Securing 'supportive environments' for health in the face of ecosystem collapse: meeting the triple threat with a sociology of creative transformation.

In this paper, we reflect on and explore what remains to be done to make the concept of supportive environments--one of the Ottawa Charter's five core action areas--a reality in the context of growing uncertainty about the future and accelerated pace of change. We pay particular attention to the physical environment, while underscoring the inextricable links between physical and social environments, and particularly the need to link social and environmental justice. The paper begins with a brief orientation to three emerging threats to health equity, namely ecological degradation, climate change, and peak oil, and their connection to economic instability, food security, energy security and other key determinants of health. We then present three contrasting perspectives on the nature of social change and how change is catalyzed, arguing for an examination of the conditions under which cultural change on the scale required to realize the vision of 'supportive environments for all' might be catalyzed, and the contribution that health promotion as a field could play in this process. Drawing on sociological theory, and specifically practice theory and the work of Pierre Bourdieu, we advocate rethinking education for social change by attending more adequately to the social conditions of transformative learning and cultural change. We conclude with an explication of three key implications for health promotion practice: a more explicit alignment with those seeking to curtail environmental destruction and promote environmental justice, strengthening engagement with local or settings-focused 'communities of practice' (such as the Transition Town movement), and finding new ways to creatively 'engage emergence', a significant departure from the current dominant focus on 'risk management'.