Towards integrated governance for water, health and social–ecological systems: The watershed governance prism Margot W. Parkes a,b, *, Karen E. Morrison b,c , Martin J. Bunch b,d , Lars K. Hallstro ¨m b,e , R. Cynthia Neudoerffer b,f , Henry D. Venema b,g , David Waltner-Toews b,c a Health Sciences Programs, University of Northern British Columbia, Canada b Network for Ecosystem Sustainability and Health, Canada 1 c Department of Population Medicine, University of Guelph, Guelph, Ontario N1G 2W1, Canada d Faculty of Environmental Studies, York University, 4700 Keele Street, Toronto, Toronto, Ontario M3J 1P3, Canada e Alberta Centre for Sustainable Rural Communities, University of Alberta, Augustana Campus, Camrose, AB T4V 2R3, Canada f Natural Resources Institute, University of Manitoba,303-70 Dysart Road, Winnipeg, MB R3T 2N2, Canada g International Institute for Sustainable Development, 161 Portage Avenue East, 6th Floor, Winnipeg, MB R3B 0Y4, Canada 1. Introduction The case for governance that explicitly integrates social and environmental concerns with the determinants of health and well- being is strongly supported by a range of international institutions and reports. The Millennium Ecosystem Assessment (MA, 2005)– uniquely among global environmental scans – argues that human well-being is fundamentally dependent on ecosystems services, categorized as provisioning, cultural, regulating and supporting services. The MA is explicitly anthropocentric, arguing that sound environmental management is essentially enlightened human self-interest. Recent World Health Organization (WHO) research reinforces the claims of the MA—estimating, for example, that 25% of the global disease burden is directly attributable to environ- mental causes, and a much higher fraction (over 80%) is attributable to indirect environment causes (Pru ¨ ss-U ¨ stu ¨n and Corvalan, 2005). Concomitantly, a multi-country World Bank study found that improved access to ecosystem services consistently correlates with better health and economic outcomes (World Bank, 2008). Further convergence is reflected in relation to the determinants of health inequities, exemplified by the WHO Commission of Social Determinants of Health statement that Global Environmental Change 20 (2010) 693–704 ARTICLE INFO Article history: Received 20 October 2009 Received in revised form 28 May 2010 Accepted 11 June 2010 JEL classification: 20.080 20.140 20.150 20.240 20.100 Keywords: Watersheds Governance Ecosystems Equity Social–ecological resilience Determinants of health Health and well-being ABSTRACT This article proposes a shift toward the integrated governance of watersheds as a basis for fostering health, sustainability and social–ecological resilience. The authors suggest that integrated watershed governance is more likely when different perspectives, including health and well-being, are explicitly understood, communicated, and sought as co-benefits of watershed management. A new conceptual device – the watershed governance prism – is introduced in relation to the multiple facets of governance that characterize contemporary water resources management and examined as an integrative framework to link social and environmental concerns with the determinants of health in the watershed context. The authors assess the diagnostic and communicative potential of such a framework, discussing its utility as a concise depiction of multiple, interacting policy priorities and as a guide to integrate different research and policy domains into the governance of water, health and social–ecological systems. ß 2010 Elsevier Ltd. All rights reserved. * Corresponding author at: Health Sciences Programs, University of Northern British Columbia, Teaching and Learning Building, East Block, 3rd Floor, Room #10- 3602 3333 University Way, Prince George, BC V2N 4Z9 Canada. Tel.: +1 250 960 6813; fax: +1 250 960 5744. E-mail addresses: parkesm@unbc.ca (M.W. Parkes), karenm@uoguelph.ca (K.E. Morrison), bunchmj@yorku.ca (M.J. Bunch), lars.hallstrom@ualberta.ca (L.K. Hallstro ¨ m), hankcynthia@yahoo.com (R.C. Neudoerffer), hvenema@iisd.ca (H.D. Venema), dwaltner@uoguelph.ca (D. Waltner-Toews). 1 http://www.nesh.ca. Contents lists available at ScienceDirect Global Environmental Change journal homepage: www.elsevier.com/locate/gloenvcha 0959-3780/$ – see front matter ß 2010 Elsevier Ltd. All rights reserved. doi:10.1016/j.gloenvcha.2010.06.001