Rethinking a health approach to Ocean One Health

Oceans are complex dynamic socio-ecological systems subject to various forms of degradation. The lack of a clear operational definition of Ocean Health can be an obstacle for the establishment of effective systems for the protection of the ocean. One Health needs to adapt and be more inclusive of non-human and ocean elements to address the gap of implementation and integration regarding Ocean Health. We argue that integrating population health concepts in a joint interdisciplinary approach, grounded in the study of populations through epidemiology as part of One Health, could provide a structured approach to understand factor dynamics and offer a robust framework for developing management systems for Ocean Health. In this commentary, we propose three key population health concepts offering a novel approach to help bridge the gap between One Health and Ocean Health. The use of (i) settings thinking to engage with local issues and opportunities by identifying intersecting factors using cross-sectoral responses to create and maintain health. (ii) Harm reduction provides public health strategies that minimize negative impacts when threats to Ocean Health cannot be eliminated quickly. The (iii) continuum of care for risk prevention and management is a framework that adapts to the level of needs and facilitates multi-benefit, transdisciplinary actions. The use of a One Health framework using the aforementioned population health concepts could provide a common vision to address challenges and support the effectiveness of programs to protect Ocean Health. One Health impact statement One Health has given limited attention to ocean settings and environments despite the critical role oceans play for all One Health elements. The identification and application of health sector expertise could be seamlessly used for the benefit of Ocean Health. This gap of knowledge and implementation needs to be addressed using transdisciplinary action if One Health and Ocean Health are to be successfully implemented and if the underlying socio-ecological pathways to problems and solutions are to be considered. This will be beneficial for all disciplines involved, from landscape ecology to conservation biology, health sectors, policy making and enforcement along with other holders and knowledge types, and provides a common setting for skills and capacity deployment. We propose three population health concepts (settings thinking, harm reduction and continuum of care) to support the implementation of a One Health framework for effective solutions within an Ocean One Health program.