Development of a One Health conceptual framework for socio-ecological systems

Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 1 Annex 1. Taskforce: Build your own fuzzy cognitive map about One Health 1. INTRODUCTION The One Health Observatory Lighthouse – HOBE (“better” in the Basque language) project is funded by Ministerio de Ciencia e Innovación / Agencia Estatal de Investigación - Spain. The HOBE project is being carried out in the bay of Plentzia, in the Butroe River that flows into it and in all its watershed. It is implemented by the Plentzia Maritime Station (PiE, by its acronym in the Basque language) and by the Basque Center for Climate Change - BC3. One Health High-Level Expert Panel (OHHLEP) define One Health as “an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems and requires mobilizing multiple sectors, disciplines, and communities to overcome threats to health and ecosystems” (figure below). The principles on which it is based are (1) equity between sectors and disciplines, (2) sociopolitical and multicultural parity, (3) socio-ecological equilibrium, (4) stewardship and the responsibility of humans to change behaviour and adopt sustainable solutions and (5) transdisciplinary and multisectoral collaboration (OHHLEP et al., 2022). One Health toward a sustainable healthy future as developed by the OHHLEP (2022) The earth's landscapes are an interwoven network of connections between terrestrial, freshwater, coastal-marine and marine landscapes (natural and transformed) and all the species that live in them, including humans and non-humans (Balzer et al., 2000). Any action can positively or negatively affect the entire network, spatially and temporally. Therefore, the HOBE Project assumes these four assumptions: 1. One Health definition from the One Health High-Level Expert Panel (OHHLEP) et al., 2022 2. Human and non-human beings depend on ecosystems (Glaser et al., 2012). 3. One Health approach is developed in a social-ecological system (Ostrom, 2009) a landscape approach (Opdam et al., 2003; Reed et al., 2015) in this case coastal-landscape. 4. Our study area is a socio-ecological system and is nested in a telecoupling system 1 (Liu et al., 2019). ====================================================================================== IMPORTANT: PLEASE DO NOT FORGET TO SIGN THE DATA PROTECTION FORM AND SEND IT TO US WITH YOUR MODEL. 1 It is an integrative way of studying coupled human and natural systems that are linked over long distances. D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 2 2. TASK FORCE OBJECTIVE To collect representations of “one health” mental models from experts in a structured and coordinated way to enable the collection of digitized data through Fuzzy Cognitive Mapping (FCM). For this, we will use the Mental Modeler software (Gray et al., 2013). With this purpose, components that might be included in the model have been collected by the HOBE project team. All components are based on a review of the literature on (i) Nature´s contributions to people (Díaz et al., 2018); (ii) the social determinants of health (Choi & Sonin, 2018; Marmot & Wilkinson, 2005); and (iii) determinants of animal health (Cipolla et al., 2015; Card et al., 2018; Bauman & Parmley, 2021; Wittrock & Duncan 2019); and (iv) socioeconomic determinants. To understand how these components, relate to human, animal and ecosystem health (One Health) our main two questions are: 1. WHAT ARE THE MOST RELEVANT COMPONENTS RELATED TO HUMAN, ANIMAL AND ECOSYSTEM HEALTH? 2. HOW DO THESE COMPONENTS RELATE TO EACH OTHER TO CONTRIBUTE TO HUMAN, ANIMAL AND ECOSYSTEM HEALTH? PLEASE READ ALL INSTRUCTIONS CAREFULLY… 3. STEP-BY-STEP 3.1. Mental Modeler software https://www.mentalmodeler.com/ You can register or use "mentalmodeler / mentalmodeler" in username and password. 3.2. Open file Mental Modeler software When you have the Mental Modeler open, upload the file OH_HOBE_en.mmp attached to this email by clicking on Load. D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 3 This file contains all “components” from different approaches. You can tell them apart by the colours (please do not change them or delete them). 3.3. Individual model construction To build your fuzzy cognitive map you have the components and you need to build the relationships between these components. A. Select the components that you believe are important for the One Health approach. a. In the supplementary information, you can find the tables with a short description of each component. b. If you believe that one component is missing you can incorporate it; please don't forget to give us a short description of it when you send us the model. Example: “Pollution” and the “One Health” are directly connected. On the other hand, a correct “Regulation of air quality” determines the presence or absence of pollutants. B. Generate the relationships between components. a. The relationships have 2 main characteristics: i. The direction of a relationship (which way the arrow is pointing) ii. The type of influence one component has on another. The feedback can be positive (+1) or negative (-1), but never zero (0). Ecosystems Human health Socioeconomic factors Animal health D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 4 Example: “Regulation of air quality” influences “Pollution.” If the system's regulation capacity decreases, the presence of pollutants is likely to be higher, and vice versa. The relationship is, therefore, negative and would be noted with a -1. Rule of thumb. When determining the relationships between components, always ask yourself: When this component increases, does the other component increase or decrease? If increase/decrease does not apply think in terms of whether it is better or worse (improvement or deterioration). You should build something like this: Some components seem to refer to the same concept, but they must be understood in the context of the corresponding health determinants group they belong to. For example, "Diversity and Diet Patterns", "Animal Food security and nutrition" and "Food and feed" all refer to food, but the first refers to human food, the second to animal food and the third to nature's capacity to provide food. +1 0 -1 Remember! 1) You don't have to use all the components, but the ones you do use, use them well! Please, do not delete the components that you leave out of the model, simply place them in a corner. 2) If you consider that a component is missing, you can add it! Please send a brief description together with the model you have built. You can start with any component of any group. Whichever one you feel most comfortable with. Take time to think! D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 5 3.4. Save your model When you finish your model, please save it and put your organization (BC3 or PiE, etc) at the end of the filename (e.g. OH_HOBE_en_YourOrganization.mmp). If you have to leave the exercise unfinished, please save it so that you can reopen it and not waste your time. 3.5. Sent your model to HOBE Project When you finish your mental map, please send it to [email protected] 4. ADDITIONAL NOTES ✓ This task force exercise lasts approximately 3h. ✓ You have time to complete the exercise until January 8th, 2024. ✓ Feel free to contact us if you need any additional explanation ([email protected] / [email protected]) If you don’t feel secure about how to develop your model, you can watch the video Introduction to mental modeler https://www.youtube.com/watch?v=UbKzyDctkrY&t=6s&ab_channel=MentalModeler. You can find more information at https://www.mentalmodeler.com 5. SUPPLEMENTARY INFORMATION Below you will find a short description of each component, sorted in alphabetical order within each category. D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 6 Category Components Brief description Human Health: The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. The SDH have an important influence on health inequities - the unfair and avoidable differences in health status seen within and between countries. (Choi & Sonin, 2018; World Health Organization: https://www.who.int/newsroom/questions-andanswers/item/determinants-ofhealth) Environment: The environment refers to the natural and human environments we live in and includes everything from our cities' infrastructure to the air quality we breathe. The physical environment is an important factor contributing to our health but has the most minor impact out of all the determinants. However, it can still have a critical effect on our overall health. Allergens According to the National Institute of Environmental Health Science2, allergies arise if the body's immune system overreacts to certain foreign substances (allergens) that are generally harmless in most people. Common allergens include pollens, fungal spores, house dust mites, and animal epithelial materials, but they can also include drugs, biological products, and insect venoms. Exposure/Access to Firearms Access to loaded firearms that are readily available plays a potential role in impulsive suicidal behaviour or rapidly escalating violent interpersonal events. Also, firearms play a role in hunting and conserving wildlife. (Ikeda et al., 2003) Location The neighbourhoods people live in significantly impact their health and well-being. Healthy People 2030 focuses on improving health and safety in the places where people are born, live, learn, work, play, worship, and age (CDC, 20183). This includes access to healthy foods, crime level, transportation quality, crowding conditions, public space, educational opportunities, job opportunities, walkability, residence quality, recreational activities, and green or blue areas. Pollution According to ATSDR4, Pollution can harm human health and the environment. It can be pollutants found in air, water and soil. It can also be harmful noise or artificial light. Exposure to toxic chemicals can lead to chronic and often irreversible health conditions such as neurodevelopment problems and congenital defects and diseases associated with endocrine disruption. The emergence of new environmental hazards, such as electronic waste, nanoparticles, microplastics, chemicals that alter the endocrine system, and water scarcity. Individual Behaviour: Smoking habits, sleep and exercise patterns, sexual activity, and mood levels are all examples of individual behaviour, which is a critical determinant for our physical health, mental health, and overall wellbeing. Positive changes to our Diversity and Diet Patterns According to the U.S. Department of Health and Human Services and the U.S. Department of Agriculture5, Healthy dietary patterns can help lower the risk of chronic disease. The core elements of a healthy dietary pattern include consuming vegetables of all types, fruits, grains (especially whole grains), low-fat or fat-free dairy, protein foods, and oils while also paying attention to portion size. Access to foods that support healthy dietary patterns supports health not only then but also across the lifespan and possibly for future generations. 2 National Institute of Environmental Health Sciences: https://www.niehs.nih.gov/ 3 (Centers for Disease Control and Prevention. (2018). Social Determinants of Health: Know What Affects Health. Retrieved from https://www.cdc.gov/socialdeterminants/index.htm) 4 Agency for Toxic Substances and Disease Registry (ATSDR): https://www.atsdr.cdc.gov/ European Environment Agency: https://www.eea.europa.eu/en/topics/in-depth/pollution 5 U.S. Department of Health and Human Services and U.S Department of Agriculture. (2020). 2020-2025 Dietary Guidelines for Americans: 9th Edition. D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 7 Category Components Brief description individual behaviour can reduce the risk of developing a variety of diseases, and many public health interventions have already focused on altering dangerous behaviours. Sleep Patterns According to AASM6, Healthy sleep habits can improve your ability to fall asleep and stay asleep. Sleep deficiency is linked to chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity, and depression. It is also linked to accidents that can result in injury or death. Factors contributing to insufficient sleep include environmental, familial, socioeconomic, social media use, and lack of physical activity. Physical Activity Physical activity is any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity refers to all movement, including during leisure time, for transport to and from places or as part of a person’s work. Both moderateand vigorous-intensity physical activity improve health. Regular physical activity is proven to help prevent and manage noncommunicable diseases such as heart disease, stroke, diabetes and several cancers. It also helps prevent hypertension, maintain a healthy body weight and improve mental health, quality of life and well-being (WHO, 20227). Psychological Assets Resilience-based interventions often target psychosocial assets such as persistence, tolerance of negative affect, self-efficacy, planning, and prosocial behaviours (e.g., empathy, kindness, teamwork, and other social skills). (Leventhal et al., 2015) Negative Mood According to Better Health8, a negative mood can be described as any feeling that makes you miserable and sad. These emotions make you dislike yourself and others and reduce your confidence, self-esteem, and general life satisfaction. Emotions that can become negative are hate, anger, jealousy, and sadness. Medical care: Factors correlated with care by a trained provider, such as provider availability and quality of healthcare. However, often we fail to realize that medical care only contributes to a small portion of our overall health. The most prevalent issue in medical care today is simply the lack of access to health services, as well as a decreasing level of health literacy in the general population. This combination can be very dangerous since the high cost of care and lack of knowledge may cause patients to delay seeking medical treatment. Health Literacy Health Literacy is the knowledge and competence to access, understand, appraise, and apply health information to make health-related judgments. (Sørensen et al., 2012) 6 American Academy of Sleep Medicine (AASM). Sleep Education. https://sleepeducation.org/healthy-sleep/healthy-sleephabits/#:~:text=Keep%20a%20consistent%20sleep%20schedule,7%2D8%20hours%20of%20sleep. https://www.nhlbi.nih.gov/health/sleep-deprivation 7 World Health Organisation (WHO). Physical Activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity 8 Better Health Channel. Negative emotions. https://www.betterhealth.vic.gov.au/health/healthyliving/negative-emotions D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 8 Category Components Brief description Genetics and Biology: While they may be thought of as the primary components of health, genetic makeup, physical body structure, and bodily function, in fact, determine only about a fifth of our measurable health. In the future, genome sequencing will become more important for predicting and preparing for future health outcomes, but it is not feasible to sequence everyone's genome at this point in time. Some biological and genetic factors have varying impacts on different segments of the population, and so variance must be considered when applying the determinants of health. The effects of ageing and inherited conditions (sicklecell anaemia, cystic fibrosis, etc.) are examples of factors with varying levels of impact on the population. Body Function According to the WHO's International Classification of Functioning, Disability, and Health (ICF)9, body functions are categorised into different subfunctions. Mental functions, such as the brain's, can be differentiated into global mental functions (consciousness, energy, drive) and specific mental functions (memory, language, calculation). Sensory functions include seeing, hearing, tasting, etc., and the sensation of pain. Voice and speech functions produce sounds and speech. There are functions of the cardiovascular system (heart and blood vessels), the haematological and immunological systems (blood production and immunity), and respiratory systems (respiration and exercise tolerance), as well as functions of the digestive system (ingestion, digestion, and elimination), the metabolic system, and the endocrine system. Human gene pool According to NIH10, a gene pool combines all the genes (including alleles) in a reproducing population or species. A large gene pool has extensive genomic diversity and is better able to withstand environmental challenges. Microbiome: The microbiome is the community of microorganisms (such as fungi, bacteria and viruses) in a particular environment. Shared with animals and ecosystems. Microbiome According to NIH11, the microbiome consists of both helpful and potentially harmful microbes. Most are symbiotic (benefiting both the human/animal body and the microbiota), and some, in smaller numbers, are pathogenic (disease-promoting). In a healthy organism, pathogenic and symbiotic microbiota coexist without problems. Nevertheless, if this balance is disturbed - caused by infectious diseases, specific diets or the prolonged use of antibiotics or other bacteria-destroying drugs - a dysbiosis occurs that stops these regular interactions. As a result, the body may become more susceptible to disease. Domestic Animals and Wildlife Health: Rather than using the social determinants lens in veterinary medicine, explanations of animal health and welfare are often framed by safeguarding the “Five Freedoms.” The freedom Veterinarian medicine: Animals Food security and nutrition Animals can access healthy food and have sufficient food or a healthy diet (Cipolla, 2015; Card, 2018). Animal Pharmacology & Drugs Animal medicines protect the food security of millions of people worldwide by enabling farmers to deliver food efficiently, safely and affordably. Understanding the degradation of antibiotics in the environment is essential, as antimicrobial resistance (AMR) is an increasing global threat. When antibiotics spill into the soil and waterways, resistant strains of bacteria can emerge in the environment. They can infect animals and humans that come into contact with them. Also, antibiotic-resistant bacteria of treated animals can be present in manure and, therefore, be disseminated into the environment and to wildlife12. 9 World Health Organisation (WHO). International Classification of Functioning, Disability and Health (ICF). https://www.who.int/standards/classifications/international-classification-of-functioning-disability-andhealth 10 National Human Genome Research Institute (NIH). Gene Pool. https://www.genome.gov/genetics-glossary/Gene-Pool#:~:text=Definition,able%20to%20withstand%20environmental%20challenges 11 National Human Genome Research Institute (NIH). Microbiome. https://www.genome.gov/genetics-glossary/Microbiome#:~:text=Definition,the%20skin%20or%20gastrointestinal%20tract. 12 Global Animal Health Association. Food Security. https://www.healthforanimals.org/importance-of-animals/food-security D2.1. Development of a One Health conceptual framework for socio-ecological systems Project: One Health Observatory Lighthouse: HOBE Taskforce: Build your own fuzzy cognitive map about one health 9 Category Components Brief description statements include freedom from hunger or thirst, freedom from pain, injury, or disease, freedom from discomfort, freedom from fear or distress, and freedom to express normal behaviour (Card et al., 2018). Mortality pressure Morbidity and mortality of wildlife and domestic animals can be attributed to a variety of factors, such as human activities like land development, predation (from wildlife to domestic animals), wildfire, poaching, electricity accidents, human consumption, culling, hunting, fishing, and automobile traffic13. Genetics and Biology: Animal genetic endowment Basic biology and organic makeup are fundamental determinants of health. Genetic endowment provides an inherited predisposition to various individual responses that affect health status. Genetic endowment sometimes predisposes specific individuals to particular diseases or health problems.14 Environment: Animal social environment Social competence is defined as the ability of an animal to optimise the expression of social behaviour as a function of the available social information. The social environment encountered early in life can affect the expression of various social behaviours later in life. The suite of interactions that occur between animals of the same species (Intraspecific), and different species (Interspecific), e.g., with humans (Taborsky et al., 2012) Needs for daily living To survive, animals need access to and availability of quality water and food, migration opportunities, stable population demographics, safe shelter and quality habitats (Wittrock & Duncan, 2019). Socioeconomics factors According to WHO, the social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. https://www.who.int/healthSocial and economic factors affect how well and how long we live. Social and economic factors include factors such as income, education, employment, community safety and social support. The choices that are available in a community are impacted by social and economic factors. These choices include our ability to afford medical care and housing and to manage stress. An individual's social status, early childhood development, and culture impact their social development and personal health. Poor social circumstances such as discrimination, concentrated poverty, and low education Access to Healthcare Access to healthcare15 for humans means having "the timely use of personal health services to achieve the best health outcomes" (IOM, 1993). It consists of four components: (i) Coverage facilitates entry into the health care system. Uninsured people are less likely to receive medical care and more likely to have poor health status. (ii) Services: Having a usual source of care is associated with adults receiving recommended screening and prevention services. (iii) Timeliness: the ability to provide health care when the need is recognised. And (iv) Workforce: capable, qualified, culturally competent providers. Many of these apply to animals (pets and livestock) access to veterinary care On the other hand, access to veterinary care is not always homogenous across communities and currently lacks a consistent definition. However, definitions have been proposed, such as “geographical proximity of resources and service; accessibility of professionals and ease of contact” (Pyatt et al., 2017), “the availability of a service in a location and its affordability for various livestock keepers” (Gizaw et al., 2021), and “geographical proximity of up-to-date resources and facilities, accessibility of professionals (physical and communicative), and ease of contact” (Pyatt et al., 2020) 13 Indian Law Portal. Causes of Death in Wildlife. https://indianlawportal.co.in/causes-of-death-in-wildlife/ 14 Nova Scotia Health Authority. Biology and Genetic Endowment http://www.cdha.nshealth.ca/dartmouth-community-health-board/population-health/biology-and-genetic-endowment 15 Institute of Medicine (US) Committee on Monitoring Access to Personal Health Care Services. Access to Health Care in America. Millman M, editor. Washington (DC): National Academies Press (US); 1993. PMID: 25144064. Healthy People 2020. https://www.ahrq.gov/research/findings/nhqrdr/chartbooks/access/elements.html