Health ecology, land degradation and development

Increasing awareness of the health implications of environmental change in developing areas demands ongoing evaluation of the composition and context of unique human and environmental systems. The relationship between the eco logy of emergent and resurgent infectious disease and land degradation is a n uncertain aspect of environmental influences on human health that varies in different development contexts. An approach for examining a dynamic heal th and environment nexus is suggested based on combining ideas about health ecology with notions of sustainable development. The rationale is derived from the experience of research on changing diarrhoeal disease endemicity a nd epidemicity in central Mozambique, recent moves towards poverty reductio n through food and livelihood security in Zambezia province, and the develo pment of a geographic health information system to control malaria. Themes include analysing the influence of land degradation on incidence of infecti ous diseases, situating human health in land-based notions of sustainable d evelopment, and communality between environmental health care and land-base d poverty reduction policies. The paper emphasizes that environmental healt h surveillance and care must be responsive to changing health ecologies in varying development landscapes and that common policy directives should be sought in avoiding both human ill-health and land degradation. Copyright (C ) 2001 John Wiley & Sons, Ltd.