Could ‘One Health’ be the Optimal Approach for Human, Animal and Environmental Health?
Starting this year, the University of Arizona (UA) will receive $3.6 million in state funding annually until 2025 to grow its One Health model—which considers the correlation of human health to environment and animal health—and promote its development in the workforce.
The effort is part of Arizona’s New Economy Initiative that will expand hiring opportunities and support new class development at the university. Educating people about One Health was pushed for years by faculty in the College of Public Health, and the university has finally been recognized to have some of the most equipped and eager professionals to drive its research and education.
One Health is a comprehensive approach that stems from the understanding that human health and well-being is deeply interconnected with animal and environmental health and well-being. It requires data, communication and cooperation from many different business sectors, even outside of the public health sciences.
A One Health model in any profession considers a bigger picture when studying a specific issue, knowing that there can be unintended consequences even when two things are seemingly unrelated. For example, the need for clean energy in our polluted world has led some bird populations to suffer from wind turbine collisions. There is even evidence that One Health could prevent pandemics by looking at the source of diseases and how they can jump from the environment to animals to humans.
The concept of One Health is not new. This holistic approach has been recorded globally in some capacity for thousands of years and is ingrained in Native American culture, but it was only in the early 2000s that it became widely recognized under that name and organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) began creating offices and hosting conferences dedicated to its development.
There are several reasons why the legislature was interested in funding the university’s program. There are about two billion people on earth who live in arid environments similar to Arizona’s, said Frank von Hippel, the environmental health scientist leading the One Health research initiative at the UA, and the water crisis is paramount here. In addition, Arizona is a border state, so there are challenges having to do with migrant health and diseases that could go in both directions of the U.S./Mexico border. “Arizona is contending with many of these problems in a way that is at the forefront of the challenges themselves,” he said.
Kristen Pogreba-Brown is an infectious disease epidemiologist at the UA who pushed for the One Health approach for many years. In her line of work, a model like this made perfect sense. Serious consideration for the approach started at the UA’s College of Public Health around 2016 out of a concern for the rising cases of avian influenza, which has a mortality rate in humans in excess of 50 percent. Connecting dots between climate change affecting bird migrations and the virus’ spread between both humans and other animals made many UA scientists recognize the need for a broader lens.
Most professionals in the health sciences operate vertically, she said, often staying in their niche and lacking communication among other sectors that have the potential to benefit from a One Health initiative as well. Imperative to the model is the collaboration of multidisciplinary teams, she said.
“The greatest weakness of any organization is almost always communication,” said Pogreba-Brown. The problem is, data is not always easily transferable across sectors, which many scientists and different field experts explain as being similar to speaking a different language that takes time to understand and decode. “We have to keep that in mind from the very beginning of a One Health Project,” she said. “How are we going to collect the data so that it all really works together?”
And that’s just within the sciences. Pogreba-Brown said people in professions like law and computer science will also be a big part of the One Health mission in the near future.
Despite new resources flooding into this emerging model nationwide, the question of how to implement One Health is proving harder to answer than expected. Recognition of the need to merge human, animal and environmental health was the first step, Pogreba-Brown said, and now they are in the communication phase, hosting conferences and teaching classes explaining why it is important. But what comes next?
A Difficult Definition
Defining One Health can be a challenge in itself. Just because a scientist may study a deadly disease that affects both humans and animals, doesn’t necessarily mean One Health work is being performed.
“The paradigm of One Health is that it is everything, but if something is everything, then it is really nothing,” said Kelly Reynolds, department chair of the Community, Environment and Policy Department at UA. She said it is important that scientists work together to define such a complex topic and consider a wide web of outcomes when dealing with public health issues.
As a general rule, One Health workers will always consider the connectedness of animals, humans and the environment. Even when only two of those pillars seem to overlap, a person working in One Health will always recognize that the third pillar is involved or affected in some way. Pogreba-Brown foresees good One Health practitioners being people who can translate conversations well between different professionals working in land management, animal sciences, agricultural sciences, medicine, etc. and serve as an access point between them all.
One of the college’s tasks right now is canvassing the public to get a sense of how a One Health approach might improve its discipline. Yevheniia Varyvoda is running the workforce development side of the initiative, but admits to the difficulties of creating jobs for a field that is still breaking onto the scene.
Varyvoda created the first One Health Occupational Outlook at the UA, synthesized from the U.S. Occupational Outlook Handbook. According to the outlook, employment in One Health is projected to grow 11 percent by 2031. Varyvoda believes there will be huge employment opportunities in the future surrounding One Health, but for now, her goal is to create a demand by outlining what it would look like.
According to the One Health Occupational Outlook, “One Health workers use scientific research, good practices, and interpersonal skills to address complex health problems of people, animals, and the environment while also advancing knowledge in this field.”
Varyvoda believes the most important thing the college can do now is collect and publish more case studies. “Without practical examples, what does it mean?” she said. And she doesn’t just want to explain what it is to scientists. Varyvoda said that social media can be a useful tool in educating the need for One Health and shrinking the education gap between scientific sectors and the general public.
Native American involvement has also pushed the One Health approach to make headway at the university. There are 22 federally recognized Indigenous tribes in Arizona that have historically used similar holistic wellness models looking at the health of the earth and animals and how those impact their communities.
Agnes Attakai is the director of the Health Disparities Outreach and Prevention Education at the UA’s Center for Rural Health. Attakai grew up on a Navajo reservation in Northern Arizona, and has seen how the drought has impacted both her community’s historic culture of healing and modern medical care.
Insufficient water and hotter than usual temperatures have caused traditional medicines found in nature to be less abundant. “Because there’s less choice for medicines, many times healers are unable to perform certain ceremonies and, in particular, healing ceremonies for people,” she said.
But construction on the new Dilkon Medical Center that would provide healthcare for Native people in Northern Arizona has also faced numerous obstacles due to a lack of water access, forcing inhabitants of Attakai’s community and surrounding communities to travel up to 50 miles one way to the nearest healthcare facility, she said.
A Future in One Health
Faculty at the UA agree that One Health must find a way into the educational system. The college now offers several undergrad classes, certificates and a master’s degree in One Health, training students in the theory and application of utilizing the approach. The fund has also helped further develop the UA’s College of Veterinary Sciences, which supports the One Health mission by emphasizing animal health as connected to that of humans.
Many believe introducing this approach in K-12 schools promotes complex, broader thinking that would benefit students before they enter higher education. Attakai said it would be beneficial for public schools to include One Health as part of science curriculums, especially as many high school students become more aware of how things are connected. Moving forward, the UA wants to emphasize the connection between One Health and climate change, which Pogreba-Brown said is inextricable.
With Arizona hitting record high temperatures, there will also be economic implications. Such heat can impair roads or infrastructure and impact the way business is conducted, as well as choke the crops Arizona is famous for growing, such as cotton, citrus and lettuce. It can also address the need for cooling centers or public drinking water systems.
Kerry Cooper believes that One Health should start with food safety. Cooper is an assistant professor at the UA’s College of Animal and Comparative Biomedical Sciences who specializes in bacterial foodborne pathogens and how they interact with animals, the environment and ultimately humans.
“No matter what food you’re eating, there’s a One Health aspect there,” he said. The produce industry is a prime example of why a One Health approach is needed, as it is responsible for half of the food borne disease outbreaks in the United States, Kerry said.
Animal interactions in crop fields increase the risk of harmful microbes in our food, whether it be from the watering system that has cattle feces or disease-carrying wildlife munching on the produce.
“It’s a complicated system,” he said. “But everybody eats!”
COVID-19 is often used as an example of how One Health intervention could predict or even prevent the next pandemic.
“In order to understand the rise of COVID and find a way to stop the spread of disease in the future, you have to understand the ecology of the animal reservoir,” von Hippel said.
In the case of COVID, that means studying the bats from which the virus is believed to have come and their interactions with the people of China. By doing this, scientists can track down the source of a future outbreak of a different COVID variant or a different disease.
“Every sector has its own definition of success,” said UA’s Mona Arora, who leads the COVID Disparities Initiative. “But if you’re in the business of trying to build the capacity to mitigate or respond more effectively to the next pandemic, your measures of success are the number of collaborations that have been made, and people that are engaged.”
During the COVID pandemic, communication between scientists and the public was misconstrued, she said. In order to avoid the same chaos happening again, there must be a desire to be educated and see the bigger picture of how simple interactions and behaviors between humans and nature can have big effects on our mental and physical condition.
According to Arora, stagnancy is the biggest danger to One Health. Keeping the conversations going and bringing the right people to the table require a persistent effort. Faculty at the UA said a lot will happen in the next few years in One Health, and to be on the lookout for new developments in the field.
Varyvoda believes that Arizona has the most potential to be a leader in One Health research and career development because of the unique environment it is in and the great minds that are collaborating on how to make it better.
“It’s important to promote it from the state side,” she said. “From a bottom level to the top.” Starting the development of One Health locally, she believes, will lead to a deeper and better understanding of practical application for everyone.
