Author: Joanne Walker
Walker, Joanne, 2016 How rural communities take action to develop sustainable and healthy communities, Flinders University, School of Health Sciences
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Background: There is growing awareness of how ecological and social determinants of health both relate to emerging public health issues that have no precedent in human history. Effects of climate change, ozone layer destruction, contamination of water through fertilizers and pesticides, are coinciding with increases in social and economic inequalities, all of which have adverse effects on health and wellbeing. Addressing these issues requires building on public health traditions and implementing a mix of new interventions that incorporate biological, material, social and cultural dimensions of public health. Aim: The aim of this dissertation was to explore the concept of ecological public health and investigate how it relates to the concept of sustainability and health of rural Australian communities. The guiding question for this research was: How are rural communities taking action to develop sustainable and healthy communities the South Coast of New South Wales? Design: Perceptions and understandings of sustainable and healthy communities, and actions rural people are taking to contribute to this were examined using a mixed method multiple case study design, grounded in a constructivist ontology. The case study focused on three neighbouring local government areas along the South Coast of New South Wales, Australia. Methods included a narrative review of the literature, which lead to the development of the Ecological Public Health and Just Sustainabilties Model. Other methods included interviews and focus groups, a scoping review of online media; and an analysis of social and health statistics. A cross case analysis focused on actions for community energy, ways to bring the community together and economic activities for young adults, a town and a coastal region. Case study analysis was guided by the population health and sustainability indicators developed by Hancock et al. (1999). Knowledge exchange and research transfer approaches were integrated into each chapter analysis and used to summarise key findings from the case study. Findings: The case study and the literature review analysis showed that the concept of sustainability and health share the same determinants. The focus groups and interviews showed that sustainability is a contentious issue, but the concept of health is not. The analysis also showed that actions to develop social sustainability (promoting conviviality, sense of place and support networks) are the foundation for any sustainability and health action in these communities. Actions are diverse, but there are silences for activities that include children and young adults, and Indigenous Australians. Some actions focused on ecological sustainability in terms of providing food and promoting the aesthetics of the natural settings, but the ‘other than human’ living systems were not central to this and absent from the discussion. The issues of population and consumption and the impact of ecological transitions (such as climate change, sea level rise, ocean acidification and biodiversity loss) are also absent. The concept of equality is implied throughout the case study analysis, however the notion of equity (intergenerational, intragenerational, social and environmental justice) was not evident. Finally, the South Coast of New South Wales is a popular region for people moving from larger urban centres as part of the seachange and treechange phenomena. It is also a region that is popular with older working adults and retirees. These demographic and urban transitions are influencing the social and cultural dynamics in rural coastal towns. In effect, these population changes are transitioning rural Australian coastal community culture, and this is influences what is considered to be a sustainable and healthy by the rural community, and actions undertaken to address these issues. In this case study there is a strong emphasis on social sustainability, (particularly in creating a convivial community) and maintaining aesthetics of the landscape. This study will be useful to public health policy makers, researchers and practitioners in gaining an understanding of the interconnections between sustainability and ecological public health; the current issues facing rural coastal communities; and ways to work with and share knowledge within the public health discipline and rural Australian communities.
Keywords: ecological public health, rural health, sustainability, sustainable development
Subject: Public Health thesis
Thesis type: Professional Doctorate
School: School of Health Sciences
Supervisor: Colin MacDougall