© PAHO-WHO KMC/IB-GC July 20, 2012 - H & H S Human Security: Implications for Public Health Technical Reference Document Sustainable Development and Environmental Health Area (SDE) PAN AMERICAN HEALTH ORGANIZATION Pan American Sanitary Bureau, Regional Office for the Americas of the WORLD HEALTH ORGANIZATION 525 Twenty-third Street, N.W. Washington, D.C. 20037 2012 Also published in Spanish (2012) as: Seguridad humana: implicaciones para la salud pública. Documento técnico de referencia ISBN: 978-92-75-31692-4 PAHO HQ Library Cataloguing-in-Publication Pan American Health Organization Human security: Implications for public health Washington, D.C.: PAHO © 2012 ISBN: 978-92-75-11692-0 I. Title 1. CIVIL PROTECTION 2. SAFETY 3. SAFETY MANAGEMENT 4. DISASTER MANAGEMENT 5. ENVIRONMENTAL HEALTH 6. HUMAN RIGHTS 7. PUBLIC HEALTH NLM WA 250 The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. 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Cover: Area of Knowledge Management and Communications/Institutional Branding-PAHO Design: Miki Fernandez/ULTRAdesigns Table of Contents © PAHO-WHO KMC/IB-GC July 20, 2012 - H & H S List of Acronyms ........................................................................................................................... v Acknowledgments .........................................................................................................................vi Foreword ............................................................................................................................................vii Preface ................................................................................................................................................ix Executive Summary .....................................................................................................................xi Next Steps in Implementation .............................................................................................................xiii I. Introduction to Human Security ....................................................................................1 Human Security: The Basics ................................................................................................................1 The Human Security Approach ...........................................................................................................3 The Protection (Top-Down) Dimension .........................................................................................3 The Empowerment (Bottom-Up) Dimension .................................................................................4 II. Public Health Practice: Mutual Alignment with Human Security ................5 Human Security: Contributions to Public Health .................................................................................6 Public Health: Contributions to Human Security .................................................................................8 III. How Public Health Applies Human Security ............................................................9 The Empowerment Approach as a Part of Public Health .....................................................................9 The Provision of Health Care Services ...............................................................................................11 Social Protection ..............................................................................................................................11 The Stewardship Function in Public Health as It Applies to Human Security .......................................13 The Health System and its Relation to Human Security .....................................................................13 IV. Concepts Related to Health and Human Security ..............................................15 Extent of Action ...............................................................................................................................15 Multidimensional Security ................................................................................................................16 Citizen Security ................................................................................................................................16 State Security ...................................................................................................................................17 Health Security and Health and Human Security ...............................................................................17 Health, Human Security, and Human Development...........................................................................18 The Potential for a Human Security Index .........................................................................................19 Social Determinants of Health: The Role of Inequity in Health and Human Security ...........................20 Climate Change, Health, and Human Security ..................................................................................21 The Relationship between Human Rights, Health, and Human Security .............................................22 V. Human Security in the Americas .................................................................................24 Specific Examples of Interventions Related to Human Security ..........................................................25 Human Security and Vulnerable Populations ..............................................................................26 Human Security and Communicable Disease (including HIV/AIDS) ..............................................27 Human Security and Violence ....................................................................................................27 Human Security and Natural Disasters .......................................................................................28 Human Security and Climate Change ........................................................................................28 Technical Reference Document •• iii •• Human Security, Environment, and Multisectoral Approaches ....................................................28 Human Security, Alcohol, and Drugs ..........................................................................................28 Human Security, Nutrition, and Access to Food ..........................................................................29 Human Security and Noncommunicable Diseases ......................................................................29 Human Security and Primary Health Care ..................................................................................30 Human Security and Social Protection ........................................................................................30 VI. Implementing the Directing Council Resolution: Next Steps .......................31 1. Conceptual ...........................................................................................................................31 2. Methodological .....................................................................................................................31 3. Operational ...........................................................................................................................32 4. Theoretical ............................................................................................................................32 VII. Conclusions .............................................................................................................................33 Appendices Appendix I: Table of Definitions .............................................................................................................35 Definitions Applicable to Health