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Intimate ecosystems: the microbiome and the ecological determinants of health


The ecological determinants of health make explicit the ways in which human health and well-being depend on the biosphere and its systems. Water, oxygen, and food are listed along with soil systems, water systems, material for shelter, energy, the ozone layer and a stable climate. Research in the sciences is uncovering the critical role that the earth microbiome, including the human microbiome, plays in human health. The relationship between commensal microbiota and the systems of the human body, as well as the ways in which these systems are interdependent with other ecosystems such as food systems, invites revisiting the ecological determinants of health. In this commentary, I argue that microbiota, including the human microbiome, should be considered ecological determinants of health. Such a characterization would recognize the importance of the microbiome to human health. It would also frame this as a public health issue and raise questions about health equity, including who benefits from the knowledge produced through biomedical research.


Les déterminants écologiques de la santé rendent explicites comment la santé et le bien-être humains dépendent de la biosphère et de ses systèmes. L’eau, l’oxygène et la nourriture figurent parmi ces déterminants comme également l’écologie du sol, le réseau hydrographique, les matériaux d’hébergement, l’énergie, la couche d’ozone, et un climat stable. La recherche dans le domaine des sciences révèle le rôle critique que joue le microbiote humain dans la santé humaine. Les rapports entre les microbiotes commensales et les systèmes du corps humain, y compris les interdépendances entre d’autres écosystèmes tels les systèmes alimentaires, invitent une réexamination des déterminants écologiques de la santé. Je soutiens, dans ce commentaire, qu’on devrait considérer les microbiotes, y compris le microbiote humain, des déterminants écologiques de la santé. Un tel caractérisation reconnaîtrait l’importance du microbiote vis-à-vis la santé humaine et le situerait dans le cadre d’un problème de santé publique. En plus, il soulèverait des questions sur l’équité en santé y compris la question de qui va bénéficier du savoir qui découlerait de la recherche biomédicale.

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    Researchers are uncovering the importance of microbiome to many of the body’s systems and the role that microorganisms play at every stage of life from birth to old age.


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I am the sole author of this article. I researched and wrote it in its entirety.

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Correspondence to Sarah Elton.

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Elton, S. Intimate ecosystems: the microbiome and the ecological determinants of health. Can J Public Health (2021).

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  • Microbiota
  • Public health
  • Ecosystem
  • Human body


  • Microbiote
  • santé publique
  • écosystème
  • corps humain