design that should be explored is the ways the physical layout of cities might be planned to provide residents with incentives and opportunities to exercise regularly as integral parts of their daily routines. Communication and information technologies complement transportation systems in human settlements, acting as the nervous systems for these social organisms. New technologies enable individuals and small groups to bypass gatekeepers and middlemen who formerly controlled access to information, prices, etc., thereby reducing the communications friction (and its associated costs) within and between settlements. New technologies and networks offer significant opportunities for identifying, monitoring, and managing many fundamental dimensions and individual facets of the complex relationships between urbanization and health and wellbeing. A focus on science-based approaches to minimizing environmental degradation by and within settlements using advanced information and communication technologies seems especially promising. Health Incentives and Disincentives for Living in Large Agglomerations Establishing the concept of geodisease-a dysfunctional, non-sustainable complex of human and natural systems evident at specific places would be a helpful conceptual and theoretical framework for applying science to health and wellbeing of human and not human life. Geodisease research would go beyond current practices in health risk mapping, identifying geographical and temporal variations in health and wellbeing indicators, and the search for environmental and anthropogenic causes to create taxonomies of geodisease and to seek commonalities and differences among occurrences of similar instances in different places. Specific elements of this approach might focus on the detection of disease clustering in relation to exposure to sources and agents (for example, relationships between land use and land cover on the one hand, and such diseases as trypanosomiasis; malaria; sleeping sickness; tsetse; and yellow fever on the other), modeling disease outbreaks and spread, and exploration of regional medicometry (the effects of medical infrastructure on health and wellbeing). A point of increasing interest in the next decade will be the ways geodisease and medicometry combine to create incentives and disincentives for migration to and residence in large settlements. Although many aspects of high density living in large settlements are unhealthy, rural areas and small towns have their own inherent health and wellbeing disadvantages, and both the quantity and quality of medical care available in large settlements generally exceed that present at the smaller, less agglomerated end of the settlement scale. As populations age they become more attuned to the need for access to high quality medical care, and the aging of world's populations will constitute an additional incentive for migration to large agglomerations in the next several decades. Environmental and Settlement Dynamics Science and engineering have contributed greatly to the quality of life and to the health and wellbeing of large settlements in the last several centuries through the basic science and science-based infrastructure that provide unprecedented number of people living at unprecedented densities with clean water, sanitation, and reliable sources of cheap energy. Maintaining that infrastructure and supply and extending them where they are currently inadequate will present serious challenges as settlements continue to expand and intensify and as world populations continue to urbanize. Obtaining water and managing its use will become increasingly difficult in the next twenty years and beyond. Obtaining adequate energy will become more demanding as per capita energy consumption in the developing world increases. Mitigating pollution from energy generation and transportation should rank high among metropolitan scientific and engineering priorities. Constant monitoring and steady conservation efforts and innovation will be needed to ensure that urban living environments are well ventilated in order to impede respiratory diseases, well plumbed in order to avoid intestinal disorders, that solid waste is recycled in a sustainable manner, and that settlements are increasingly designed to better withstand such ineluctable hazards as earthquakes, fires, flooding, landslides, tsunamis, and volcanoes. In all these respects, urban design will enhance health and well being more effectively to the degree that it is science based, drawing upon the experience of many large settlements in different parts of the world. Modern Metropolitan Culture Highly agglomerated living offers residents considerably greater freedom of choice in personal and small group behavior and mores than has historically been possible in smaller settlements. Many of the historically new freedoms cities offer seem to enhance health and wellbeing, but some seem to leave some individuals and groups adrift in unfamiliar settings. Science and technology might be more effectively employed on behalf of large settlements if more were know about the interplay of culture and settlements. Some possibilities that might profitably be pursued are the tensions between community and diversity among new migrants to large settlements, how trade and travel affect cultures and cultural values, and the health consequences of the globalization of food sources and supplies, with specific reference to the ways foodways change when people migrate to and settle in large urban agglomerations. Articulated food chains usually result in greater food diversity and more reliable supply than is characteristic of rural areas, but typically at higher cost and with the substitution of refined for whole foods. Altered and new ways of preparing food may also have beneficial or harmful consequences. Players Many members of the ICSU family of organizations and affiliates would find a focus on living environments an element of direct interest if included as part of an initiative on science for health and wellbeing, including, but not restricted to:
Outputs The working group on living environments suggested that the products of living environments research on science for health and wellbeing should consist of publications designed for and useful to educators at the secondary school and university levels, and of policy-focused and policy-relevant publications consisting of guidelines, standards, and recommendations. The identification of these outputs is not meant to preclude such other forms of dissemination of results as workshops, short courses, etc., when and where appropriate. Audiences Consistent with the outputs noted above, the working group proposed that the results of living environments research be addressed specifically to: government agencies at various levels from local to international; legislators and regulators; professional groups, especially in health care specialties; educators; relevant private sector decision makers and researchers; town planners; and citizen and volunteer organizations. Prepared by Ronald Abler (rabler@aag.org)
Working Paper 2: Water Connections between water and health:
Water management: Local level: Watershed development - sources of pollutants, (natural and chemical), agriculture.
Regional level: strategy for water use, flood control, geopolitical aspects. National level: conflict, sharing water, strategic issues. Influence of technology: desalinisation, cloud seeding, sanitation. Outputs Local requirements in a global context (global climate change, water cycle, consequences of not managing water can be catastrophic) Audience Science community, local users, resource planners, strategic planners, healthcare industry, educators. Prepared by JoAnn Joselyn (jjoselyn@cires.colorado.edu) and Ian Dowman (idowman@ge.ucl.ac.uk)
Working Paper 3: The Impacts of Technology on Health and Wellbeing Unions to be involved IUPsyS, IBRO, IUPESM, IUPS. Others? Topics and focus How do technologies - mainly information technologies - impact human health and wellbeing? The topic will be focused on some specific issues, most of them related to brain and cognitive functions. First of all, we will consider those technologies which provide means for diagnosis and remediation. The first case to be considered is the set of technologies developed to investigate brain functioning. Neuroimaging is becoming a common tool in the study of cognitive processes, which necessitates deeper mutual knowledge between scientists developing models of the brain functions and scientists who design or refine modern neuroimaging tools (PET and fMRI). Another set of techniques which are expanding are the Virtual Reality techniques, which provide a method for exposing patients to situations, for instance in desensitization procedures. Phobias, mainly social and spatial phobias, can be treated by using controlled immersion of patients in virtual environments (a technique that can be used in hospital contexts, but also at the patient's home). People with mild psychopathological disorders can benefit from these techniques which avoid direct exposure to situations that are quite difficult to reconstruct in hospital settings. Virtual Reality must also be approached as a currently available product in our societies and an object for which some people develop intense interest, and even some forms of addiction. The consequence is loss of reality monitoring and tendency to mix up reality and imagination. By generating a strong feeling of presence, these techniques are a source of emotional disturbances that require more documented approach in order to prevent users of computer-based virtual environments from weakened sense of reality. Outputs An inventory of the impact of information technologies on mental processes; a set of guidelines regarding the practice of technology-based therapies. 4. Audience for these outputs Clinical community; researchers involved in clinical settings. Prepared by Michel Denis (denis@limsi.fr) |
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