Watershed management and public health: an exploration of the intersection of two fields as reported in the literature from 2000 to 2010.

Watersheds are settings for health and well-being that have a great deal to offer the public health community due to the correspondence between the spatial form of the watershed unit and the importance to health and well-being of water. However, managing watersheds for human health and well-being requires the ability to move beyond typical reductionist approaches toward more holistic methods. Health and well-being are emergent properties of inter-related social and biophysical processes. This paper characterizes points of connection and integration between watershed management and public health and tests a new conceptual model, the Watershed Governance Prism, to determine the prevalence in peer-reviewed literature of different perspectives relating to watersheds and public health. We conducted an initial search of academic databases for papers that addressed the interface between watershed management (or governance) and public health themes. We then generated a sample of these papers and undertook a collaborative analysis informed by the Watershed Governance Prism. Our analysis found that although these manuscripts dealt with a range of biophysical and social determinants of health, there was a tendency for social factors and health outcomes to be framed as context only for these studies, rather than form the core of the relationships being investigated. At least one cluster of papers emerged from this analysis that represented a cohesive perspective on watershed governance and health; "Perspective B" on the Watershed Governance Prism, "water governance for ecosystems and well-being," was dominant. Overall, the integration of watershed management/governance and public health is in its infancy.