Module 1 is an introduction to understanding health ecologically. The module is split into 6 lessons plus a light exercise to wrap up. We hope through this module that you gain a solid foundation in seeing how different environments and systems, and their behaviours and designs, influence the broader conversation on health.

At the core of our work is understanding what health means - what does it mean to be healthy?

Stress is a natural process. However, modern life has brought with it a state of being in chronic stress. The key problem is that the human body is designed to be able to withstand a small amount of stress, not a chronic amount. When this occurs, an otherwise normally functioning biological systems starts to dysregulate and lead to health complications.

The lived expertise of all the individuals of a given community is what we define as community expertise -- that great, invaluable, communal knowledge, understanding, and insight.

We live in multiple environments: natural, social, built, economic, and political. These environments have an influence on our health. They can contribute to our exposure to environmental stressors such as pollution or psychosocial stressors such as marginalisation and safety fears.

Data is a powerful tool for justice and language for accountability. The United Nations describes data as the “lifeblood of decision-making and the raw material for accountability.” However, data can easily be manipulated and used to entrench inequities. This area of work explores how data intentionally used for health justice considers the human-societal factors.

Taking an ecological approach to health necessitates the idea that the state of health is the result of a constant negotiation between the human and their environment. It positions that we can only be healthy when the systems around us are healthy, these include the natural environment as well as the social, built, and economic environments.

Taking an ecological approach to health necessitates the idea that the state of health is the result of a constant negotiation between the human and their environment. It positions that we can only be healthy when the systems around us are healthy, these include the natural environment as well as the social, built, and economic environments.

Module 2 explores the pathways to health injustice. These pathways add depth to lessons from module 1 and cover broader societal issues and phenomenas such as environmental justice and racism as pathways to poor health outcomes.

Susceptibility refers to the effects of biological inequality on the human immune response, specifically the fact that persistent environmental stressors on a community place these individuals at a heightened risk of developing severe symptoms and chronic illnesses compared to a normative population, not exposed to significant stressors.

Trauma can come from direct pathways as well as systemic. Norwegian sociologist, Johan Gultang, introduced the term structural violence in the 1960’s to describe the outputs of racism, classim, sexism, and other marginalizations

The key takeaway is that sex and gender are one way of conceptualising a complex ecosystem made up of multiple cells and microbes which digests, reproduces, thinks, and loves, rather than a universal truth. Ideas about sex and gender vary greatly across the world and throughout time, all with their own stories, societal roles and examples of people who transgress them.

There are various problems with targeting a community based on their race, specifically in the context of health. To say “Black community” or “Indigenous Community” is a misnomer as it doesn’t see the person to place relationship, which is essential to understanding health.

What is often missing from the conversation is how environmental hazards, due to being an experience of stress and trauma can lead to mental distress.

The term ‘climate change’ whilst now firmly established in our lexicon still fails to be mentally accessible due to its ambiguity. Only articulating the phenomena based on outputs does little to orientate our attention and cognitive abilities toward the inputs, which contribute to the output or problem. Identifying and understanding the root factors that contribute to a problem is crucial to establishing long lasting and accurate solutions.

Module 3 focuses on the determinants of health. Determinants of health are areas of work discussed in epidemiology that combine together to affect the health of individuals and communities. The work recognises that health is an outcome of various dynamic and intersecting systems.

The "social, commercial, and political determinants of health" refer to the various factors that influence a population's health and well-being beyond individual lifestyle choices and access to healthcare. These determinants encompass the structural, economic, and social forces that shape people's lives and opportunities, ultimately impacting health outcomes and health equity. 

Let’s ask the question as to whether ‘Unemployment and job insecurity’ is a social determinant when the word social as an adjective can mean both in something relating to society as well as describing how people live, such as ”we are social beings as well as individuals”, let alone its use as a noun.

This lesson explores how determinants of health show up as health risks. Translating health determinants into health risks involves understanding how various factors influencing health can increase the probability of developing specific diseases or conditions in your community.

This module wraps up with an exercise in how to apply this theory into practice.

Here we introduce what’s to be expected in Module 3 that centred around making your own community health impact assessment

Here are some case studies from a community health impact assessment co-learning programme we ran in 2024.

This area of work is a site of structural harm by systems that are oftentimes unable and unwilling to change, it is not a place for everyone. We have a responsibility to safeguard at this level, this will be a difficult process, and we must be prepared for nothing or no response from local authority and developers.

We’ve put together a number of short articles to help contextualise and expand on topics that have been brought up so far in this course. We recommend reading at least two of them before advancing.

Knowing who you are connected to and what influence each of you have is an important step. For an HIA to travel beyond your internal purposes, it is helpful to locate your cheerleaders in political and decision making positions.

Building a theory of change is a traditional method of planning how your actions will have material effects. As a process it invites you to question your methods in order to have a realistic pathway to success. It can also act as a way of encouraging stakeholders, partners, and members of the public to become supporters of your work.

This lesson is a walk-through in facilitating some sessions with your community and how to start organising outputs into a CHIA