Highlights

Introduction

In a century characterized by unprecedented environmental and social challenges, evaluators can influence societal improvements by encouraging consideration of the broader impacts of actions. However, to have this influence, evaluators must adopt a moral stance that works towards planetary health; one that requires more than narrowly meeting a client’s request or the siloed analysis of work for the public good but instead championing broader engagement on the determinants of planetary health (Brousselle et al., 2024a; Brousselle & McDavid, 2021). This approach involves considering and including the dimensions critical for the whole planet to thrive and also choosing the approach that is right for the political, cultural, and social contextual dynamics. Adopting planetary health lenses can help us implement holistic and positive actions.

Planetary health is a concept representing the interconnections between the ecosystem and living species, and the conditions necessary to support the well-being of all life forms. It is a different notion from “ecosystem” as ecosystems may or may not support human life. Planetary health was defined by Whitmee and colleagues as:

the achievement of the highest attainable standard of health, wellbeing, and equity worldwide through judicious attention to the human systems—political, economic, and social—that shape the future of humanity and the Earth’s natural systems that define the safe environmental limits within which humanity can flourish. (Whitmee et al., 2015, p. 1978)

Redvers and colleagues found this definition too human-centric and not reflecting the perspective that all kinds of lives are equal (Redvers et al., 2022). The following definition was then created:

Planetary health is an approach that considers the interdependence between the elements (air, soil and water) and living beings (plants, animals including humans), emphasizing the importance of cultivating a positive ecosystem to support the flourishing of all forms of life. (Brousselle et al., 2024a, p. 175; Brousselle et al., 2024b)

Interestingly, in French and in English, we are creating new concepts and new words to represent the deep interconnections between the ecosystem and living species, when such concepts have existed for multi-generations in some Indigenous cultures. This disparity illustrates how culture and language represent and frame our worldviews, which impact the way we think and the way we act. For example, in the language of Nuu-chah-nulth people (Canada, BC) the expression  hesook-ish tsawalk means everything is one, everything is connected (Umeek Atleo, 2011); in the language of Haida people (Canada, BC) gina waadluxan gud ad kwaagid means everything depends on everything else (https://www.haidanation.ca/because-gina-waadluxan-gud-ad-kwaagid-everything-depends-on-everything-else-a-summary-of-haida-gwaii-marine-protected-areas-virtual-open-house/). In the southern part of Africa, the concept of ubuntu exists: Ubuntu ‘is an essentially relational ethics, which prizes relationships of interdependence, fellowship, reconciliation, relationality, community friendliness, harmonious relationships and other-regarding actions such as compassion and actions that are likely to be good for others, in which actions are morally right to the extent that they honour the capacity to relate communally, reduce discord or promote friendly relationships with others, and in which the physical world and the spiritual world are fundamentally united’ (Ewuoso & Hall, 2019, p. 100). (as cited in Brousselle et al., 2024a, p. 175)

Creating new planetary health language to help us consider the whole system of relationships necessary for all forms of life to thrive is not enough. We also need support to help us navigate and apply this concept in all our actions. This is where frameworks, approaches, and tools can be helpful.

The Planetary Health Framework (presented below) was developed with this objective: to help us consider and include the key dimensions that matter for both human and natural systems when designing and implementing projects, programs, and policies that lead to thriving communities. The framework was created to identify sets of factors that, when considered, improve the design and successful implementation of interventions that will make a positive difference. It can be used in evaluation projects to systematically include dimensions that matter for planetary health. Since the framework’s development, different approaches and tools have been created to support the work of evaluators (Brousselle et al., 2024b; Brousselle et al., 2022). This work has been developed based on three main premises:

Evaluators should explore engagement approaches to navigate dynamic contexts characterized by polarized perspectives and to empower communities while leading a transformation agenda.

An approach that creates space for deliberation, dissent, and divergent thinking can generate new perspectives based on lived experiences, and particular values and representations, (Brousselle et al., 2024b, p. 271)

Furthermore, listening to and carrying a diversity of voices, from the usually heard to the marginalized, oppressed, and excluded can make the evaluation project a direct contributor to increasing ‘social, economic and environmental justice, rather than being complicit in sustaining an oppressive status quo’ (Mertens, 2023, p. 12).

The United Nations Sustainable Development Goals

In 2015, all United Nations Member States adopted the 2030 Agenda for Sustainable Development. This initiative calls for action to support “peace and prosperity for people and the planet, now and into the future” (United Nations, 2025). The agenda outlines 17 goals and 169 targets. However, researchers quickly identified potential risks in the proposed approach and made suggestions to strengthen the implementation and achievement of these Sustainable Development Goals (SDGs). Below, we provide a brief overview of these discussions.

Rockström and Sukhdev (2016) observed that the SDGs are interconnected and illustrate how, for example, the food system spans multiple SDGs, including Life Below Water (#14), Life on Land (#15), Gender Equality (#5), Good Health and Well-being (#3), Clean Water and Sanitation (#6), Climate Action(#13), Responsible Consumption and Production (#12), No Poverty (#1), Zero Hunger (#2), and Decent Work and Economic Growth (#8). However, SDGs are in most cases not considered in a holistic manner and their connections are being ignored.

Second, interventions can offer win-win solutions, yielding positive impacts on multiple SDGs simultaneously (Bowen et al., 2017). However, they may also involve trade-offs, potentially having negative impacts on some SDGs (Bowen et al., 2017). Choosing a few SDGs to work on, without considering their negative impacts on other SDGs is unlikely to bring good to societies overall. Lim et al. (2018) emphasize that identifying a clear end goal would help resolve conflicts when an intervention creates trade-offs in impact. Unfortunately, no such objective has been clearly defined.

Third, the linear presentation of the SDGs does not accurately reflect their causal relationships. Some SDGs are, in fact, determinants of others. The Stockholm Resilience Center (2016) offers a pyramidal representation of the SDGs, highlighting which ones serve as foundational to others (see Figure 2.1).

Figure 2.1 The SDGs Wedding Cake

Source and credits: Azote for the Stockholm Resilience Centre (2016). The SDGs wedding cake, Stockholm University (CC BY-ND 3.0): https://www.stockholmresilience.org/research/research-news/2016-06-14-the-sdgs-wedding-cake.html

Overall, progress toward the implementation of the goals has been largely insufficient. The United Nations indicates that we are collectively off-track (United Nations, 2024) (see Figures 2.2 and 2.3).

Figure 2.2 Overall Progress Across Targets Based on 2015-2024 Global Aggregate Data

Source: United Nations. (2024). The Sustainable Development Goals Report, p.4: https://unstats.un.org/sdgs/report/2024/The-Sustainable-Development-Goals-Report-2024.pdf

Figure 2.3 Progress Assessment for the 17 Goals Based on Assessed Targets, by Goal (percentage)

Source: United Nations. (2024). The Sustainable Development Goals Report, p.4: https://unstats.un.org/sdgs/report/2024/The-Sustainable-Development-Goals-Report-2024.pdf

In fact, studies show that when organizations adopt the SDGs, they often cherry-pick certain dimensions. Dimensions related to Earth's life support systems are frequently overlooked, as they are considered more difficult to implement (Heras-Saizarbitoria et al., 2022; Lim et al., 2018; Stafford-Smith et al., 2017).

In the majority of the cases, the SDGs only serve to add color and fancy icons to the reports in a trend towards “SDG icon-picking” that may point to impression management and SDG-washing. (Heras-Saizarbitoria et al., 2022, p. 325)

The fact that the SDGs are so broad has given ample room for cherry-picking and given rise to a form of sustainability metonymy, whereby meeting selected targets of choice (e.g., economic growth, eliminating global hunger) are taken to signify conformity to the whole of the 2030 Agenda, irrespective of other goals and targets disregarded in the process. (Siegel & Lima, 2020, p. 2 cited in Heras-Saizarbitoria et al., 2022, p. 325)

Studies recommend that all goals be approached from a systemic perspective, taking planetary boundaries into account. This approach would highlight both co-benefits and trade-offs, enabling real progress toward sustainable and healthy ways of living within planetary boundaries.

Using the Planetary Health Framework to guide our actions can help holistically address the United Nations 2030 Sustainable Development Agenda and avoid the commonly used pick and choose approach (Uitto, 2021). However, the dimensions of the Planetary Health Framework have been developed based on the literature from various knowledge domains, rather than being specifically tailored to the SDGs. For example, the concept of prosperity was used to avoid apparent contradictions between certain dimensions, such as Economic Growth and the respect for Planetary Boundaries. The Planetary Health Framework covers all SDGs and could be tailored to specifically address the specificities of each one and all.

The Planetary Health Framework

The Framework (see Figure 2.4) identifies interconnected natural systems (exterior circle) and human systems (interior circles). Key dimensions of natural and human systems have been included based on what researchers have identified as critical dimensions that will lead to positive outcomes for both natural and human systems. The dimensions of governance and power relations are of different nature. They were included as their consideration maximizes the chances of any given intervention (project, program, policy) to be successfully implemented.

Figure 2.4 The Planetary Health Framework

Source: Adapted from Brousselle, A., & McDavid, J. (2021). Evaluation for Planetary Health. Evaluation, 27(2), 177. https://doi.org/10.1177/1356389020952462

Natural Systems

Nine planetary boundaries have been scientifically identified along with the ‘safe operating space’ in which human beings can live (Richardson et al., 2023; Rockström et al., 2009; Steffen et al., 2015). Some of the systems identified within these nine boundaries are interconnected and impact one another, such as climate change and biodiversity. For instance, evidence indicates that crossing the planetary boundary for either climate change or biosphere integrity can sharply heighten the risk of crossing the other (Richardson et al., 2023). Steffen et al. (2015)’s study indicated that four of the nine systems have already transgressed what is considered a safe space for human life on Earth. Richardson et al. (2023)’s updated study indicates that six out of nine systems are beyond safe limits and that for all boundaries previously transgressed, the level of transgression has increased. Figures 2.5 and 2.6 illustrate this evolution.

Figure 2.5 Planetary Boundaries in 2015

Source: Steffen, W., Richardson, K., Rockström, J., & al. (2015). Sustainability. Planetary boundaries: guiding human development on a changing planet. Science, 347, 1259855. https://doi.org/10.1126/science.1259855

Figure 2.6 Planetary Boundaries in 2023

Source: Richardson, K., Steffen, W., Lucht, W., Bendtsen, J., Cornell, S.E., Donges, J.F., Drüke, M., Fetzer, I., Bala, G., von Bloh, W., Feulner, G., Fiedler, S., Gerten, D., Gleeson, T., Hofmann, M., Huiskamp, W., Kummu, M., Mohan, C., Nogués-Bravo, D., Petri, S., Porkka, M., Rahmstorf, S., Schaphoff, S., Thonicke, K., Tobian, A., Virkki, V., Weber, L. & Rockström, J. (2023). Earth beyond six of nine planetary boundaries. Science Advances, 9(37). https://doi.org/10.1126/sciadv.adh2458

Rockström et al.’s (2009) and Steffen et al.’s (2015) work on Planetary boundaries was used as a foundation for identifying the natural systems dimensions of the Planetary Health Framework. To make the dimensions more accessible to everyone, these nine dimensions were synthesized as three main dimensions: (1) pollutants in air, soil, and water; (2) land and water preservation and management; and (3) biodiversity.

1. Pollutants in air, soil, and water.

These dimensions aim at reducing and controlling sources and quantities of CO2, chlorofluorocarbons, pesticides, fertilizers, aerosols, plastics, heavy metals and radioactive products that are disposed into the biosphere. Greenhouse gas emissions are pollutants. Reducing pollutants will directly affect climate change, ocean acidification, chemical pollution, atmospheric aerosols, global freshwater, stratospheric ozone depletion as well as biogeochemical flow boundaries.

2. Land and water preservation and management.

These dimensions focus on protecting natural environments (land and water) from human-led alterations that disturb natural cycles. Restoring and regenerating land and water spaces and systems will increase thriving lifeforms and enhance natural systems. Critical zones are carbon sinks (sequestering carbon), river basins, moisture feedback cycles and water quality. This dimension will affect climate change, ocean acidification, changes in land use, global freshwater use, and biodiversity loss.

3. Biodiversity.

This dimension is about protecting plants and animals by creating conditions that maintain and enhance ecological diversity. Species are disappearing, but the density of living species populations is also decreasing (World Wild Fund for Nature, 2022). Diverse ecologies are more resilient, more adaptable and more likely to withstand climate change-related shocks. By paying attention to biodiversity and to our impact on biodiversity we can create opportunities for living species to thrive in rich and healthy ecosystems.

Human Systems

The framework includes five dimensions of human systems. Health, equity, and prosperity dimensions can have a positive and protective effect for human beings. The two other dimensions, power and governance, relate to the capacity to successfully implement initiatives; as such, they are of a different nature than the three other human systems dimensions.

The following sections describe each dimension and illustrate their interconnection with one another and with planetary boundaries.

1. Health.

Health is a determinant of our ability to enjoy and thrive in life.

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.” (World Health Organization)

Health is determined by many factors related to individual behaviors and characteristics, our physical environment, access to health services, and is largely determined by our position in society in terms of income, education, gender, racism, employment and working conditions. Culture also influences what matters for our health (see Figure 2.7).

Culture normalizes behaviors and influences our attitudes and actions. For example, in the past, driving without wearing a seatbelt was common, as was smoking in public indoor spaces. Over time cultural attitudes have shifted; new norms have emerged that protect our health. We can reduce our impact on the environment while working on population health determinants by prioritizing programs and policies that create co-benefits. By selecting climate change interventions that positively impact health, we create poly-benefits that impact the health of our families, communities, and the natural world. For example, active transportation (e.g. cycling or walking) reduces greenhouse gas emissions and improves air quality in urban environments, which leads to reduced hospitalizations and health conditions. Increasing physical activity also has positive consequences on physical and mental health. Furthermore, scientists have documented positive health impacts of having public spaces where people can walk and meet, of having green spaces that include trees and forests, and streets that are safe for children, pedestrians, and cyclists. Demonstrating and communicating how new projects, programs, and policies have the potential to create opportunities for people to improve their health can increase public support for projects designed to meet climate or sustainability targets.

2. Equity.

Equity is defined as “the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequality (e.g. sex, gender, ethnicity, disability, or sexual orientation). Health is a fundamental human right. Health equity is achieved when everyone can attain their full potential for health and well-being.” (World Health Organization)

Equity is a major but often overlooked determinant of health.

In 1980, the Black Report (Black et al., 1980) showed that inequities explained the persistence of mortality gradients over time: even if health outcomes improved for a whole population and major causes of deaths were reduced, a gradient persisted among different social classes of the population. This work led public health researchers to consider equity as a major factor impacting population health. Inequities are defined as inequalities on which we can act. They are perceived to be a central matter for health and social justice. To positively impact health, one needs to improve equity. If not, there is a risk of increasing inequalities which, in the end, will have a negative health effect for those who are disadvantaged (Buregeya et al., 2019). (as cited in Brousselle & McDavid, 2021, p. 175)

As we saw in the previous chapter, equity is also a major determinant of population resilience. It is a major determinant of our collective capacity to adapt, be less impacted, and recover from crises.

Implementing equity lenses would invite to consider the local, global and intergenerational perspectives to redress environmental injustices.

Figure 2.7 First Nations Health Authority Health and Wellness Framework

Source: First Nations Health Authority, First Nations Perspective on Health and Wellness. https://www.fnha.ca/wellness/wellness-for-first-nations/first-nations-perspective-on-health-and-wellness

3. Prosperity.

Prosperity in societies enables individuals, families, communities and the state to make choices that can enhance well-being. Adequate income is a condition necessary to meet needs ranging from food and shelter to well-being. Ensuring minimum income is met at the individual level is central. But the logic of continuous growth at a collective (societal and global) level is not sustainable (Alexander, 2015b). Recent writings contest the need to grow the economy as if there were no limits and suggest instead that beyond a certain level, the quest for (material) growth negatively impacts the environment. O’Neill et al. (2018) indicate that a certain level of income and thus of economic activity is required for a country to implement social programs that would ensure population well-being and to allow population needs to be met, but that economic growth shouldn’t be an end in itself. To live collectively within planetary boundaries, steady-state economic activity or even de-growth of the wealthiest economies would be needed to allow other countries to reach a level of wealth necessary for their population well-being (Alexander, 2015b; O’Neill et al., 2018). Economic growth cannot indefinitely be pursued knowing that there are limited resources and that global population continues to grow. (as cited in Brousselle & McDavid, 2021, p. 174)

We choose to use the term prosperity rather than economic growth to include the many forms of economic and social activities that contribute to well-being. Prosperity includes contributions such as social capital, informal exchange and sharing systems, and/or out-of-market solidarity systems, for example. GDP is no longer considered a valid indicator of progress (Alexander, 2015a; Jackson, 2017; O’Neill et al., 2018; Raworth, 2017). There is an on-going debate around Green Growth, Degrowth and Green New Deal. Green growth is likely to lead to reduced greenhouse gas emissions but also to increased unemployment and inequities unless strong redistributive social programs are concurrently implemented (O’Neill, 2020). Degrowth, with strong redistributing policies, and Green New Deal seem to be models that would allow for reduced impacts on greenhouse gas emissions while also mitigating negative social impacts and achieving a just transition (D’Alessandro et al., 2020; O’Neill, 2020). The use of the term prosperity in the framework refers to the rights of human beings to have enough resources to fulfil their basic needs and enjoy life. (as cited in Brousselle et al., 2022, p. 340)

We need to think about an economic system that allows for prosperity, defined as sufficiency and well-being, without pushing us beyond planetary boundaries (O’Neill et al., 2018).

Transitioning away from carbon-intensive economic activities will involve the redeployment of resources in our economic sectors and support for workers as they convert to different, more sustainable activities. Furthermore, encouraging the local economy allows a greater control over production conditions. Developing a solidary local economy to support our ecological transition is a win-win approach.

4. Governance.

Governance refers to the ways and means employed by society to make collective decisions, choose collective goals, and take action to achieve those goals. (Chaffin et al. 2016, p.401)

With regards to climate change and the need for effective governance models to respond to the climate crisis, the 2023 IPCC report states:

C.1.2 Government actions at subnational, national and international levels, with civil society and the private sector, play a crucial role in enabling and accelerating shifts in development pathways towards sustainability and climate resilient development (very high confidence). Climate resilient development is enabled when governments, civil society and the private sector make inclusive development choices that prioritize risk reduction, equity and justice, and when decision-making processes, finance and actions are integrated across governance levels, sectors, and timeframes (very high confidence). Enabling conditions are differentiated by national, regional and local circumstances and geographies, according to capabilities, and include: political commitment and follow-through, coordinated policies, social and international cooperation, ecosystem stewardship, inclusive governance, knowledge diversity, technological innovation, monitoring and evaluation, and improved access to adequate financial resources, especially for vulnerable regions, sectors and communities (high confidence). (IPCC, 2023, p. 24)

These findings apply to planetary health. When exploring what governance for planetary health means for a project, evaluators should also consider Indigenous self-determination rights on lands where Indigenous Peoples live.

Governance in Canada, as in many countries, is a multi-level function. Working respectfully with local Indigenous peoples and communities, expanding shared decision-making with these communities and institutions, and giving space to a diversity of cultural practices is part of building more equitable and more resilient communities.

5. Power relations. Power is a dimension that encompasses many aspects of projects.

Closely related to governance, power relations are an important determinant of whether/how resources for policies and programs are allocated and benefits and costs are distributed, how programs are designed and whether/how they are implemented. It is important to consider who holds power due to systemic inequity/bias, how power can be redistributed to people and communities who are marginalized by dominant systems, and what and how opportunities and partnerships for shared capital, resources, land, governance are created. (Brousselle et al., 2022, p. 342)

Transformational projects that aim for changes in how we live and work to reduce our collective footprint may also lead to strong political opposition from some interest groups, particularly those that are invested in activities that are carbon emissions sensitive. Anticipating resistance as interventions are designed and especially as they are implemented can help address power-related challenges; some approaches include finding allies, sharing decision-making, building coalitions, and using governance institutions effectively.

The framework has inspired different approaches and tools (Brousselle & Buregeya, 2018; Brousselle et al., 2024b; Brousselle et al., 2022). In particular, the Rapid Assessment Tool for Planetary Health (Brousselle et al., 2024b) was created to assess projects, programs, and policies at the local government level in Canada. The tool and its use and contribution will be presented in Chapter 3.

A Transformative Approach

The field of evaluation offers many avenues to make positive change, and it is up to evaluators both individually and collectively to design their approaches to create as much positive change as possible. As Patton says, this is where one can put their skin in the game (Patton, 2020). In particular, the elements below can be kept in mind for shaping your evaluation project.

Positive transformation can be enhanced by:

• Working at the nexus of natural and human systems, considering the broader context in our evaluations, locally and globally (Patton, 2020; Rowe, 2021; Uitto, 2021). Considering the evaluand into its own context matters (Uitto, 2021), while also considering interactions and dynamic relationships, which highlight the importance of system thinking (Magro et al., 2021; Magro & van den Berg, 2019; Patton, 2021b).

• Redefining accountability (Rodriguez-Bilella et al., 2021, p. 164).

Evaluators should assume ‘some moral fiduciary responsibility’, not towards commissioners, but by defending the interests of those less able to do so for themselves, as stated by House (House, 2020, p. 32), yet also to be a voice for nature, elements and living species. (as cited in Brousselle et al., 2024a, p. 187)

Evaluators should be accountable towards other living species, nature, youth, and towards future generations (Brousselle et al., 2024a). This involves adopting a futurist/prospective reading of the challenges instead of focusing on the past only, as most evaluations do (Patton, 2021a). It is also an invitation to revisit who should be invited to participate in the evaluation project (Montrosse-Moorhead et al., 2019).

• Addressing the root causes of discrimination and giving voice to marginalized, colonized and oppressed people and communities (Mertens, 2023, 2024). Consider human rights violations, racism, discrimination and oppression based on sex and gender, color, religion, culture and origin, age, etc.

A transformative lens acknowledges that there are multiple perspectives, each expressing a different reality, where some voices are heard, and some are not. It is this inequality of whose voice matters that underpins our discussion about transformative evaluation. (Rodriguez-Bilella et al., 2021, p. 162)

• Revisiting the role of the evaluator.

The role of the transformative evaluator is facilitative rather than directive – being in charge of the evaluation process and making judgements as an expert evaluator. (Rodriguez-Bilella et al., 2021, p. 163)

This is particularly true when working on Indigenous lands and with Indigenous people (see Exhibit 1). Evaluators should support self-determination and encourage Indigenous-led projects. That’s the only way to be as responsive as possible to local community cultures and principles. Where can we start?

A transformative evaluation design begins with a stage of building relationships as a first step to understand who needs to be included and how they can be included in ways that are culturally respectful (Mertens, 2018; Mertens & Wilson, 2019). (as cited in Mertens & Catsambas, 2021, p. 169)

Advocating for a more inclusive approach to evaluation—socially, by including a diversity of groups, and environmentally, by systematically integrating consideration of the environmental impacts of human activity—requires the evaluator to go beyond the traditional role of “knowledge creator” and to embrace the role of “social change agent” (Mertens, 2024).

Conclusion

The Planetary Health Framework is a kind of map that can be used for different purposes and adapted to different contexts. It can be used for the purpose of engaging in dialogue with different kinds of actors. Furthermore, acknowledging the existence of different cultures and values, the Planetary Health Framework can be adapted to make it meaningful to local communities. Even if this model aims at speaking to a macro-level global community, the various dimensions of the framework may need to be adapted and negotiated to make sense to different peoples with different cultures (Brousselle et al., 2022).

Successful evaluations are processes and products that are leading to felt ownership by people involved and recognized as credible, legitimate. This will be achieved if and only if many different local actors are being part of modeling the evaluation in a way meaningful to them. (Brousselle et al., 2022, p. 335)

Different uses of this framework and derivative tools in the evaluative context will be presented in the next chapters.