Nutritional Criminology: Why the Emerging Research on Ultra-Processed Food Matters to Health and Justice.

There is mounting concern over the potential harms associated with ultra-processed foods, including poor mental health and antisocial behavior. Cutting-edge research provides an enhanced understanding of biophysiological mechanisms, including microbiome pathways, and invites a historical reexamination of earlier work that investigated the relationship between nutrition and criminal behavior. Here, in this perspective article, we explore how this emergent research casts new light and greater significance on previous key observations. Despite expanding interest in the field dubbed 'nutritional psychiatry', there has been relatively little attention paid to its relevancy within criminology and the criminal justice system. Since public health practitioners, allied mental health professionals, and policymakers play key roles throughout criminal justice systems, a holistic perspective on both historical and emergent research is critical. While there are many questions to be resolved, the available evidence suggests that nutrition might be an underappreciated factor in prevention and treatment along the criminal justice spectrum. The intersection of nutrition and biopsychosocial health requires transdisciplinary discussions of power structures, industry influence, and marketing issues associated with widespread food and social inequalities. Some of these discussions are already occurring under the banner of 'food crime'. Given the vast societal implications, it is our contention that the subject of nutrition in the multidisciplinary field of criminology-referred to here as nutritional criminology-deserves increased scrutiny. Through combining historical findings and cutting-edge research, we aim to increase awareness of this topic among the broad readership of the journal, with the hopes of generating new hypotheses and collaborations.

Using self-reported health as a social determinants of health outcome: a scoping review of reviews.

Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.

Transformative learning for a sustainable and healthy future through ecosystem approaches to health: insights from 15 years of co-designed ecohealth teaching and learning experiences.

This paper presents insights from the work of the Canadian Community of Practice in Ecosystem Approaches to Health (CoPEH-Canada) and 15 years (2008-2022) of land-based, transdisciplinary, learner-centred, transformative learning and training. We have oriented our learning approaches to Head, Hands, and Heart, which symbolise cognitive, psychomotor, and affective learning, respectively. Psychomotor and affective learning are necessary to grapple with and enact far-reaching structural changes (eg, decolonisation) needed to rekindle healthier, reciprocal relationships with nature and each other. We acknowledge that these approaches have been long understood by Indigenous colleagues and communities. We have developed a suite of teaching techniques and resources through an iterative and evolving pedagogy based on participatory approaches and operating reciprocal, research-pedagogical cycles; integrated different approaches and ways of knowing into our pedagogy; and built a networked Community of Practice for continued learning. Planetary health has become a dominant framing for health-ecosystem interactions. This Viewpoint underscores the depth of existing scholarship, collaboration, and pedagogical expertise in ecohealth teaching and learning that can inform planetary health education approaches.

Relationships are everything: The underpinnings of grassroots community action in the COVID-19 pandemic in Toronto.

Most government emergency/pandemic response plans feature top-down decision making and communication strategies and a focus on 'hard' (physical) infrastructure. There is nothing about the importance of the ideas and communications originating from communities, the social infrastructure that supports their impact locally and their contribution to the central administration. In this study, we found that the 'soft' (social) infrastructure within communities and between communities and formal institutions is key to an inclusive and more equitable response to large-scale crises like the COVID-19 pandemic. Grassroots leaders in six Toronto neighbourhoods were interviewed between the first and second waves of the COVID-19 pandemic in Toronto about what helped or hindered community action. Three themes emerged: (1) Grassroots leaders and community organizations were able to act as key connection points in a two-way flow of information and resources with residents and service providers; (2) Grassroots leaders and groups were challenged to engage in this work in a sustained capacity without adequate resourcing; and (3) there was a disconnect between community-centred grassroots approaches and the City's emergency response. We conclude that there needs to be pre-disaster investment in community level planning and preparation that fosters two-way connections between all municipal emergency/disaster and pandemic preparedness plans and community-centred organizations and grassroots leaders working in marginalized communities.

A Realist Approach to Analysis in a Participatory Research Project.

BACKGROUND: Realist reviews have shown the effectiveness of participatory action research but the realist approach has not been used in combination with a participatory approach in qualitative data analysis. OBJECTIVES: To study the links between preexisting conditions in neighborhoods and the kind of actions taken at the community level during the coronavirus disease 2019 pandemic in Toronto, a community-university research partnership used a critical realist approach to analyze qualitative interviews with grassroots leaders. This article describes the procedures developed to enable participation of the full community- academic team in the analysis. METHODS: One analyst coded paragraphs in all 46 interviews for preexisting conditions (contexts), actions taken (intervention components), the often implicit factors that underpinned the actions (mechanisms), and observed results (outcomes) as stated by the interviewees. Each interview was summarized in terms of the contexts (C), actions (I), mechanisms (M) and outcomes (O) identified and one to seven midrange CIMO hypotheses were developed for each interview. A second level of analysis involved sense-making workshops with the community partner and a cross-section of interviewees using the CIMO statements. CONCLUSIONS: This article describes the realist approach to analysis and the changes that were made to enable a mixed team of community leaders and academics to generate overall statements of impact. This is a novel approach to qualitative data analysis, with a range of implications for the use of this technique in participatory research.

Exiting the Anthropocene: Achieving personal and planetary health in the 21st century.

Planetary health provides a perspective of ecological interdependence that connects the health and vitality of individuals, communities, and Earth's natural systems. It includes the social, political, and economic ecosystems that influence both individuals and whole societies. In an era of interconnected grand challenges threatening health of all systems at all scales, planetary health provides a framework for cross-sectoral collaboration and unified systems approaches to solutions. The field of allergy is at the forefront of these efforts. Allergic conditions are a sentinel measure of environmental impact on human health in early life-illuminating how ecological changes affect immune development and predispose to a wider range of inflammatory noncommunicable diseases (NCDs). This shows how adverse macroscale ecology in the Anthropocene penetrates to the molecular level of personal and microscale ecology, including the microbial systems at the foundations of all ecosystems. It provides the basis for more integrated efforts to address widespread environmental degradation and adverse effects of maladaptive urbanization, food systems, lifestyle behaviors, and socioeconomic disadvantage. Nature-based solutions and efforts to improve nature-relatedness are crucial for restoring symbiosis, balance, and mutualism in every sense, recognizing that both personal lifestyle choices and collective structural actions are needed in tandem. Ultimately, meaningful ecological approaches will depend on placing greater emphasis on psychological and cultural dimensions such as mindfulness, values, and moral wisdom to ensure a sustainable and resilient future.

A connected community response to COVID-19 in Toronto.

In this commentary, we describe initial learnings from a community-based research project that explored how the relational space between residents and formal institutions in six marginalised communities in Toronto, Ontario, Canada impacted grassroots responses to the health and psycho-social stresses that were created and amplified by the coronavirus disease 2019 (COVID-19) pandemic. Our research found that grassroots community leaders stepped up to fill the gaps left by Toronto's formal public health and emergency management systems and were essential for mitigating the psycho-social and socioeconomic impacts of the pandemic that exacerbated pre-existing inequities and systemic failures. We suggest that building community resilience in marginalised communities in Toronto can embody health promotion in action where community members, organisational, institutional and government players create the social infrastructure necessary to build on local assets and work together to promote health by strengthening community action, advocating for healthy public policy and creating supportive environments.

A Connected Community Approach: Citizens and Formal Institutions Working Together to Build Community-Centred Resilience.

Urban resilience research is recognizing the need to complement a mainstream preoccupation with "hard" infrastructure (electrical grid, storm sewers, etc.) with attention to the "soft" (social) infrastructure issues that include the increased visibility of and role for civil society, moving from (top-down, paternalistic) government to (participatory) governance. Analyses of past shock events invariably point to the need for more concerted efforts in building effective governance and networked relations between civil society groupings and formal institutions before, during, and after crisis. However, the literature contains little advice on how to go about this. In this paper, we advance a Connected Community Approach (CCA) to building community resilience with a specific focus on the relationship between community and formal institutions. In the literature review that informs this work, we assess the current, limited models for connecting communities to formal institutions, as well as the emerging role of community-based organizations in this work, and we offer our own assessment of some of the key tensions, lacunae, and trends in the community resilience field. Principally, we explore the potential of the CCA model, as spearheaded by the East Scarborough Storefront and the Centre for Connected Communities in Toronto, Canada, as a promising approach for building the relational space between civil society and the state that is so often called for in the literature. The paper concludes with future directions for research and practice.

Project Earthrise: Proceedings of the Ninth Annual Conference of inVIVO Planetary Health.

The "Earthrise" photograph, taken on the 1968 Apollo 8 mission, became one of the most significant images of the 20th Century. It triggered a profound shift in environmental awareness and the potential for human unity-inspiring the first Earth Day in 1970. Taking inspiration from these events 50 years later, we initiated Project Earthrise at our 2020 annual conference of inVIVO Planetary Health. This builds on the emergent concept of planetary health, which provides a shared narrative to integrate rich and diverse approaches from all aspects of society towards shared solutions to global challenges. The acute catastrophe of the COVID-19 pandemic has drawn greater attention to many other interconnected global health, environmental, social, spiritual, and economic problems that have been underappreciated or neglected for decades. This is accelerating opportunities for greater collaborative action, as many groups now focus on the necessity of a "Great Transition". While ambitious integrative efforts have never been more important, it is imperative to apply these with mutualistic value systems as a compass, as we seek to make wiser choices. Project Earthrise is our contribution to this important process. This underscores the imperative for creative ecological solutions to challenges in all systems, on all scales with advancing global urbanization in the digital age-for personal, environmental, economic and societal health alike. At the same time, our agenda seeks to equally consider our social and spiritual ecology as it does natural ecology. Revisiting the inspiration of "Earthrise", we welcome diverse perspectives from across all dimensions of the arts and the sciences, to explore novel solutions and new normative values. Building on academic rigor, we seek to place greater value on imagination, kindness and mutualism as we address our greatest challenges, for the health of people, places and planet.

Retail Food Environment Intervention Planning: Interviews With Owners and Managers of Small- and Medium-Sized Rural Food Stores.

Retail food environments are an important setting for promoting healthier diets and reducing the global burden of diet-related disease. The purpose of this 2-year community-university partnership was to develop a health promotion intervention for stores in a rural and remote region of British Columbia, Canada. This article reports on the qualitative interviews that were conducted with retail operators as part of an intervention planning process. Seven in-depth, semistructured interviews were conducted with store owners and managers of small- and medium-sized stores in a rural and remote region. Interviews were analyzed using thematic analysis to identify business operations and practices relevant to intervention planning and implementation. Relevant considerations for health promotion planners included the unique business models of rural stores; the prominence of regional travel and "outshopping" in rural and remote regions; challenges balancing between choice, value, and profitability; relationships with suppliers; and using local products to attract and retain customers. Involving retailers in settings-based approaches to improve population nutrition may help to mobilize existing practices and ensure that interventions are responsive to local context.

Many lenses for planetary health: seeding citizen engagement for sustainable futures visioning with new ways of seeing.

OBJECTIVES: This pilot project sought to seed citizen engagement processes for sustainable futures visioning with ideas, perspectives, and processes informed by Indigenous ways of knowing. METHODS: Five circle dialogues were convened with students, faculty, and members of the public, in the spring of 2019, using Indigenous talking circle methodology and intentionally seeded with "disruptive" ideas to encourage reflexivity and open space for "out-of-the-box" thinking. These were complemented by a series of one-on-one dialogues with members of the pan-Canadian research team. Pre- and post-dialogue surveys, notes taken by participants, team members, and co-facilitators, as well as notes from one-on-one interviews, constituted the data drawn upon for this paper. RESULTS: Participants were overwhelmingly positive about their experience, noting they were able to go further and deeper in their thinking and listening, and that they valued the Indigenous talking circle methodology, even if they stopped short of claiming the experience had transformed their way of seeing the world. Key points raised in the dialogues included the need for a more relational worldview, the need to repair severed relations with the land and nature, the importance of Indigenous ways of knowing, the importance of community building, and the need to question the fundamental assumptions undergirding contemporary Western societies. CONCLUSIONS: While caution must be exercised in drawing conclusions and extrapolating from this modest pilot project, our experience underscores the value of processes that intentionally catalyze critical reflexivity and openness to other ways of seeing, informed by Indigenous ways of knowing and talking circle methodology.

RéSUMé: OBJECTIFS: Ce projet pilote visait à faire germer des idées, des opinions et des processus éclairés par les modes de savoir autochtones dans des processus de mobilisation citoyenne pour faire naître des scénarios d'avenir durables. MéTHODE: Cinq cercles de dialogue ont été organisés avec des étudiants, des professeurs et des personnes du public, au printemps 2019, en faisant appel à la méthode autochtone des cercles de la parole et en semant délibérément des idées « perturbatrices ¼ afin d'encourager la réflexivité et de sortir des sentiers battus. Les cercles ont été complétés par une série de dialogues individuels avec les membres de l'équipe de recherche pancanadienne. Les sondages pré- et post-dialogue, les notes prises par les participants, les membres de l'équipe et les coanimateurs, ainsi que les notes des entretiens individuels ont constitué la matière première du présent article. RéSULTATS: La très grande majorité des participants ont trouvé l'expérience positive : ils ont dit avoir pu aller plus loin et plus profond dans leur réflexion et leur écoute et avoir apprécié la méthode des cercles de la parole autochtones, sans toutefois aller jusqu'à dire que l'expérience avait transformé leur vision du monde. Les principaux points soulevés dans les dialogues ont été le besoin d'avoir une vision du monde plus relationnelle, le besoin de réparer les relations rompues avec la terre et la nature, l'importance des modes de savoir autochtones, l'importance de la solidarité sociale et le besoin de remettre en cause les hypothèses fondamentales qui soutiennent les sociétés occidentales contemporaines. CONCLUSIONS: S'il faut faire preuve de prudence avant d'extrapoler et de tirer des conclusions d'un simple projet pilote, notre expérience souligne la valeur des processus qui induisent intentionnellement une réflexivité critique et une ouverture à d'autres façons de voir, éclairés par les modes de savoir autochtones et par la méthode des cercles de la parole.

Stop ringing the alarm; it is time to get out of the building!

The volume of calls for governments and public health officials to take concerted action on climate change has become almost deafening. Public health researchers and practitioners need to look beyond what we know about the health impacts of climate change, to what we are doing as our part in contributing to holding global temperature rise to under 1.5°C. This commentary reflects on the common threads across the articles of a special section in this issue of the Canadian Journal of Public Health, "Moving on IPCC 1.5°C", which sought examples of bold research and action advancing climate change mitigation and adaptation. Among the articles, there are signs that the public health community is gaining momentum in confronting the climate crisis. Three critical lessons emerged: the need for institutional change from the top of public health, the essential power of community in intersectoral action on climate change preparedness, and the importance of centring Indigenous wisdom to decolonize colonial legacy systems. We encourage readers to move public health research and practice from an instrumental relationship with nature to one of reverence and sacred reciprocity.

RéSUMé: Le volume des appels aux gouvernements et aux autorités de santé publique à agir de concert face aux changements climatiques devient assourdissant. Au-delà de ce que nous savons des effets des changements climatiques sur la santé, les chercheurs et les praticiens en santé publique doivent examiner ce que nous faisons pour maintenir la hausse de la température mondiale en deçà de 1,5 °C. Dans ce commentaire, nous réfléchissons à la trame commune des articles d'une rubrique spéciale dans ce numéro de la Revue canadienne de santé publique, « Réaction au cri d'alarme du GIEC ¼, qui sollicitait des exemples d'études et de mesures audacieuses pour faire progresser l'atténuation des changements climatiques et l'adaptation à ces changements. Dans les articles de la rubrique, il y a des signes que la communauté de la santé publique se mobilise pour faire face à la crise climatique. Trois leçons essentielles s'en dégagent : la nécessité d'un changement institutionnel au sommet de la santé publique, le pouvoir essentiel de la communauté dans l'action intersectorielle de préparation aux changements climatiques, et l'importance de miser sur la sagesse autochtone pour décoloniser les systèmes hérités du colonialisme. Nous encourageons nos lecteurs à faire passer la recherche et la pratique en santé publique d'une relation instrumentale avec la nature à une relation de révérence et de réciprocité sacrée.

Neighbourhood climate resilience: lessons from the Lighthouse Project.

OBJECTIVE: The Lighthouse Project (2017-2018) explored the role that faith-based organizations (FBOs) might play as resilience hubs for climate-related stresses and extreme weather emergencies in disadvantaged urban environments of three cities. This paper discusses the role that public health played in these initiatives and makes an appeal for more participatory, community-engaged public health in light of the persistent gaps in its approach to equitable climate change preparedness. METHODS: Pilots were initiated in the Greater Toronto and Hamilton Area (GTHA): Brampton's Emergency Managers offered pre-selected FBO volunteers specialized training to be part of the city's emergency response in establishing FBO sites as emergency muster stations. An environmental organization in Hamilton explored how its existing networks could rally around a local social resilience challenge, and a community organizer in Toronto undertook network building to support mostly newcomer populations in one inner-city neighbourhood. All pilots used a mix of cold calling, workshops, municipal presentations, and participation in local programming and public events. Two convened local working groups. RESULTS: By the end of the pilot, Brampton's Emergency Management Office had made one contractual relationship with an FBO and its volunteers. In Hamilton, a multi-stakeholder network emerged to support the climate preparedness of agencies serving local vulnerable populations. In Toronto, a residents' working group was established to address neighbour well-being and emergency response in one apartment tower. Work in all three communities is ongoing. CONCLUSION: Multi-stakeholder support for community organizations and local volunteers can enable partnerships in neighbourhood-level climate resilience-before, during and after extreme weather events. Public Health, while not typically top-of-mind as a key ally in this work, is well positioned to make a contribution. Consistent with place-based approaches, an emergent community development design enabled community animators to catalyze collaborations to suit the on-the-ground realities of each site.

RéSUMé: OBJECTIF: Le projet Lighthouse (2017-2018) a exploré le rôle de « carrefours de résilience ¼ que peuvent jouer les organisations confessionnelles (OC) face aux perturbations climatiques et aux situations d'urgence météorologique extrême dans les milieux urbains défavorisés de trois villes. Notre article porte sur le rôle que la santé publique a joué dans le cadre de ces initiatives et exhorte la santé publique à être plus participative et plus engagée localement, vu les lacunes qui persistent dans sa démarche de préparation équitable aux changements climatiques. MéTHODE: Des projets pilotes ont été amorcés dans la région du Grand Toronto et de Hamilton (RGTH) : les gestionnaires des mesures d'urgence de Brampton ont offert une formation spécialisée à des bénévoles d'organisations confessionnelles présélectionnées pour qu'ils fassent partie des interventions d'urgence de la ville en faisant de leurs OC des postes de rassemblement d'urgence. Un organisme de Hamilton voué à la protection de l'environnement a exploré les moyens pour ses réseaux existants de se rassembler pour résoudre des problèmes locaux de résilience sociale, et un organisateur de quartier de Toronto a constitué un réseau pour aider principalement les populations de nouveaux arrivants d'un quartier déshérité du centre-ville. Tous les projets pilotes ont procédé selon un mélange de démarchage téléphonique, d'ateliers, de présentations aux élus municipaux et de participation aux animations publiques et aux programmes locaux. Deux ont constitué des groupes de travail locaux. RéSULTATS: À la fin du projet pilote, le bureau de la gestion des situations d'urgence de Brampton avait établi une relation contractuelle avec une OC et ses bénévoles. À Hamilton, un réseau multilatéral est né pour aider les organismes locaux de services aux populations vulnérables à se préparer aux changements climatiques. À Toronto, on a établi un groupe de travail composé de résidents d'une tour d'habitation pour s'occuper du bien-être entre voisins et des interventions d'urgence. Le travail se poursuit dans les trois villes. CONCLUSION: L'appui d'un large éventail d'acteurs aux organismes associatifs et aux bénévoles locaux peut rendre possibles des partenariats pour la résilience climatique au niveau des quartiers­avant, pendant et après des événements météorologiques extrêmes. La santé publique, bien qu'elle ne vienne pas immédiatement à l'esprit comme étant un allié essentiel dans ce genre de travail, est bien placée pour apporter une contribution. Conformément aux approches fondées sur le lieu, un plan de développement de proximité émergent a permis à des animateurs socioculturels de chaque ville de faire naître des collaborations adaptées à la réalité sur le terrain.

Psychosocial adaptation to climate change in High River, Alberta: implications for policy and practice.

OBJECTIVES: Psychosocial adaptation to climate change-related events remains understudied. We sought to assess how the psychosocial consequences of a major event were addressed via public health responses (e.g., programs, policies, and practices) that aimed to enhance, protect, and promote mental health. METHODS: We report on a study of health and social service responses to the long-term mental health impacts of the 2013 Southern Alberta flood, in High River, Alberta. Qualitative research methods included (i) telephone interviews (n = 14) with key informant health and social services leaders, (ii) four focus group sessions with front-line health and social services workers (n = 14), and (iii) semi-structured interviews with a sample of community members (n = 18) who experienced the flood. We conducted a descriptive thematic analysis, with a focus on participants' perceptions and experiences. RESULTS: Findings of this study suggest (1) the long-term psychosocial impacts of extreme weather and climate change require sustained recovery interventions rooted in local knowledge and interdisciplinary action; (2) there are unintended consequences related to psychosocial interventions that can incite complex emotions and impact psychosocial recovery; and (3) perceptions of mental health care, among people exposed to climate-related trauma, can guide climate change and mental health response and recovery interventions. CONCLUSION: Based on this initial exploration, policy and practice opportunities for public health to enhance psychosocial adaptation to our changing climate are highlighted.

RéSUMé: OBJECTIFS: L'adaptation psychosociale aux événements liés au changement climatique est encore sous-étudiée. Nous avons cherché à évaluer comment les conséquences psychosociales d'un événement majeur ont été abordées par des mesures de santé publique (p. ex. programmes, politiques, pratiques) visant à améliorer, à protéger et à promouvoir la santé mentale. MéTHODE: Nous faisons le compte rendu d'une étude des mesures sociosanitaires appliquées pour remédier aux effets à long terme sur la santé mentale de l'inondation survenue en 2013 à High River, dans le Sud de l'Alberta. Nos méthodes de recherche qualitative ont compris : i) des entrevues téléphoniques (n = 14) avec des informateurs aux échelons supérieurs de la santé et des services sociaux; ii) quatre groupes thématiques avec des intervenants sociosanitaires de première ligne (n = 14); et iii) des entrevues semi-dirigées avec un échantillon de résidents (n = 18) touchés par l'inondation. Nous avons mené une analyse thématique descriptive axée sur les perceptions et l'expérience des participants. RéSULTATS: Selon les constatations de l'étude : 1) les impacts psychosociaux à long terme des conditions météorologiques exceptionnelles et du changement climatique nécessitent des interventions de rétablissement soutenues, ancrées dans les connaissances locales et dans l'action interdisciplinaire; 2) les interventions psychosociales peuvent avoir des effets pervers qui provoquent des émotions complexes et nuisent au rétablissement psychosocial; et 3) la perception des soins de santé mentale, chez les personnes exposées aux traumatismes d'origine climatique, peut guider la réaction au changement climatique et aux problèmes de santé mentale et les interventions de rétablissement. CONCLUSION: Nous mettons en avant, à la lumière de cette première exploration, des possibilités d'améliorer l'adaptation psychosociale au changement climatique au moyen de politiques et de pratiques de santé publique.

An Innovative Model for Healthcare Leadership Education.

A key goal of programs in health management, policy and research is to transform students into effective leaders. Academic experience can impart knowledge about the skills or competencies required but may not be sufficient to transform students into leaders of health system change.

Preparing for the future of public health: ecological determinants of health and the call for an eco-social approach to public health education.

As a collective organized to address the education implications of calls for public health engagement on the ecological determinants of health, we, the Ecological Determinants Group on Education (cpha.ca/EDGE), urge the health community to properly understand and address the importance of the ecological determinants of the public's health, consistent with long-standing calls from many quarters-including Indigenous communities-and as part of an eco-social approach to public health education, research and practice. Educational approaches will determine how well we will be equipped to understand and respond to the rapid changes occurring for the living systems on which all life-including human life-depends. We revisit findings from the Canadian Public Health Association's discussion paper on 'Global Change and Public Health: Addressing the Ecological Determinants of Health', and argue that an intentionally eco-social approach to education is needed to better support the health sector's role in protecting and promoting health, preventing disease and injury, and reducing health inequities. We call for a proactive approach, ensuring that the ecological determinants of health become integral to public health education, practice, policy, and research, as a key part of wider societal shifts required to foster a healthy, just, and ecologically sustainable future.

Eighth Annual Conference of inVIVO Planetary Health: From Challenges to Opportunities.

inVIVO Planetary Health (inVIVO) is a progressive scientific movement providing evidence, advocacy, and inspiration to align the interests and vitality of people, place, and planet. Our goal is to transform personal and planetary health through awareness, attitudes, and actions, and a deeper understanding of how all systems are interconnected and interdependent. Here, we present the abstracts and proceedings of our 8th annual conference, held in Detroit, Michigan in May 2019, themed "From Challenges, to Opportunities". Our far-ranging discussions addressed the complex interdependent ecological challenges of advancing global urbanization, including the biopsychosocial interactions in our living environment on physical, mental, and spiritual wellbeing, together with the wider community and societal factors that govern these. We had a strong solutions focus, with diverse strategies spanning from urban-greening and renewal, nature-relatedness, nutritional ecology, planetary diets, and microbiome rewilding, through to initiatives for promoting resilience, positive emotional assets, traditional cultural narratives, creativity, art projects for personal and community health, and exploring ways of positively shifting mindsets and value systems. Our cross-sectoral agenda underscored the importance and global impact of local initiatives everywhere by contributing to new normative values as part of a global interconnected grass-roots movement for planetary health.

Addressing Mental Health in a Changing Climate: Incorporating Mental Health Indicators into Climate Change and Health Vulnerability and Adaptation Assessments.

A growing number of health authorities around the world are conducting climate change and health vulnerability and adaptation assessments; however, few explore impacts and adaptations related to mental health. We argue for an expanded conceptualization of health that includes both the physiological and psychological aspects of climate change and health. Through a review of the global literature on mental health and climate change, this analytical review explores how mental health can be integrated into climate change and health vulnerability assessments and concludes with recommendations for integrating mental health within climate change and health vulnerability and adaptation assessments.

Healthy Cities and the Transition movement: converging towards ecological well-being?

This commentary identifies similarities, differences and opportunities for synergy and mutual learning between the Healthy Cities and the Transition movements. We outline what we consider to be the 'pressing issues' facing humanity and the planet in the early 21(st) century; consider the extent to which health promotion has engaged with and addressed these issues; compare Healthy Cities and the Transition movement; and conclude by suggesting possibilities for moving forward.