Intended for healthcare professionals

CCBYNC Open access

Rapid response to:


Time and tide

BMJ 2019; 366 doi: (Published 17 July 2019) Cite this as: BMJ 2019;366:l4671

Rapid Response:

Re: Time and tide

I am happy to read the emphatic appeal of Michael Depledge and his colleagues that much more and immediate research and planning actions are needed for improvements in marine ecosystems to promote human health.

However, I would like to add a more fundamental argument to the authors' certainly courteous reasoning for the shortcomings so far ("In a world of multiple health threats and challenges, it is understandable if medical practitioners and policy makers focus on the most immediate problems they face, such as cardiovascular disease, diabetes, and depression"): There is still too much focus on diseases and the treatment of diseases without considering the impact of environmental, economic and social determinants.

As long as medical practitioners and policy makers fail to recognize determinants for a health-promoting environment, they will not realize that chronic diseases are also affected by the state of marine ecosystems. So if we want medical practitioners and the health community to make essential contributions to the improvement of the state of the global oceans, we, as environmental public health experts, ought to emphasize more strongly teaching our colleagues of the imperative for a comprehensive environment and socioeconomic based health approach - I am truly convinced that the authors share this view ...

Competing interests: No competing interests

09 August 2019
Susanne Moebus
Professor of Urban Epidemiology
Centre for Urban Epidemiology, University Hospitals of Essen, University Duisburg-Essen
Hufelandstr. 55, 45122 Essen, Germany