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Health as ecosystem

Health is an ecosystem and health reflects our ecosystem.

We can look at this paradox from the perspective of symmathesy, defined by Nora Bateson as the active, mutual learning between people and their context, that gets us to where we are and holds us where we are, to see this multifaceted problem with fresh eyes.

Taking a multi-contextual and a meta-contextual approach illustrates where in the whole system, we can make real innovations for better health, often in the space between institutions.

In an ecosystem, the health of the system of interactions and interdependencies, and the health of particular populations, are not separable.  The health of our population is the dynamic outcome of, and a barometer of, the health of the ecosystem of social institutions that produces it.  It is also the outcome of, and a barometer of, the biosphere ecosystem, with the strongest connection being the various biomes that we coexist with inside and outside our bodies.

When our population is suddenly subject to a raft of long term illnesses, it is safe to say that these ecosystems, the social and the biosphere, are sick.  When we study health, we typically use data that has lost its context.

The particular person in their particular situation is largely lost in the search for statistically valid causes and treatments.  If we study instead the symmathesy – the specific learning taking place between elements of these ecosystems – we recover multiple contexts and “warm data”.

In the social ecosystem these contexts might be the worlds of work, of education, of the family, of food production and retail, of regulation and law.

Typically, double binds, negatively reinforcing cycles, across social and institutional contexts, result in patterns of stuck and destructive behaviour. Stuck situations are characterised by polarised binary choices.  We need the complexity of the ecosystem in order to escape those apparently binary choices.

People and populations will find away to be healthy when they are not subject to the constraints that appear necessary from the perspective of a single institution, for instance that children must go to school.  The apparent binary options of ‘attend school’ ‘don’t attend school’ conceal many generative routes to education.

Towards an Ecology of Health

To develop better policy it is completely necessary to understand the specific interactions between contexts.  Short circuits, such as the indiscriminate use of antibiotics, lead to future stuckness.  Policies that free up multi-dimensional learning between contexts can be extremely effective.

The effectiveness of Buurtzorg, for example, may be primarily due to the freeing of local learning.  So our project looks at the relational dynamics that fall between the cracks. Inherently it must operate at an individual, community and policy level, and treat these levels as interwoven and indistinct.

Aidan Ward and Russell Gundry

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