Health in Ecological Perspectives in the Anthropocene

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Editors
Toru Watanabe Chiho Watanabe
Department of Food, Life National Institute for Environmental Studies
and Environmental Science Tsukuba, Ibaraki, Japan
Faculty of Agriculture, Yamagata University
Yamagata, Japan

ISBN 978-981-13-2525-0    ISBN 978-981-13-2526-7 (eBook)

https://doi.org/10.1007/978-981-13-2526-7

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Contents

1 Ecohealth and Human Ecology as Underlying Theoretical

Background.............................................................................................. 1
Toru Watanabe and Chiho Watanabe

Part I Use of Spatial Information to Describe the Health Impact

of Various Environmental Factors in Urban and Rural Areas
2 Health Impact of Urban Physicochemical Environment
Considering the Mobility of the People.................................................. 13
Chiho Watanabe
3 Population Mobility Modeling Based on Call Detail Records
of Mobile Phones for Heat Exposure Assessment
in Dhaka, Bangladesh.............................................................................. 29
Shinya Yasumoto, Chiho Watanabe, Ayumi Arai, Ryosuke Shibasaki,
and Kei Oyoshi
4 Air Pollution and Children’s Health: Living in Urban Areas
in Developing Countries.......................................................................... 43
S. Tasmin
5 Statistical Analysis on Geographical Condition of Malaria
Endemic Area: A Case of Laos Savannakhet Province........................ 55
Bumpei Tojo

Part II Developing “Eco-health” Approach in the World in Transition

6 Ecohealth Approach to Longevity Challenges in Anthropocene:
A Case of Japan........................................................................................ 71
Kazuhiko Moji

v
vi Contents

7 Importance of Appropriate and Reliable Population Data

in Developing Regions to Understand Epidemiology
of Diseases................................................................................................. 83
Satoshi Kaneko and Morris Ndemwa
8 Access to Health Care in Sub-Saharan Africa: Challenges
in a Changing Health Landscape in a Context
of Development......................................................................................... 95
Peter S. Larson

Part III Urban “Shape” and Health Risks

9 Health Risk Assessment for Planning of a Resilient City
in the Changing Regional Environment................................................. 109
Kensuke Fukushi
10 An Ecological Context Toward Understanding Dengue
Disease Dynamics in Urban Cities: A Case Study
in Metropolitan Manila, Philippines...................................................... 117
Thaddeus M. Carvajal, Howell T. Ho, Lara Fides T. Hernandez,
Katherine M. Viacrusis, Divina M. Amalin, and Kozo Watanabe
11 Floods and Foods as Potential Carriers of Disease
Between Urban and Rural Areas............................................................ 133
Gia Thanh Nguyen, Jian Pu, and Toru Watanabe
12 Flood and Infectious Disease Risk Assessment...................................... 145
Nicholas J. Ashbolt
Chapter 1
Ecohealth and Human Ecology
as Underlying Theoretical Background

Toru Watanabe and Chiho Watanabe

Abstract The chapter introduces the concept of ecohealth and human ecology,
which are the backbones of this book through all the chapters. The chapter briefly
explains why these two concepts are important to understand the effect of physico-
chemical and microbiological environment on human health. Then, it summarizes
the transition of environmental health issues between the mid-twentieth century and
present, based on observations mainly in Japan. The last part of the chapter describes
the role of human ecology and ecohealth in the contemporary world and
Anthropocene together with introductions for each chapter.

Keywords Human ecology · Ecohealth · Environmental health · Planetary health ·

Anthropocene

1.1 Defining Ecohealth and Human Ecology

Ecohealth and human ecology have a lot of commonality, both embracing the idea
of mutual influence between human health and environment. As a result of this, both
are cross- or trans-disciplinary, and both accommodate a variety of ideas within the
respective field, reflecting their historical, multi-origin background. The difference,
if any, is while echoealth is focusing on health, one aspect of human existence,
focus of human ecology is somewhat broader ranging from the survival of human
population to the issue of socio-ecological relationship.

T. Watanabe (*)
Department of Food, Life and Environmental Science, Yamagata University,
Tsuruoka, Yamagata, Japan
e-mail: [email protected]
C. Watanabe (*)
Department of Human Ecology, School of International Health,
Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Current affiliation: National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
e-mail: [email protected]

© Springer Nature Singapore Pte Ltd. 2019 1

T. Watanabe, C. Watanabe (eds.), Health in Ecological Perspectives
in the Anthropocene, https://doi.org/10.1007/978-981-13-2526-7_1
2 T. Watanabe and C. Watanabe

The term, Human Ecology, was used in late nineteenth century for the first time,
and thus it may not be considered as a brand-new academic field. The focus of the
field has been and will be changing depending on the nature of human-environment
relationship at given time/era and given location/geography. In this regard, it cannot
be overemphasized that the scale of human activity has become so large that it can
be recognized as something driving earth system.
Thus, for human ecology, any human-environmental relationship should be
examined under both local and global context, which is in principle bidirectional
(i.e., human to environment and environment to human). For example, day-to-day
(or daily) movement observed in a population residing in and near an urban area
does not only influence the local environment in terms of traffic jam, urban air pol-
lution, and psychological stress on the commuters, but also influence the global
environment in terms of climate change through altered heat environment and
increasing gaseous and aerosol load. Urban flood events on the one hand will be
expected to increase as one of extreme events due to global climate change, while
on the other hand, urban infrastructure planning, the water control policy, as well as
local preparedness including early warning system, evacuation planning, all affect
the impact of urban flood on the local population. Although it is difficult to exactly
point out when such a situation emerged for the first time, it is evident that such dual
consideration was not so common, say, a half century ago when the Silent Spring by
Rachel Carson was published. As such, human-environmental relationship is by
nature an ever-changing phenomenon.
Ecohealth is also a relatively new field concerning the interrelationship between
human health and their surrounding environment. What ecohealth means varies
among the researchers, and according to Malee [1], it accommodates three different
streams, namely ecosystem health, conservation medicine, and global change (and
human health). Added to these three, a new, slightly different approach, which
Malee calls ecosystems approach to human health, has been added to the asset of
ecohealth. This approach can be characterized by its emphasis on the ecological
perspectives of the human health and its concern on the link between socio-­
environmental health (including social determinant of health, or social epidemiol-
ogy) and systems science, which is well overlapped with the health-oriented part of
human ecology.

1.2  istorical Transition (Traditional to Present)

H
of the (Field) Research in Urban Engineering
and in Environmental Health

Environmental health is a field literally dealing with relationship between environ-

mental factors and human health, which in principle could be within the scope of
human ecology. Historically, focused environmental factors in environmental health
have not been the same. Although there have been geographical variations in this
focus, there are a common trend. Generally, focus in the initial phase was on micro-
bial environment and home/work place (indoor) environment. These foci were
1 Ecohealth and Human Ecology as Underlying Theoretical Background 3

referring to a small-scale environment such as individual, for example, like personal

hygiene, or household level such as optimal room temperature, desktop brightness,
or ventilation frequency. Such small-scale environments are relatively easy to be
quantified and manipulated appropriately. In addition, the effects could be captured
easily since most of the effects of these small-scale factors are immediate effects on
physiological status of individuals, which can be monitored with relative ease.
Environmental contaminations of locality were one of the major factors that shift
the focus of environmental health to new direction. Among these contaminations
were air pollutions due to automobile exhausts (Los Angeles in 1930s to 1940s, for
example) or industrial facilities (represented by Yokka-ichi incidents in 1960s) as
well as chemical contaminations of water body in various localities (represented by
Minamata and Itai-itai incidents in 1950s), all of which were thought to cause
adverse health outcomes. Most of these incidents were associated with expanding
industry-driven economy of the mid-twentieth century observed in countries that
are deemed as “developed” in the current context. The researcher needed to identify
the responsible agent(s) of the adverse health status, to identify the sources – which
were in most cases industries – and to figure out the optimal solutions. For these
purposes, researchers need to visit – sometimes very often – the contaminated sites,
do surveys including relevant sampling, perform chemical analyses in the labora-
tory, and even do some proving experiments. Actually, a lot of technical progresses
were made in the latter half of the twentieth century in the area of environmental
health. In addition, many researchers learned that solutions of these issues require
understanding of social aspects of the problems.
Field surveys in human ecology in Japan took off around this period. In the initial
phase, surveys were often conducted in some variations of isolated populations,
including a couple of studies in islands located south to Japan major islands, a lin-
guistic group residing in a relatively limited area of Papua New Guinea, and group
of Japanese emigrants living in rural areas in some Latin American countries. These
relatively isolated populations offer ideal opportunities for researchers to define a
“human population” and to examine the environment-population relationship with-
out much interference by external forces. Some of the earlier studies dealt with the
exposure to trace elements with or without adverse health impacts. Through the
comparison of several subpopulations within a linguistic population in PNG, these
studies tried to understand the relationship between the human population and their
ecological environment. On the other hand, using stable isotopic ratio of major ele-
ments such as nitrogen and carbon in the human biological samples obtained from
these subpopulations, qualitative difference of food consumption among the sub-
populations were demonstrated and linked with corresponding ecological settings.
These studies had their roots in the conventional industrial health, emphasizing
spontaneous human activity, namely food consumption, which is directly associated
with the ecological settings in which the population is immersed. This was espe-
cially true for relatively isolated populations.
In the late 1980s, a new aspect of environmental health studies in human ecology
set out focusing on the environmental contaminations and their effects in develop-
ing countries. A series of survey was conducted in Bangladesh, where their drinking
water, that is, groundwater of the area, was contaminated by hazardous level of
4 T. Watanabe and C. Watanabe

inorganic arsenic. In this series of the survey, not only the exposure but also the
effects (toxic manifestations of arsenic) were quantified; in addition, metabolism of
arsenic in the body was also quantified. Although the implications of the findings
were more biology-/toxicology-oriented, the studies showed that the analyses of
human-environment interrelationship should take within-population variation of
individuals. Following the arsenic studies, we have broadened the scope of environ-
mental health studies (2006) to examine the consequence of lifestyle changes in the
rural area of developing countries. This new series of study involved some 30 com-
munities in 6 Asian countries, and tried to elucidate the relationship between the
lifestyle-related factors, exposure to various environmental factors, and their out-
come. An intriguing finding was that relationship between economic and lifestyle-­
related parameters and the health outcome might be different between two genders;
in other words, health-related effects of lifestyle change mainly due to growth in
market-oriented economic activity appeared gender-dependent. Thus, this new type
of study in the environmental health in human ecology emphasizes the importance
of within-population biological difference and of relatively complex relationship
between the changes in society and impacts in health.
Urban Environmental Engineering (UEE), a part of Urban Engineering which
has contributed to safe and comfortable human life in urban areas, is a discipline
close to environmental health. UEE aims to improve living and surrounding natural
environment in urban areas by developing and implementing technologies and poli-
cies to reduce or eradicate the emission of various contaminants from domestic and
industrial sectors. For example, design of infrastructures such as road, bridge, water
supply, and sewer system, which can give positive or negative impact on urban envi-
ronment, is an important subject in UEE. While studies in the environmental health
reveal the relationship between environmental factors and human health, UEE stud-
ies try to address environmental contamination, which may have been proved to
relate to human health in environmental health studies, in engineering approaches.
John Snow’s canonical study of cholera in London in seventeenth century is well
known as the first epidemiological study, which revealed a lower prevalence of chol-
era in areas supplied with water treated by slow sand filtration. We would like to
define this study as the first UEE study since the slow sand filtration of well water
before being supplied could be recommended based on this observation, although
the filtration technology per se had developed 20 years before Snow’s work. Since
then, as new contaminants (e.g., carcinogenic organic matters, algae,
Cryptosporidum) were identified and recognized as emerging issues, UEE research-
ers have developed new water treatment technologies such as rapid sand filtration,
chlorine disinfection, ozonation, activated charcoal, and membrane filtration. Issues
on urban drainage have been addressed by UEE studies in the same manner. Well-­
designed discharge and/or treatment of urban drainage with modern sewer systems
have reduced exposure of urban dwellers to contaminants in the drainage. Health
risks caused by various contaminants have been also reduced, contributing for
increase in urban populations, which in turn would lead to the development of
industries and economy, although such developments sometimes required a higher
level of management of urban drainage which increased and contained more
1 Ecohealth and Human Ecology as Underlying Theoretical Background 5

h­ azardous materials. Developed or industrialized countries like Japan and the USA
have already faced and overcome such a situation in the past, while some develop-
ing countries are still struggling to harmonize the development and contamination
in urban areas.
Developed countries have new challenges for sustainable urban environment due
to climate change and changing society such as maturation, aging, globalization,
and probably informatization (computerization). These challenges are totally differ-
ent from the past ones and will be more difficult to solve since exact nature of the
impacts due to changing climate and changing society on urban environment is
almost uncertain. Some studies have forecasted possible impacts of climate change
on urban environment, but there are still a lot of uncertain factors in the results.
Even if changes in urban environment in the future can be predicted with enough
accuracy, we have to design policies or plans to mitigate its impacts on urban dwell-
ers, including risk of human health problems. This appears hardly achievable if we
solely rely on engineering approach especially when we are required to change our
lifestyles due to lack of any knowledge and technologies to address the impacts. To
tackle these complicated issues on urban environment, approaches from human
ecology and ecohealth including human ethology, psychology, politics, economics,
and so on are useful, and it has been already started to establish new disciplines
integrating wide fields relevant to sustainable urban environment, one of which is
Sustainability Science created in 2005 at the University of Tokyo, Japan.

1.3 Human Ecology and Ecohealth in Anthropocene

The last half of twentieth century was the period when the interaction between
human and environment began to show new changes, i.e., while the human impact
on environment rapidly increased, health impact of environment becomes more
complex, subtle, and diversified, which made scientific community to create the
term, “Anthropocene.” Describing changes and discussing about the cause and con-
sequence of such changes are beyond the scope of this chapter, and those interested
readers should refer to recent reports and books (see Planetary health [2–4]). Here,
we would like to emphasize two features of Anthropocene along the context of this
book. The first one is growing importance of urban ecosystem. About a half of the
whole human population is currently living in the city, or urban area, and environ-
mental impact by urban population occupies substantial or sometimes predominant
part of the total impact by humans [5]. Thus, city is quantitatively the most signifi-
cant habitat for contemporary humans, which needs to be tackled by both human
ecology and ecohealth research. At the same time, this accelerating domination of
urban areas is closely linked with qualitative changes both in human health issues,
like epidemiological transition, and in population structure per se, i.e., aging of the
population. The second one is that human impact has become detectable at global
scale; the most notable one is the climate change, but researchers also have warned
that humans need to pay more attention to other areas like nitrogen/phosphorus
6 T. Watanabe and C. Watanabe

flows, land use, etc. In addition, environmental pollution has reemerged as a real
threat very recently. Environmental pollution was listed as one of the target domains
in the planetary boundaries paradigm [6] but is often regarded as something that we
could already overcome, at least in the developed regions.
Chapters in this book more or less address topics related with these two features
(see Fig. 1.1). Living in urban areas can affect human health either positively or nega-
tively. For human ecology, starting with its focus on relatively isolated/independent
populations, urban area with its large, vaguely defined, highly mobile population
has been a hard-to-tackle objective. Chapter 2 discusses about the issue of mobility
of the people, introducing recent studies how it can be grasped and how it is related
with distribution of various diseases. ICT-supported data collection on human-­
associated events (e.g., translocation of the people at daily level) made it feasible to
study the urban “population” without giving up the idea of grasping population and
their environment simultaneously. In Chap. 3, Yasumoto describes the use of the
Call Detail Records (CDR), one of the techniques to capture the people’s daily
mobility, which was mentioned in Chap. 2. Basic methods, analytical techniques,
and interpretation will be presented and discussed paying attention to technical
problems. Potential importance of population mobility data will be demonstrated by
a case study of heat exposure assessment in an urban area in developing country. In

Climate change
2,3 RS-GIS

ICT
11
5 7
Air pollution
4 Non-Infectious
Diseases
Urban env
6 9, 10,12 Rural env
Infectious
Diseases
8
Longevity

Fig. 1.1 Structure of this book. Numbers are referring to chapter numbers attached to an arrow
that shows the major content of the chapter; for example, both Chaps. 2 and 3 deal with RS-GIS-
based approach to health issues in the urban environment
1 Ecohealth and Human Ecology as Underlying Theoretical Background 7

Chap. 4, negative side of urban living in developing countries is discussed, focusing

on the health impact of air pollution on children. Cities in the developing world are
the key of sustainable world, since they are and will be the only place where popula-
tion increase will be observed in the next couple of decades. As already mentioned,
health impact of air pollution has been getting growing attention of public health
people recently [6].
RS-GIS is a powerful combination of tools to study human-environmental inter-
actions as is shown in the previous chapters. This approach is also effective in elu-
cidating the determinants of disease distribution outside urban areas as Tojo
explained in Chap. 5. These authors tried to find relationship among Malaria inci-
dence and land use, a combination of natural and anthropogenic conditions, medi-
ated by the presence of vector mosquitoes. Here, the ecologies of vegetation,
mosquito, and human were observed and integrated, suggesting the potential rela-
tionship between spatial distribution of the disease and land use. Looking from
another standpoint, this study is a straightforward example of application of eco-
health principle.
Growth of urban area is closely associated with the transition in human health
partly due to the aging of population. Effect of population level aging on the
environment-­human relationship is not simple. In Chap. 6, Moji discusses the “chal-
lenges” of longevity in Anthropocene, mainly focusing on Japan. First, historical
backgrounds that might enable the country to enjoy the highest longevity level in
contemporary world are discussed. Then, the author describes the challenges includ-
ing financial pressures on medical/health care and on young generations, which is
now being observed only in a couple of countries with extended longevity like Japan
but will be observed in most of the countries in the near future, suggesting that to
tackle these challenges, concept of interdependent health (consistent with ecohealth
framework) rather than concept of independent health (more coincidental to con-
ventional biomedical approach) is required. Chapters 7 and 8 have put more empha-
sis on developing regions in the world. Chapter 7 discusses the importance of
appropriate and reliable population data in developing regions in conducting
“regional” or “community”-based health survey. Many developing countries lack
the resident registration, which makes grasping health status of a population very
difficult. There have been some ambitious trials to establish such a system in devel-
oping countries, particularly in rural areas. Procedure and impacts on public health
of such system are described here, based on the authors’ experience to establish
Health and Demographic Surveillance System (HDSS) in Kenya. Potential needs,
conceptual origin, possible usage, and future perspectives of HDSS will be elabo-
rated. HDSS can be regarded as a tool for ecohealth approach since it emphasizes
the importance of demographic and social aspects in health science. In Chap. 8,
Larson analyzes the status of health care in contemporary Africa. He claimed that
existing healthcare systems are built on the past own (or Latin American?) success-
ful experience, which ironically generate problems because these ancient systems
could not match up with the health transition occurring/occurred in Africa.
The final part of the book will mostly deal with the issue of infectious diseases in
urban areas. Urban area is vulnerable to outbreak and/or spread of infectious
8 T. Watanabe and C. Watanabe

d­ iseases due to its high population density, massive population, and high mobility
of people. Climate change also has potential to make urban areas more vulnerable
to infectious diseases. Chapter 9 summarizes how the regional (urban) environment
in Asian cities is changing under the effects of climate change and urbanization, and
how risk of waterborne infectious diseases increases in the changing environment.
The risk increased with urban flood, which may happen more frequently under cli-
mate change, is demonstrated in a case-study in Jakarta, Indonesia. This case-study
indicates the necessity of health risk assessment for planning of resilient city, to
which knowledge and techniques in UEE are expected to contribute. Chapter 10
examines the spatial distribution of the Dengue fever, a typical tropical infectious
disease and considered as the most sensitive one to climate change, for which eco-
health approach should be effective. In this chapter, K. Watanabe’s group shows that
ecohealth model with statistical and process-based approaches is also applicable
and effective to this disease dynamics in urban areas. As a result of model applica-
tion, the authors’ group will present how the ecological factors, urbanization and
climate, currently affect the disease distribution in an urban area, Metro Manila, the
Philippines. This context is very significant in the control and prevention of this
arboviral disease. Chapter 11 takes up the issue of flood and food on human health
from a unique aspect dealing with the transmission of health risk agents (contami-
nants) between urban and rural areas. As written in Chap. 9, floods not only threaten
people’s lives, but they also bring additional risks for diseases resulted from expo-
sure to contaminated floodwater. In this chapter, the authors provide the literature
review to demonstrate the significance of indirect route of exposure in health risk
management, mainly via food contamination induced by floods, as well as direct
exposure to contaminants in floodwater. Based on the literature review, the authors
try to define flood as a carrier of contaminants from urban to rural areas and food as
the carrier in the opposite direction. The final Chap. 12 will elaborate the ideas of
the preceding chapters and try to quantify the impacts by the application of
Quantitative Microbial Risk Assessment (QMRA). QMRA is a general concept
which is widely applicable to a variety of issues, but this chapter describes an out-
line of what to consider when considering a QMRA associated with flood events.
With a view to aid in the prioritization of flood planning, mitigation, and controls
strategies, the author provides an example of QMRA application as well as its short-
coming and further research needs related to flooding.
While most of the chapters are discussing about local events, the readers may
notice they are not restricted in the targeted area but rather connected with global
issues or found in many places in the world. This is one of the distinct features of
the health issues in Anthropocene.
Most of the authors were the members of a project, “GRENECOH” (GRENE-­
Ecohealth (“GREen NEtwork of Excellence; environmental information”) funded
by the Ministry of Education, Culture, Sports, Science and Technology; MEXT)
(PI=CW), and most of the chapters were the results of the project. In addition, some
chapters included the outcomes from a project (PI=KF), which a part of authors
joined, supported by Japan Society for Promotion of Science (JSPS) Grant-in-aid
1 Ecohealth and Human Ecology as Underlying Theoretical Background 9

for Scientific Research (Number JP26241025 and JP17H01624). The authors would
like to acknowledge and thank the supports of MEXT and JSPS.

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 Part I
Use of Spatial Information to Describe
the Health Impact of Various
Environmental Factors in Urban
and Rural Areas