Cumulative determinants of health impacts in rural, remote, and resource-dependent communities

Abstract

The environmental and social dynamics of resource development pose challenges for health research, policy, and practice, due the need to understand and respond to multiple interacting stressors and processes that can impact on human health and well-being over space and time. Cumulative health impacts can, therefore, be usefully understood as part of ongoing efforts to address the combined social and environmental determinants of health. This Chapter begins with an overview of the range of prospective, reactive, and integrative approaches that inform Canadian and global approaches to assessing health impact. It then highlights key considerations relevant to understanding the health impacts of resource development in rural, remote, and resource-dependent communities by drawing on exemplars and experiences within northern BC, Canada. The Chapter concludes by discussing the examples from northern BC in relation to a cascade of direct and indirect impacts on social and environmental determinants of health. The interface between impact assessment and the determinants of health is an important challenge in its own right, but is especially important in the context of the environmental, community, and health impacts of resource development. Combining these issues and perspective provides a more integrated view of the cumulative determinants of health impacts.