顯⽽易⾒，我們正⾯對環境和公共衛⽣的兩⼤危機。在環境⽅⾯，我們已經可以親⾝體驗氣候變化， 例如⽬前香港已看到記錄以來最熱的三⽉。但是，環境危機遠不⽌於此。⼈類活動正威脅著地球的健康，並且已發展到出現⼤規模森林砍伐、⽣物多樣性減少和海洋酸化的情況。
⾄於公共衛⽣，無疑最迫切的問題就是2019冠狀病毒病。同時，我們絕不能忽視非傳染性疾病（例如2型糖尿病和⼼⾎管疾病）患病率上升的趨勢。
驟眼⼀看，環境和公共衛⽣危機是分開的，不過其實它們息息相關。全球⽣態變化可以間接影響我們的健康，例如通過「⼤⾃然不⾜症」，⼜例如熱浪也會直接影響我們的健康。我們⽇益惡化的健康狀況（主要歸因於非傳染性疾病）也會令我們更難抵抗疾病及全球⽣態變化所引致的健康威脅。
⽬前有沒有辦法同時解決這兩個危機呢？從根本上分析，環境和公共衛⽣危機的起因正是因為我們對經濟增長永無⽌境的追求，⽽促使我們⽇益剝削⽣態系統，並且導致社會出現不公正和不平等的情況⽇益嚴重。
除了健康的社會決定因素（例如低下階層⼈仕因所處⾝的不利位置⽽其健康狀況更容易受到影響），此外，⽣態決定因素也很重要。在2015年的⼀份討論⽂件中，加拿⼤公共衛⽣協會指出，要應對全球挑戰，我們必先明⽩⼤眾的福祉與我們的⽣態系統是⼀脈相連的。
有了這種理解才會意識到我們要使⽤社會⽣態系統的概念才能夠更有效確保所有⼈的健康和福祉。最終，⽬前的社會價值觀是絕對需要有根本性轉變，因為我們必須意識到⼈類的健康取決於地球的健康。如果我們好好保護地球系統，我們亦同時在保護我們的健康。
為了實現這根本性轉變，我認同Margot W. Parkes及其同事在《加拿⼤公共衛⽣雜誌》中所提到的建議。當中評論提到跨部⾨的合作是必不可少的，⽽有關環境和健康以外的私營和公共部⾨都需要同⼼協⼒，⼀起連結追求社會平等、環境⽣態品質和公共衛⽣的普世價值，然後將其轉化為到我們的系統當中。但願通過這種綜合⽅法，我們可以邁向可持續發展、 平等和健康的未來。
英屬哥倫比亞⼤學⼟地與糧食系統學院本科⽣ Rachel Chan
It is evident that two crises – environmental and public health – are happening right now. On the environment, we can experience climate change first-hand – Hong Kong saw the hottest March on record. However, the environmental crisis is much more than that. Our planet’s health is being jeopardised by human activity to the point that we see large-scale deforestation, biodiversity loss and ocean acidification.
On public health, one of the most pressing concerns right now is undoubtedly Covid-19. Yet, we must not lose sight of the rising prevalence of non-communicable diseases, such as Type 2 diabetes and cardiovascular disease.
It might appear that the environmental and public health crises are separate. However, they are closely linked. Global ecological changes can impact our health indirectly – for example, through "nature deficit disorder” – and directly, such as through heatwaves. Our worsening health, mostly attributable to non-communicable diseases, can also make us more predisposed to health threats imposed by global ecological changes.
Is there a way to address these crises simultaneously? The environmental and public health crises fundamentally have the same cause: the never-ending pursuit of economic growth, leading to increased exploitation of our ecosystems and increasingly unjust and inequitable societies.
Apart from social determinants of health – when one is socially disadvantaged because of inequities, one is more predisposed to worse health – ecological determinants are important. In a discussion paper in 2015, the Canadian Public Health Association noted that addressing global challenges requires understanding that the well-being of humans and our ecosystems are interconnected.
With this understanding comes the awareness of using eco-social approaches to achieve better health and well-being for all. Ultimately, a fundamental shift in societal values is needed; we have to appreciate that human health depends on the Earth’s health. If we nurture the Earth’s systems, we also nurture our health.
To achieve this fundamental shift, I echo the suggestions of Margot W. Parkes and colleagues in a commentary in the Canadian Journal of Public Health that a multi-sectoral approach is indispensable. Private and public sectors beyond health and environment need to collaborate and connect the values of equity, ecosystems and public health, then translate that into our systems. With such integrative approaches, we can be hopeful about a transition to a sustainable, just and healthy future.
Rachel Chan, undergraduate student, Faculty of Land and Food Systems, University of British Columbia