15. “Health as a Social-technical Enterprise Anchored in Social-ecological Justice and Stakeholder Collaboration: Insights from Mexico-Lerma-Cutzamala Hydrological Region”

Human health and wellbeing depend on the health and integrity of ecosystems we co-inhabit with other species and the ways we use natural capital in our economy. They depend on the ways people are able (or not) to satisfy basic needs: breathing clean air, drinking clean water, eating healthy food, and having access to healthy housing, a safe and secure neighborhood, a stable livelihood, and healthcare. Science grapples with deciphering how environmental, biological, and lifestyle/behavioral factors interact to co-determine health. Meanwhile, major promoting and degrading factors are highly unevenly distributed across populations and landscapes; significant social-ecological health injustice prevails. We present four innovations to address recognized limitations of existing health research and practice: (1) an integrative framework to tackle innate conundrums and conceptualize important domains; (2) an integrative operational process for designing health-water-ecology-climate projects that enable multi-component research and its translation; (3) coupled mixed methods systems modeling-GIS/geospatial analysis, plus exposure vs. response/risk curves for groups with differential vulnerability to stressors—to reveal promoters and degraders of health, and structural injustices; and (4) a social-technical capacity building enterprise model to frame health-sustainability projects based on prior successful multi-stakeholder experience in Mexico. Our ongoing project—“Climate Change Impacts & Resilience in the Mexico-Lerma-Cutzamala Hydrological Region”—illustrates their application. We argue health, sustainability and climate resilience challenges be reframed as opportunities to co-create social-technical enterprises at different spatial, temporal and human scales, firmly anchored in the moral pursuit of social-ecological justice, and enabled by stakeholder partnerships.