In recent years, the intersection between human health and the natural environment has garnered increasing attention within public health discourse and scientific inquiry. This complex relationship is not novel; rather, it is deeply rooted in historical perspectives that have evolved alongside societal understanding of health determinants. A landmark paper published in the International Journal for Equity in Health titled “Health & nature: a critical review of historical perspectives to support narratives for change” by Amengual-Moreno, Cash-Gibson, Vivas, and colleagues, provides a compelling and comprehensive review of these perspectives. Their analysis repositions nature not merely as a backdrop to human life but as a fundamental determinant of health, emphasizing the urgent need for transformative narratives.
The authors embark on an ambitious exploration of how the trajectory of human health has been conceptualized in relation to nature from antiquity to the contemporary era. By tracing back to ancient civilizations, they reveal how early societies intrinsically linked environmental factors to well-being. Philosophers like Hippocrates posited that imbalances in the environment—whether in air quality, water, or soils—could manifest as diseases. This early understanding framed health as something inherently tied to natural ecosystems, promoting a holistic view that integrated environmental stewardship with human wellness.
Fast forward to the industrial revolution, a marked shift occurred. Rapid urbanization, technological advancement, and environmental degradation disrupted the delicate balance between humans and their surroundings. This period saw the emergence of biomedical paradigms focusing on disease pathogens and individual treatment rather than root-cause prevention involving environmental factors. Epidemiology emerged as a discipline, yet often sidelined the broader ecological context. The authors underscore that although the industrial era brought incredible progress, it also entrenched a separation between humanity and nature, fueling health disparities and environmental injustices that persist today.
Central to this historical critique is the concept of health equity—the idea that everyone deserves fair access to factors that promote good health, including clean air, water, green spaces, and biodiversity. Amengual-Moreno and colleagues argue compellingly that environmental inequities are not incidental but systemic, grounded in socioeconomic and political structures that govern resource distribution. Their review highlights that marginalized communities have disproportionately suffered from environmental harms, which in turn exacerbate health inequities. Recognizing environmental justice as a health imperative is a critical step towards enabling more inclusive and equitable health outcomes.
The authors also navigate through emerging scientific frameworks that reincorporate nature into health paradigms. The “One Health” approach, for example, explicitly integrates the health of humans, animals, and ecosystems into a unified conceptual model. This multidisciplinary framework reflects a growing acknowledgment that human health is inextricably linked to ecological integrity. Similarly, “planetary health” frameworks extend this logic by situating human well-being within the context of global environmental changes, such as climate change, biodiversity loss, and pollution. These innovative approaches challenge reductionist views and rally for systemic thinking in health policies and research.
One of the most striking contributions of the review is its call for transformative narratives—stories and frameworks that reimagine the human-nature relationship in ways that inspire action and policy change. Narratives have profound power to shape public perception, funding priorities, and political will. Historically, narratives centered on conquest and domination of nature paralleled exploitative exploitation of natural resources and disregard for ecological limits, fueling health threats. The authors advocate for counter-narratives that emphasize interdependence, resilience, and symbiosis, thereby fostering cultural shifts toward sustainability and well-being.
The integration of nature-based solutions into health interventions represents a promising frontier highlighted by Amengual-Moreno et al. Nature-based solutions encompass strategies such as urban greening, restoration of natural habitats, and promotion of biodiversity to address health challenges, including mental health disorders, respiratory illnesses, and non-communicable diseases. By harnessing the therapeutic and preventive potential of natural environments, these interventions embody a return to more holistic and preventative health paradigms. The authors emphasize the importance of rigorous evidence to guide policymaking, ensuring that nature’s health benefits are effectively leveraged and equitably distributed.
Importantly, this critical review contextualizes the ongoing global climate and biodiversity crises as existential threats to human health with roots in historical neglect of ecological factors. Anthropogenic environmental changes are intensifying health risks through increased disease transmission, food insecurity, heat stress, and mental health burdens. The authors underscore the imperative of embedding environmental considerations at the core of health systems and governance. Health professionals, policymakers, and communities must transcend siloed thinking and collaborate across sectors to tackle these interconnected challenges effectively.
The implications for global health equity are profound. Climate change and environmental degradation disproportionately affect vulnerable populations—those already burdened by poverty, marginalization, and limited access to health care. Drawing on historical perspectives, Amengual-Moreno and colleagues argue that tackling these inequities requires structural changes rooted in social justice, recognizing the rights of nature and integrating indigenous knowledge systems that often embody sustainable coexistence principles. Their review champions participatory approaches that empower marginalized voices in health and environmental decision-making.
At the methodological level, the paper underscores the value of interdisciplinary research combining historical analysis, epidemiology, environmental science, and social theory to unravel the complexities of health-nature interactions. Such comprehensive assessments can inform robust models that predict health impacts of environmental changes and design adaptive strategies. The authors highlight emerging data technologies and geographic information systems (GIS) as potent tools to monitor environmental determinants of health in real time, enabling proactive interventions.
Philosophically, the paper challenges the dominant anthropocentric worldview that prioritizes human needs without regard for ecological consequences. The authors invite readers to embrace an ecocentric ethic—a recognition that human health and flourishing depend on the health of the broader biosphere. This paradigm shift calls not just for new scientific metrics, but for a profound cultural reorientation, including changes in education, governance, and economic systems to prioritize sustainability and resilience.
Moving forward, the critical review insists that educational curricula in public health and medicine incorporate environmental health comprehensively, equipping future professionals with the knowledge and skills to address pressing ecological determinants of health. There is a call for integrating experiential learning in natural settings to re-establish emotional and cognitive connections with nature, which have been eroded in modern urbanized societies. Such education reform is vital to cultivating health leaders who can champion integrated, equitable, and sustainable health solutions.
The role of urban design and architecture in mediating health-nature relationships receives attention as well. The authors explore how cities can be redesigned to foster biodiversity, air quality, and accessible green spaces, thus serving as health-promoting landscapes. These concepts align with “biophilic design” principles that incorporate natural elements to enhance psychological well-being and social cohesion. Urban ecosystems, when thoughtfully managed, become frontline arenas for health interventions addressing chronic disease, social isolation, and environmental justice.
The review also engages with policy challenges and opportunities, analyzing barriers to mainstreaming nature-based health approaches, including entrenched economic interests, regulatory inertia, and limited cross-sector collaboration. Strategies to overcome these barriers include incentivizing green infrastructure investments, strengthening environmental health governance frameworks, and promoting public engagement campaigns that shift societal values. The authors stress the importance of accountability mechanisms to ensure that policies translate into measurable health and environmental outcomes.
Importantly, Amengual-Moreno and colleagues celebrate examples of communities and regions that have successfully integrated nature restoration with health improvements, underscoring replicable models. Indigenous-led conservation efforts and urban rewilding initiatives serve as inspiring blueprints demonstrating that health and nature goals are achievable in synergy. Such success stories generate hope and momentum, illustrating that through intentional narrative shifts and systemic action, a healthier, more equitable future is attainable.
As the world faces daunting health and environmental crises, this critical review provides a timely, nuanced roadmap for researchers, practitioners, and policymakers. It calls for renewed attention to the deep historical entanglement of health and nature, advocating for narratives and policies that embody this connection with clarity and urgency. In an era of unprecedented human impact on the planet, embracing nature as a central pillar of health equity is not merely idealistic; it is essential for survival and flourishing.
By weaving historical insights with contemporary scientific advances, Amengual-Moreno, Cash-Gibson, Vivas, and their colleagues reinvigorate the conversation on health’s ecological foundations. Their work urges a collective paradigm shift—from exploitation to stewardship, from fragmentation to integration, from reactive illness treatment to proactive health promotion rooted in nature. This transformative vision holds the promise of catalyzing innovative, equitable solutions that honor the intricate bonds between human well-being and the vitality of the natural world.
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Subject of Research: The historical relationship between health and nature, focusing on environmental determinants of health and their implications for health equity and narratives promoting systemic change.
Article Title: Health & nature: a critical review of historical perspectives to support narratives for change.
Article References:
Amengual-Moreno, M., Cash-Gibson, L., Vivas, L. et al. Health & nature: a critical review of historical perspectives to support narratives for change. Int J Equity Health 24, 247 (2025). https://doi.org/10.1186/s12939-025-02550-y
Image Credits: AI Generated
