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Essay question

Develop an intervention for a specific case study of your choice, addressing current challenges of social determinants of planetary health in the Anthropocene.

Essay guidance

The essay will need to address the complexity of factors, such as environmental, biological, social, political historical, cultural and economic which determine planetary health. Take into account the planetary boundaries and social determinants when you describe the context of life in the Anthropocene which has altered planetary health and negatively impacts health outcomes, putting some people at a higher risk of suffering than others. Choose your case study wisely to be able to depict the complexity of issues, which then allows you to develop an intervention. It is important that for your case study you have the relevant literature to comprehend and analyse the diversity of factors and their interplay, which will then allow you to propose a meaningful intervention.

The case study should be determined by allowing you to depict the complexity of issues that determine people’s health in the Anthropocene. This could be the burden of a particular disease to a particular marginalised population or the impact of a particular anthropogenic factor such as fracking, gas production, soy bean production and environmental degradation that impact on people’s health. Whatever you choose, it is important to be very precise to allow you to develop an intervention for a specific topic, in a specific place, an area based intervention.. An intervention is a health policy aiming at improving people’s living conditions and can be measured by consequent health outcomes. It is important to distinguish between a targeted intervention that tend to be discrete and specific and the need for systemic and structural change (of which the latter involves multiple interventions of different sorts and all levels of society).

In terms of this essay and your proposed intervention, think about what kind of health policy we need to address for example the spread of vector-borne diseases to new areas, because of changing climate and environmental degradation, including urbanization, biodiversity loss, forest fragmentation and deforestation. This would allow you to address the complexity of factors, such as the epidemiology of vector, parasite or virus involved, together with local and global environmental changes, such as increasing surface temperature, species loss and along with socioeconomic factors.

Essay structure
In the first part of your essay consider the interplay of social determinants of health with planetary boundaries to analyse the historically grown process of the context in which your intervention takes place. Here it is important to allude to all influencing factors, maybe even mapping them out to show the complexity of interrelationships that inform illness. Illness in this case can be related to a re-emergence of a disease affecting a particular population in a specific context. It can also be a particular anthropogenic factor that alters planetary health and leads to diverse negative health outcomes for a specific population in a particular context.

Whereas the first part describes the complexity of the context, the second part should be directly aimed at a proposed intervention in that specific area, for a specific population. Be careful that in the second part you address the following questions:

1. Where will this take place?
2. Who will be targeted?
3. What is the health outcome or behaviour you wish to address?
4. What is the nature of the intervention?
5. How will you evaluate the success of the intervention?
6. What challenges do you expect in this intervention?

Be critical with your own intervention, taking into account the challenges of developing an intervention within the realm of planetary health.

It is important that your essay is set out in paragraphs using subheadings and with a high standard of spelling and grammar. Start of with an introduction to the topic, an argument, how you are going to support your argument throughout the essay and what you expect the outcome to be. Avoid bullet points and do not include any figures, which are not discussed in the text.

Your paragraphs should relate back to your main argument and be coherent throughout the essay.

The essay should end with a conclusion that does not only summarize what you have been doing, but much more go beyond your initial argument, showing what has been learned and critically assess the limits as much as an outlook for future interventions.

References should be Harvard format and must be consistent.

Two illustrative examples : these are two examples of topics that could be written about, you can write either one depending on how much knowledge you have about the topic. Alternatively any another topic could be used.

Firstly, taking cases of malaria in high altitude environments in the Andes, you could focus on one particular region and people within a specific country. In the Andes, may it be the Columbian, Ecuadorian, Peruvian or Bolivian it would be mostly marginalised indigenous and mestizo people who are at a highest risk, with limited access to quality health care services, no previous experience with malaria. Depending on the area, their livelihood would be likely determined by other planetary boundaries such as melting of glaciers and no access to drinking water, disruption of nitrogene and phosphorus cycle leading to a depletion of soil, deforestation, increased flooding… and historically grown factors of unequal power relations, access to economic, political and social resources, such as disrupted social networks because of forced migration, conflict, as much as inadequate housing, food insecurity, and malnutrition. This would also give you the chance to analyse the Anopheles life cycle and how it changes under a changing environment and then how the parasite itself is very sensible to minimal changes in temperature. In terms of intervention, so what would improve people’s livelihood in such a given environment, how could we for example build resilience, by protecting and establishing healthy ecosystems? Who is mostly at a high risk, are these children or adults? This would then be the target. A decrease in malaria infections, or maybe even an eradication of malaria in the region could then be the measured health outcome. There are plenty of potential interventions here, which could not only have the measured one health outcome, but improve the overall living conditions and therefore various health outcomes. Be creative!

Secondly, think about the fracking and the potential health impacts on local populations. This would allow you to go into the context of CO2 emissions, and burning of fossil fuels as the main anthropogenic driver of climate change. While addressing also negative health impacts, risks for fossil fuel extractions in a country with a high GDP and a low GDP and if and how fracking contributes to sustainable development or how past experiences have played out around the world. If fracking is happening and the health assessment describes several risks so then we need to think about interventions that can reduce the risk and improve people’s access to quality health care. Your intervention could be focused on one particular group of people who would be at the highest risk for a negative health outcome, or at a negative health outcome that would put people at risk. It might be important here to look at the complexity of issues that might likely be negatively affected and how this could be addressed in an intervention. So, for the intervention, one could focus on a small community in England close to a fracking site and focus on the impact of fracking on air pollution for example, measuring the intervention outcome on reduced respiratory infections. It would be interesting to see how air pollution could be reduced and how through this intervention human and ecological health could be improved.

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