Ecosystem change and human health: implementation economics and policy.

Thumbnail Image



Journal Title

Journal ISSN

Volume Title

Repository Usage Stats


Citation Stats


Several recent initiatives such as Planetary Health, EcoHealth and One Health claim that human health depends on flourishing natural ecosystems. However, little has been said about the operational and implementation challenges of health-oriented conservation actions on the ground. We contend that ecological-epidemiological research must be complemented by a form of implementation science that examines: (i) the links between specific conservation actions and the resulting ecological changes, and (ii) how this ecological change impacts human health and well-being, when human behaviours are considered. Drawing on the policy evaluation tradition in public economics, first, we present three examples of recent social science research on conservation interventions that affect human health. These examples are from low- and middle-income countries in the tropics and subtropics. Second, drawing on these examples, we present three propositions related to impact evaluation and non-market valuation that can help guide future multidisciplinary research on conservation and human health. Research guided by these propositions will allow stakeholders to determine how ecosystem-mediated strategies for health promotion compare with more conventional biomedical prevention and treatment strategies for safeguarding health.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'.





Published Version (Please cite this version)


Publication Info

Pattanayak, SK, RA Kramer and JR Vincent (2017). Ecosystem change and human health: implementation economics and policy. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 372(1722). pp. 20160130–20160130. 10.1098/rstb.2016.0130 Retrieved from

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.



Subhrendu K. Pattanayak

Oak Foundation Distinguished Professor of Environmental and Energy Policy

Subhrendu K. Pattanayak is the Oak Professor of Environmental and Energy Policy at Duke University. He studies the causes and consequences of human behaviors related to the natural environment to help design and evaluate policy interventions in low-income tropical countries. His research is in three domains at the intersection of environment, development, health and energy: forest ecosystem services, environmental health (diarrhea, malaria, respiratory infections) and household energy transitions. He has focused on design of institutions and policies that are motivated by enormous inequities and a range of efficiency concerns (externalities, public goods and imperfect information and competition).

Dr. Pattanayak approaches these problems through systematic reviews of the literature (meta-analyses) and statistical modeling with high-resolution objective data collected in the field. He then uses those data to test hypotheses salient to policy manipulation, developed both from economic frameworks, stakeholder discussions and direct observations in the field. He employs empirical methods that exploit quasi-experimental variation (or experiments where feasible and appropriate), captured through household, community and institutional surveys. He typically matches these survey data with meso-scale secondary statistics and estimates econometric models to generate policy parameters. Dr. Pattanayak has collaborated closely with multi-lateral agencies, NGOs, governments, and local academics in Brazil, Costa Rica, Ethiopia, India, Indonesia, Mexico, Nepal, Sri Lanka and the U.S.


Randall Kramer

Juli Plant Grainger Professor Emeritus of Global Environmental Health

Before coming to Duke in 1988, he was on the faculty at Virginia Polytechnic Institute and State University. He has held visiting positions at IUCN--The World Conservation Union, the Economic Growth Center at Yale University, and the Indonesian Ministry of Forestry. He has served as a consultant to the World Bank, World Health Organization and other international organizations. He was named Duke University's Scholar Teacher of the Year in 2004.

Kramer's research is focused on the economics of ecosystem services and on global environmental health. He is currently conducting a study on the effects of human land use decisions on biodiversity, infectious disease transmission and human health in rural Madagascar. Recent research projects have used decision analysis and implementation science to evaluate the health, social and environmental impacts of alternative malaria control strategies in East Africa. He has also conducted research on health systems strengthening, economic valuation of lives saved from air pollution reduction. and the role of ecosystems services in protecting human health.


Jeffrey R. Vincent

Korstian Distinguished Professor in Forest Economics and Management in the Nicholas School of the Environment and Earth Sciences

Jeffrey R. Vincent is an economist who works mainly on forest policy issues in low- and middle-income countries. Over his career, he has blended academic research, teaching, and administration; leadership of large, donor-funded policy-advising projects; and capacity-building and mid-career training. Prior to joining Duke’s Nicholas School of the Environment in 2007, he held positions at the University of California, San Diego (School of International Relations & Pacific Studies), Harvard University (Institute for International Development), and Michigan State University (Department of Forestry). His current research focuses on the economics of forest restoration, with a primary emphasis on countries in Asia. His past research has addressed various topics, including the tropical timber trade, forest concession policies, biodiversity conservation, the effects of air pollution and climate change on agriculture, green accounting, and valuation of forest ecosystem services. He received the McKinsey Award for the most significant article published in the Harvard Business Review in 2003 and the Cozzarelli Prize for the best article in applied biological, agricultural, and environmental sciences published in PNAS in 2006. He is a Fellow at the Beijer Institute of Ecological Economics in Stockholm, Sweden and the South Asian Network of Development and Environmental Economists in Kathmandu, Nepal and Co-Editor-in-Chief of the Cambridge University Press journal, Environment and Development Economics.

Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.