Health & nature: a critical review of historical perspectives to support narratives for change.

Introduction: The ongoing ecosocial crisis threatens the health of our planet, as ecological boundaries are overreached and social needs remain unmet. Achieving health equity and sustainable development requires re-evaluating the interconnections between nature and health, including the social narratives shaping this relationship. The ways in which we construct and adopt these narratives-consciously or not-translates into different implications for research, policy and practice. This study critically analyses the historical evolution of how the health-nature relationship is conceptualised in the scientific literature, and classifies the different eco-social values and theoretical considerations embedded within each emerging perspective. By raising awareness of the diverse perspectives used and their implications for research, policy and practice, the findings aim to provide a conceptual guide for narratives that aim to drive change towards health equity and sustainable practices.

Methods: We conducted a critical review to identify the main perspectives of the health-nature relationship in the scientific literature over the past 60 years, and to categorize them based on their ecological theoretical positions, ranging from anthropocentric to non-anthropocentric. Snowballing techniques were applied to include other relevant literature.

Results: Our review identified eight main perspectives on the health-nature relationship during this time period: Environmental health, Ecology of health, Holistic medicine, Political ecology of health, Eco Health, One Health, Planetary Health, and Indigenous traditions. We then classified them by their consideration of nature, and ecological positions.

Discussion and conclusions: Our results found diverse and evolving perspectives on the health-nature relationships, with anthropocentric to non-anthropocentric ecological theoretical positions embedded within them. When selecting and applying perspectives to support transformation, researchers and policymakers should have a clear idea of the implicit and explicit theoretical positions embedded within them. Researchers, policy makers, and practitioners should carefully consider these findings when selecting frameworks to guide narratives of change, and interventions aiming to address the political, ecological, economic, and cultural drivers of environmental degradation, human and natural exploitation, and social and health inequalities that our planet is struggling with. Recognizing these varied perspectives presents an opportunity to embrace diverse epistemologies that can inspire positive ecosocial change and foster a more sustainable and equitable relation between human societies with nature.