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An ecological framework for improving child and adolescent health
  1. Chris Bem1,
  2. Neil Small2
  1. 1 ENT Department, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
  2. 2 Faculty of Health Sciences, University of Bradford, Bradford, UK
  1. Correspondence to Dr Chris Bem, Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK; chrisbem{at}


The rise in non-communicable disease as a principal cause of premature mortality and a continuing failure to address health inequalities requires a critical examination of prevailing paradigms in health. In this paper, we offer ecology as an alternative way to view health need and as a guide to action to enhance human health and model a healthy economy. After describing the shortcomings of the prevailing biophysical approach to health, we describe an ecological approach to health that brings to the forefront social and environmental determinants and empowers health workers together with their communities to achieve a health-affirming society and economy.

  • health economics
  • health service
  • medical education
  • mortality
  • obesity
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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.

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