A Health and Ecological Systems Framework for Vector-Borne Diseases in Puerto Rico
Citation:
Fisher, W., R. DeJesus-Crespo, AND S. Yee. A Health and Ecological Systems Framework for Vector-Borne Diseases in Puerto Rico. Society for Environmental Toxicology and Chemistry North America 39th Annual Meeting, Sacramento, CA, November 04 - 08, 2018.
Impact/Purpose:
It is a challenge to frame the social, economic and environmental factors that influence public health. A conceptual framework was previously introduced using as a basis the DPSIR (Driving forces, Pressure, State, Impact and Response) approach for environmental systems, but adapting it to accommodate human activities and behavior. To better determine its utility, this conceptual model (called the EcoHealth DPSIR) was used to characterize the findings of two recent studies on influences of environment, society and economic status on vector-borne diseases (Zika and dengue) in Puerto Rico. Plotting the new information in the EcoHealth format revealed relationships that reinforce the importance of equity and economic status in vulnerability to disease.
Description:
Environmental, social and economic factors can influence public health, but the interactions can be difficult to understand and anticipate. A systems context, that is, a conceptual approach that simultaneously considers environmental, social and economic factors, is essential. Previously in the One Health session, we described a systems framework originating from an environmental context (DPSIR—Driving force, Pressure, State, Impact and Response) that was adapted to include social and economic aspects of human activity and behavior. The resulting EcoHealth DPSIR was illustrated using vulnerability and effects of asthma. The concept is further illustrated by examination of recent research in the San Juan metropolitan area of Puerto Rico in relation to vector-borne (mosquito) Zika and dengue diseases. Two studies demonstrated correlation of environmental factors, such as wetland area, nutrient enrichment, rainfall and flooding with the capacity of mosquito populations to carry virus and subsequent disease incidence in humans. Socio-economic factors, such as income level, moderated the influence of environmental factors on disease incidence in humans. The resulting relationships emphasize the importance of factors like equity, governance and personal choices in public health; and the consequent impacts of disease on human well-being and economic production.