Environmental justice and One Health: Toward an integrated framework for equitable and sustainable health outcomes

The One Health framework, which recognizes the interdependence of human, animal, and ecosystem health, has gained considerable momentum in global health policy. However, its full potential to address health inequities remains underexplored. Environmental justice (EJ), defined by the US EPA as the fair treatment and meaningful involvement of all people regardless of race, color, culture, national origin, income, and educational levels with respect to the development, implementation, and enforcement of protective environmental laws, regulations, and policies, constitutes a natural and necessary complement to One Health. This narrative review examines the conceptual, empirical, and policy interfaces between EJ and One Health, arguing that each framework is incomplete without the other. This review analyzes how socially marginalized populations bear disproportionate environmental burdens through differential exposures to pollutants, zoonotic risks, antimicrobial-resistant pathogens, and the adverse health consequences of climate change. The manuscript also discusses how the One Health approach can be enriched by incorporating EJ principles, including procedural justice, community participation, and the recognition of structural determinants of health. Five guiding principles for integration (namely, structural equity, community-centered participation, epistemic diversity, intersectional vulnerability analysis, and global justice) are proposed, together with concrete recommendations for researchers, policymakers, and international health organizations aiming to build a more equitable One Health governance architecture.