Epistemicide

Introduction

There is a need to understand the history behind framing health as individual choices or behaviours to better appreciate why an ecological health approach looks like and its significance in eradicating health inequities.

Early Christianity saw disease and illness as divine punishment, believing it could only be alleviated through repentance and prayer. This belief discouraged the use of Nature, such as medicinal plants for healing (source). This belief set part of the course of individualising disease and disconnecting disease (and healing) from the places we inhabit. 

Moving along to the age of the science method, rooted in Greek and Cartersian philosophy of mind and body dualism. Health was severed from its metaphysical and spiritual aspects and instead, focus was placed on bodily biological factors. This came to be known as the ‘biomedical model of health’, which emphasised a ‘bottom-up’ reductionist and mechanistic view of health, where health was seen merely as the absence of disease (Tamm, 1993) (Rocca & Ajum, 2020).

The reductionist approach of the biomedical model of health, whilst having utility in the medical domain, provided a scientific basis for discourse of so-called ‘degeneracy’, the idea that differences in health and societal outcomes across a population could be solely attributed and explained by biologically-based inheritable mechanisms. This spurred obscene solutions of racial and societal cleansing, made popular for example by the Eugenics movement in Britain and the Nazi regime (Nye, 1993).

Today, parts of this framing are still evident, we only have to look at how racialised Black communities were seen as inherently being more vulnerable to Covid-19 due to genetics rather than the consequences of their racialisation (source).

The biomedical model of health failed to adequately account for wider causal psychological, and environmental factors and so there were calls to expand upon the biomedical model of health by acknowledging ‘top-down’ factors that also contribute to health and disease.

This has come to be known as the biopsychosocial model of health, which emphasises an interplay between biological, psychological and socio-cultural factors in determining health and disease. Biological factors themselves are seen as necessary but not sufficient cause of disease, and so ‘top-down’ psychological, behavioural and socio-cultural factors must be be taken into account, where an individual's health is a psychophysical phenomenon that is socially situated (Engel, 1977; Tretter & Löffler-Stastka, 2019).

This conception of health aligns with the WHO’s definition where “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (World Health Organisation, 2020). 

The biopsychosocial model of health was built upon by new ecological models of health, that emphasised the complex relationships between wider ecological factors (e.g. biodiversity, pollutant exposure, socio-economic issues) and the individuals lived experience in contributing to health and disease. Ecological models of health, similar to Indigenous models, situates health as a balanced interplay between Nature and individual with emphasis on human health acting reciprocally with planetary health (source 1, source 2, source 3)

This model of health aligns with Indigenous concepts of health, such as of the Aboriginal and Torres Strait-Islanders, which conceptualise health as not only an individual-level phenomenon but one that extends to the wider community. With this view, a person's health and wellbeing is deeply connected to the community's physical land, and social, emotional, and cultural functioning across the lifetime (source). Dr. Camacho, a Quechua midwife, medical doctor, and scholar says that healing is in the soil, we heal the soil, we heal the people (source). Centric Lab takes a similar ecological approach to health that acknowledges the dynamic interplay between external antecedents and internal biological systems - defined as “the ability for our biological systems to enter stability after experiencing trauma or stress throughout our entire lifetime, to give us all an equal opportunity to realise our full potential.” (Centric Lab, n.d.).