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Planetary health provides a perspective of ecological interdependence that connects the health and vitality of individuals, communities, and Earth's natural systems. It includes the social, political, and economic ecosystems that influence both individuals and whole societies. In an era of interconnected grand challenges threatening health of all systems at all scales, planetary health provides a framework for cross-sectoral collaboration and unified systems approaches to solutions. The field of allergy is at the forefront of these efforts. Allergic conditions are a sentinel measure of environmental impact on human health in early life-illuminating how ecological changes affect immune development and predispose to a wider range of inflammatory noncommunicable diseases (NCDs). This shows how adverse macroscale ecology in the Anthropocene penetrates to the molecular level of personal and microscale ecology, including the microbial systems at the foundations of all ecosystems. It provides the basis for more integrated efforts to address widespread environmental degradation and adverse effects of maladaptive urbanization, food systems, lifestyle behaviors, and socioeconomic disadvantage. Nature-based solutions and efforts to improve nature-relatedness are crucial for restoring symbiosis, balance, and mutualism in every sense, recognizing that both personal lifestyle choices and collective structural actions are needed in tandem. Ultimately, meaningful ecological approaches will depend on placing greater emphasis on psychological and cultural dimensions such as mindfulness, values, and moral wisdom to ensure a sustainable and resilient future.

Population health intervention research (PHIR) seeks to develop and evaluate policies, programmes and other types of interventions that may affect population health and health equity. Such interventions are strongly influenced by context – taken to refer to any feature of the circumstances in which an intervention is conceived, developed, implemented and evaluated. Understanding how interventions relate to context is critical to understanding how they work; why they sometimes fail; whether they can be successfully adapted, scaled up or translated from one context to another; why their impacts vary; and how far effects observed in one context can be generalised to others. Concerns that context has been neglected in research to develop and evaluate population health interventions have been expressed for at least 20 years. Over this period, an increasingly comprehensive body of guidance has been developed to help with the design, conduct, reporting and appraisal of PHIR. References to context have become more frequent in recent years, as interest has grown in complex and upstream interventions, systems thinking and realist approaches to evaluation, but there remains a lack of systematic guidance for producers, users and funders of PHIR on how context should be taken into account. This document draws together recent thinking and practical experience of addressing context within PHIR. It provides a broad, working definition of context and explains why and how context is important to PHIR. It identifies the dimensions of context that are likely to shape how interventions are conceptualised, the impacts that they have and how they can be implemented, translated and scaled up. It suggests how context should be taken into account throughout the PHIR process, from priority setting and intervention development to the design and conduct of evaluations and reporting, synthesis and knowledge exchange. It concludes by summarising the key messages for producers, users and funders of PHIR and suggesting priorities for future research. The document is meant to be used alongside existing guidance for the development, evaluation and reporting of population health interventions. We expect the guidance to evolve over time, as practice changes in the light of the guidance and experience accumulates on useful approaches. The work was funded by the Canadian Institutes of Health Research (www.cihr-irsc.gc.ca) – Institute of Population and Public Health (CIHR-IPPH) and the UK National Institute for Health Research (NIHR).

Often the goal of health and social development agencies is to assess communities and work with them to improve community capacity. Particularly for health promoters working in community settings and to ensure consistency in the definition of health promotion, the evaluation of health promotion programmes should be based on strengths and assets, yet existing information for planning and evaluation purposes usually focuses on problems and deficits. A model and definition of community capacity, grounded in community experience and focusing on strengths and assets, was developed following a 4-year, multi-site, qualitative, action research project in four Toronto neighbourhoods. There was significant community involvement in the four Community Advisory Committees, one for each study site. Semi-structured, open-ended interviews and focus groups were conducted with 161 residents and agency workers identified by the Community Advisory Committees. The data were analyzed with the assistance of NUDIST software. Thematic analysis was undertaken in two stages: (i) within each site and (ii) across sites, with the latter serving as the basis for the development of indicators of community capacity. This paper presents a summary of the research, the model and the proposed indicators. The model locates talents and skills of community members in a larger context of socioenvironmental conditions, both inside and outside the community, which can act to enable or constrain the expression of these talents and skills. The significance of the indicators of community capacity proposed in the study is that they focus on identifying and measuring the facilitating and constraining socioenvironmental conditions.

The Community Intervention Trial for Smoking Cessation (COMMIT) was one of the largest health promotion interventions in North America. Using 11 pairs of matched intervention and control communities, the U.S. National Cancer Institute sought to establish the viability of a community-based approach to smoking cessation, with the expectation of significant impacts on cessation rates amongst heavy smokers during the four years of intervention. The evaluation components of the COMMIT trial relied primarily on the use of surveys to document quantitative changes in attitudes, beliefs and behaviours. A complementary ancillary qualitative evaluation was conducted by the author in the only Canadian intervention site in the trial in Brantford, Ontario. Depth interviews and focus groups were conducted with 45 members of a Smokers' Network established by COMMIT. Subsequently, 35 intervention staff, researchers and community influential were interviewed. Transcripts were coded and analyzed using qualitative analysis software. Several objectives guided the qualitative evaluation study in Brantford: 1) establish the degree to which the COMMIT met the needs of smokers for assistance in quitting; 2) identify the factors that inhibited or facilitated program success; and 3) consider the implications for community mobilization for smoking cessation. Findings in each of these areas are discussed. This work seeks to contribute to knowledge development in health promotion at the level of theory and method, as well as substantively in terms of the design and implementation of community health promotion interventions. A critical-interpretive methodology is advanced as being consistent with the 'new' health promotion, based on a review of the literature on social theory which also argues for an explicit critical and emancipatory orientation to theory and practice in health promotion. These approaches are applied to the examination of a community-level smoking cessation intervention. Chapter 9 contains a critical sociological examination of the nature of tobacco control, drawing upon the work of Goffman. Doctor of Philosophy (PhD)