A holosphere of healthy and sustainable communities

Public health practice is in a transitory state, expanding considerably beyond medical and behavioural models of health and disease to encompass physical and social environmental health determinants. A new public health practice is emerging, apparent in initiatives like the international healthy cities/communities projects. This new public health practice must integrate the challenge of sustainable development, as defined by the 1987 World Commission on Environment and Development. The holosphere framework locates health as its central metaphor, and defines six interacting environmental spheres: a viable natural environment, a sustainable economic environment, a sufficient economy, an equitable social environment, a convivial community, and a livable built environment. There are five functional roles for local government: policy, legislation, education, partnerships and advocacy. Representative actions from each of the six environmental spheres of the holosphere framework are identified and discussed, using the five functional roles of local government. There is a need for new intersectoral forums to act upon the knowledge generated by integrative models such as the holosphere. Canadian Round Tables on Environment and Economy are encouraging examples of such intersectoralism.