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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Suggested Citation:"2 Conceptual Issues." Institute of Medicine. 2014. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary. Washington, DC: The National Academies Press. doi: 10.17226/18552.
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Below is the uncorrected machine-read text of this chapter, intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text of each book. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

2 Conceptual Issues This chapter provides a summary of presentations outlining the conceptual issues of coastal waters and ocean ecosystem services and human health. The first presentation gives an overview of the concept of ecosystem services and ways to use this in natural resource management decision making and other practices of corporations and governments. The second presentation describes broad efforts to protect ecosystem services, using the Puget Sound and Gulf of Mexico as examples, and the need to develop indicators to assess the health of coastal and ocean environments and the services they provide to humans. The presentations are followed by a summary of the discussion that ensued. UNDERSTANDING ECOSYSTEM SERVICES Lydia Olander, Ph.D. Director, Ecosystem Services Program, Nicholas Institute, Duke University Lydia Olander began the presentation by defining the concept of ecosystem services as the benefits people obtain from ecosystems.1 The term ecosystem services is not an entirely new concept, she said. The notion of ecosystem services was included in the thinking of Gifford Pinchot, the first chief of the Forest Service, in the 1900s when he discussed conservation as the wise use of the earth and its resources for the lasting good of men. In contrast to the past, today’s concept of 1 “An ecosystem is a dynamic complex of plant, animal, and microorganism communities and the nonliving environment interacting as a functional unit.” Humans are an integral part of ecosystems (MEA, 2005). 5

6 ECOSYSTEM SERVICES AND HUMAN HEALTH ecosystem services goes beyond the typical services of timber production, grazing lands, crop production, and fish production to include the categor- ization, quantification, and valuation of a broader range of services. Additionally, she noted, the field is grappling with how to operationalize the concept for use in resource management decision making, and how to incorporate it into standard practices. The concept is moving beyond the realm of ecosystem scientists and economists to the decisions and actions of conservation organizations, governments, and corporations. According to Olander, one of the key events that changed thinking in the scientific community in the early 1990s was Biosphere 2, a research effort to recreate the biosphere and have a self-sustaining environment. Biosphere 2’s initial experiments failed to sustain human life in a closed and independent biosphere system as hoped. The biosphere experienced a broad range of negative impacts: oxygen levels plummeted, carbon dioxide levels skyrocketed, nitrous oxide rose to levels that impair brain function, and water purification failed. Further, of 25 vertebrate species studied, 19 died. Pollinators became extinct, and ants, cockroaches, and katydids became rampant. These results highlighted the fact that ecosystem services, the underpinning of human well-being, are not well understood and are difficult to recreate. Millennium Ecosystem Assessment and Ecosystem Changes Olander proceeded to describe the Millennium Ecosystem Assessment (MEA) (2005), an extensive effort to provide an integrated assessment of the consequences of ecosystem change for human well-being. The MEA identifies four categories of ecosystem services that lead to health and well-being: (1) provisioning, (2) regulating, (3) cultural, and (4) supporting services. Provisioning services are the typical goods produced or provided by ecosystems. These include foods such as crops, livestock, fish from capture fisheries and aquaculture, and wild foods. Fibers are another product category and typically include timber, cotton, hemp, silk, and wood fuel. In addition, genetic resources, freshwater provisions, biochemicals, natural medicines, and pharmaceuticals obtained from the environment are ecosystem provisions. These provisions tend to have a market value. Regulation and sustainability of ecosystem processes is another type of service and an important contributor to human health. These processes include climate regulation, air quality regulation, erosion regulation,

CONCEPTUAL ISSUES 7 water purification, disease and pest regulation, pollination, and natural hazard regulation such as flood protection. The category of cultural services is more abstract and includes non- material benefits obtained from ecosystems. Services such as spiritual and religious values, knowledge systems, education values, inspiration, aesthetic values, social relations, sense of place and recreation, ecotourism, and others are among those included in this category. Olander described an example of another cultural service that is not typically considered— darkness. In Puerto Rico, darkness is a very important part of the ecosystem and is critical to ecotourism and recreation. Bioluminescent bays, for example, draw many ecotourists but light pollution is a problem. The category of supporting services includes those services necessary for the production of all other ecosystem services such as primary production, production of oxygen or photosynthesis, and soil formation. Olander highlighted that biodiversity is underpinning all services. The MEA framework has been used in two ways, Olander said. The first way is in tracking the status of the environment as it relates to people or assessing trends in ecosystem services. The second way is in improving the management of natural resources. For example, the MEA framework was used to understand increased flooding across the globe. The MEA can help illustrate how flooding affects people; the impact can be seen in deaths, use of health care services, disease vectors, and many others. But it is useful in identifying and understanding the causes or drivers of flooding. Two reasons were identified as contributing to the human impact of flooding: (1) people increasingly occupy regions exposed to extreme events and (2) significant losses of coastal habitat reduces flood protection and increases the risk of floods. The latter describes the loss of ecosystem services. Loss of coastal habitat can be tracked as an indicator of increasing flood risk. In addition, by focusing on this driver, linkages to other services that might be lost or gained can be examined to understand trade-offs and synergies. The loss of coastal habitat can reduce shellfish and fish nurseries, which can result in fewer fish, fewer fish-related jobs, higher costs of fish, and fewer fresh fish available for consumption (the latter could have an impact on health). Further, the loss of coastal habitat can lead to a reduction in nitrogen transformation and storage which can increase the impact of nitrogen loading and increase the risk of eutrophication (high nutrient levels) leading to coastal dead zones and fish loss. But there can also be positive impacts such as better wave energy because sea grasses are not in the way

8 ECOSYSTEM M SERVICES AND D HUMAN HEAL LTH (e.g., to generate energy from m surface wavves). Both thhe negative aand positiv ve impacts mu ust be considerred. Th he primary fin nding of the MEA M is that 60 percent (115 out of 24) of the ecoosystem services examined d are being deggraded or useed unsustainabbly (MEA A, 2005). Eco osystem serv vices that haave been deggraded incluude capture fisheries, water w supply, waste w treatmeent and detoxxification, watter purificcation, naturall hazard proteection, regulattion of air quaality, regulation of regiional and local climate, reegulation of eerosion, spirittual fulfillmennt, and aeesthetic enjoymment. The usee of two ecosyystem servicess in particular— r— capture fisheries annd freshwater— —are now weell beyond levvels that can be sustainned at currentt demands, mu uch less futurre levels, Olannder said. An n aspect of th he MEA that needs n to be hiighlighted, Olander noted,, is the efffort to build linkages l betw ween the servvices and hum man well-beinng. As can n be seen in Figure F 2-1, ecoosystem servicces are linkedd to constituennts of well-being—seccurity, basic material forr a good lifee, health, good social relations, an nd freedom of o choice andd actions. Thhe arrow coloors identiffy the potential for mediaation by sociioeconomic ffactors, and tthe arrow widths iden ntify the intensity of linnkages betw ween ecosysteem servicees and human n well-being. FIGURRE 2-1 Linkag ges between ecoosystem servicces and human well-being. SOURC CE: MEA, 2005. Reprinted wiith permission ffrom the Millennnium Ecosysteem Assessm ment.

CONCEPTUAL ISSUES 9 Ecosystem Services Framework to Improve Natural Resource Management Decisions Olander continued with a discussion of the use of an ecosystems services framework to improve the management of natural resources. It is also important to understand how changes in resource management decisions affect the production of ecosystem services, she said. This relationship between management and actions and ecosystem services outcomes is called a production function by the scientific community. To further explain a production function, consider that X percent of habitat loss results in a Y percent decrease in coastal flood protection provided by the ecosystem, which results in a Z percent increase in an impact (for example, mortality). The question then is, how much reduction in coastal habitat, of which types and where, result in how much of an increase in flooding and of what type and where? Olander noted that there are trade-offs and synergies in the management of natural resources. A small change in coastal habitat may have a large impact on fisheries but only a small impact on flood protection. So it is important to understand the relationships across services. Further, if decisions need to be made, the trade-offs need to be evaluated. For example, people want to live in coastal zones for recreational, spiritual, and economic opportunities. But housing development and infrastructure can damage the services the coastal systems produce. Ideally ecosystem services approaches can make the trade-offs inherent in management choices (across services that matter to different people) explicit. Olander described a compelling example from the MEA related to mangroves. Natural mangroves provide many services, including nursery and adult fishery habitat, fuel wood and timber, and carbon sequestration; they detoxify pollutants and provide protection from erosion and natural disasters. However, the promotion of shrimp farming in these areas has raised concerns about the potential ecological and economic impact of clearing mangroves for shrimp farming. Researchers studying the value of mangrove conservation showed that while financial cost-benefit analysis demonstrates that it is financially worthwhile for an individual to convert mangrove forests into commercial shrimp farms, once other factors are taken into account, such as the water pollution from shrimp ponds and restoring the mangrove after the shrimp pond is abandoned, shrimp farming is no longer as economically beneficial to society (Sathirathai and Barbier, 2001). The study demonstrated that consideration of other values and changes in services may lead to different decisions.

10 ECOSYSTEM SERVICES AND HUMAN HEALTH Olander noted that there are a number of ways to approach valuation and comparing alternatives. Some are qualitative in nature, for example an ecosystem services management effects matrix (see Figure 2-2). The matrix allows decision makers to consider a range of management options and to assess their impact on ecosystem services against a gradient from strong positive to strong negative impact. Olander also described another framework commonly used by researchers, published by de Groot and colleagues (2010), which is useful for linking ecosystem services to human well-being in a way that facilitates quantification of impact. As shown in Figure 2-3, ecosystem services are generated by ecosystem functions. Ecosystem functions are intermediate between ecosystem processes and services and are generally described as the capacity of the ecosystem to provide goods and services that can benefit people. The actual use of the service provides benefits, and those benefits can be valued. Olander noted that value can be assessed based on stakeholder preferences or economic costs and benefits; however, economic value may be difficult to impossible to assess for some services. For example, market values are easier to assess for food services which are valued by the market than for cultural services such spiritual and religious benefits. A range of qualitative to quantitative ecosystem tools are available to value services. These tools continue to be evaluated and new tools are being developed. Below are some examples that show the range of different types of tools available: • Ecosystem Services Review is a structured methodology for corporate managers to proactively develop strategies for managing risks and opportunities arising from their company’s dependence and impact on ecosystems (Hanson et al., 2012). • Integrated Valuation of Ecosystem Services and Tradeoff (InVEST)2 models are based on production functions that define how an ecosystem’s structure and function affect the flows and values of ecosystems (Tallis et al., 2010). • Social Values for Ecosystem Services (SolVES)33is a geographic information system (GIS) application for assessing, mapping, and 2 InVEST is available at: http://www.naturalcapitalproject.org/download.html (accessed August 25, 2013). 3 SolVES is available at: http://solves.cr.usgs.gov (accessed August 25, 2013).

FIGURE F 2-2 Ecosyytem services manaagement effects maatrix applied to a marsh m scenario. 11 SOURCE: S Personal communication, Peete Caligiuri, The Nature N Conservancyy, September 11, 20013. Reprinted withh permission.

12 ECOSYSTEM M SERVICES AND D HUMAN HEAL LTH FIGUR RE 2-3 Framew work for linkin ng ecosystems aand biodiversityy to human weell- being. NOTE: econ = econo omic, WTP = willingness w to ppay. SOURC CE: Adapted from f de Groot et al., 2010. R Reprinted with permission froom Elsevieer. quantifying g the social vaalues of ecosyystem servicees (Sherrouse et al., 2011). • Artificial Intelligence I f Ecosysteem Services (ARIES)47is a for Web-based d technology y to assist rapid ecossystem serviice assessment and valuation n (Bagstad ett al., 2011). In summary, Olander O high hlighted that the conceptt of ecosysteem servicees is a logicall thought proccess which caan be used inn quantitative or qualitaative assessmment of impliications and trade-offs. E Efforts are noow focuseed on figuring g out how to implement tthese methods more broaddly and to o develop deccision-making g tools, whichh continues too be a compllex challennge. 4 ARIE ES is available at: http://www w.ariesonline.orrg (accessed Auugust 25, 20133).

CONCEEPTUAL ISSUES 13 INTEGRATIION OF ENV VIRONMENNTAL HEALLTH AND MA ARINE ECO OSYSTEM S SERVICES Tracyy Collier, Ph.D D. Science Director,, Puget Soundd Partnershipp Trracy Collier began b by idenntifying the PPuget Sound P Partnership ass a good example e of th he integrationn of environm mental health and ecosysteem servicees. However, he added th hat a way to evaluate its eeffectiveness is needed y to measure any increase in the servicces produced bby d, particularly Puget Sound, as its protection an nd restorationn have provedd very costly. Co gure from thee World Healtth Organization ollier then refferenced a fig (WHO O) (see Figurre 2-4) which h illustrates the intersecttion of climaate changee and human n health, poin nting out that though the m marine system ms and cooastal systemms were not explicitly callled out in thhe figure, thhey would be encompaassed in the biodiversity b l oss and ecossystem function and th he decline in ecosystem seervices in genneral. Collierr explained thhat although the work k done to prrotect coastall ecosystems is focused on provid ding services tot the humanss that use theem, all aspectts of the coasttal ecosysstem should beb considered. FIGUR RE 2-4 Linkag ges between climate change aand human heallth. SOURC CE: WHO, 20133. Reprinted witth permission off the World Heaalth Organizatioon.

14 ECOSYSTEM SERVICES AND HUMAN HEALTH Much work is being done to identify the stressors that affect the coastal ecosystems, such as nutrients resulting from residential, agricultural, and urban runoff, and consequent harmful algal blooms, particularly cyanobacteria blooms. These stressors have greatly impacted delivery of ecosystem services such as drinking water and recreational access. Though there is a lot of information about stressors and how they affect our ecosystems, Collier noted that there was not very much known about how altered ecosystems actually affect humans. Puget Sound Partnership Christine Gregoire, governor of Washington state, created the new state agency, the Puget Sound Partnership, in 2007, to work toward a “swimmable, fishable, diggable Puget Sound by 2020.” Collier noted that this defined the political view of ecosystem services for the Partnership; however, in order to put together the policies and write the legislation to create a new state agency, more specific detail was needed. It also became clear that when identifying the types of ecosystem services to be achieved or protected, some kind of translation was necessary to help policy makers understand these terms. After much discussion, six primary goals were identified in order to restore and protect ecosystem services provided by Puget Sound: • species and food webs (e.g., biological biomass and biodiversity), • habitats and processes (e.g., eel grass as a habitat that contributes to shoreline protection),58 • water quality issues (e.g., toxic contaminants, pathogens, and nutrients in the water), • water quantity (the annual flows are highly variable, with serious consequences), • human health, and • human well-being. Collier said it was significant that this list explicitly calls out human health and human well-being as specific and separate goals for the Partnership’s efforts to restore Puget Sound. However, it is important to find a way to measure improvements in the services and to establish their economic, social, and cultural values. 5 Eel grass softens the impact of waves and currents, preventing coastal erosion and providing a calm space where organic matter and sediments are deposited.

CONCEPTUAL ISSUES 15 Collier emphasized that salmon is an extremely important part of the Puget Sound ecosystem. There are five species of Pacific salmon— chinook, chum, coho, pink, and sockeye. Along with steelhead and bull trout, many populations of all of these anadromous fish species (except pink salmon) are listed under the Endangered Species Act. In addition, there are very substantial legal requirements to maintain salmon populations as part of the tribal treaty rights, which Collier mentioned had been in the news recently, when regional tribes grew dissatisfied with what they perceived as a lack of progress in this area. Unfortunately, there is a great deal of habitat loss due to increasing urbanization, which impacts the salmon life cycle, threatening the juvenile salmon on their path downstream and in nearshore habitats. Puget Sound is unique among North American estuaries in that it was carved by glacial action and is a deep fjord with shallow sills. This reduces water circulation at several points so that it tends to be isolated hydrologically. Because it is so deep and marine, many species, including some salmon, spend their entire lives within the estuary, which is not the case in most estuaries, where animals come and go at different stages of their lives. It is isolated not only hydrologically, but also, to an extent, biologically. What goes into the Sound, such as toxics, tends not to flush out as happens in other estuaries. A study comparing polychlorinated biphenyls (PCBs) in whole-body chinook salmon along the West Coast found much higher levels in Puget Sound specimens than those to the north or south. These high levels of contaminants have led to fish consumption advisories, limiting Puget Sound salmon consumption. In fact, said Collier, this is a good example of an intersection between the ecosystem services and environmental health, affecting community issues important to policy makers. Deepwater Horizon Oil Spill and Seafood Safety Collier next spoke about the Deepwater Horizon explosion of spring and summer 2010. After acknowledging the tragic loss of human life, the fire, and the enormous release of oil into U.S. waters, he turned to the issue of seafood safety. About one-third of the federal fishing waters in the Gulf of Mexico—a major portion of the U.S. fisheries supply, second only to Alaska and the Bering Sea—had to be shut down for several months as a result of the disaster. It takes a long time after an oil spill has closed an area to determine when it can be reopened. Extensive chemical and sensory testing is required, and many hundreds of sites or fish must

16 ECOSYSTEM SERVICES AND HUMAN HEALTH be sampled to establish the safety of the seafood supply. The testing after the Deepwater Horizon oil spill was both lengthy and expensive. Aromatic hydrocarbons were presumed to be the most toxic components of oil spills, and fish sampled after the waters had been re- opened were expected to show low or no oil exposure, which federal sampling and analysis confirmed. Indeed, in some cases, levels of contamination were 100 to 1,000 times lower than the government-set levels at which human health is threatened (FDA, 2013). However, Collier noted that, despite these test results, it was very difficult to convince people of the safety of fish taken from the Gulf of Mexico. Another important aspect of the contamination levels set for safe human consumption of the fish, added Collier, is that fish start to die from the oil exposure at levels far below those set as safe for human consumption. This means that though the scientists knew that there was no chance the fish tested could have been contaminated to the point that eating them would have been a danger to human health—because fish cannot live at that the level of contamination, dying at levels far below that—still, the analyses had to be done, to show people the fish were safe. Also, there is a point at which fish will start to smell of oil and, even though these fish would still be considered safe for consumption, they obviously should not be allowed into the market. Collier pointed out that this discrepancy creates a big disconnect between the work of scientists and actual risk to human safety. The point to consider here, Collier noted, is that most agree that marine fish consumption confers certain health benefits to humans—for example, better cardiovascular health, better development of fetal brains, and perhaps even longer life. So, when a fishery is shut down for an oil spill or for levels of PCBs (as in the Puget Sound fish example above), a large part of what would be an otherwise beneficial food source is being removed from people’s diets. In other words, while shutting down fisheries or putting up fish consumption advisories is done to protect human health, there may well be adverse implications for human health as a consequence if the food source cannot be replaced, or is replaced with less healthy food. Collier mentioned that a study is being done on fish consumption in the Gulf of Mexico following the Deepwater Horizon explosion. He expressed a hope that sufficient good data would be collected to show if there was in fact a reduction in rates of fish consumption below normal consumption rates, and if there were a reduction, what connection could be made to any observable health outcomes.

CONCEPTUAL ISSUES 17 Public Perceptions About Seafood Safety Collier also discussed the difficulty in balancing public perceptions and communicating about seafood safety. The issue of public fear of fish contamination versus the health benefits of eating fish is a problem in Puget Sound, said Collier. Many people are very concerned about eating salmon (even though the PCB levels may not be health threatening), while on the other hand, there is a population of non-English speakers who need to be warned not to eat bottom fish from severely contaminated areas. Collier stressed that while the Puget Sound Partnership is cleaning up stormwater and reducing toxic and nutrient inputs—and thus improving the health of the biota, improving the safety of swimming beaches, and reducing harmful algal blooms—they should also be demonstrably improving human health by making access to safe seafood more reliable. Seafood should be regarded by the community as safe and beneficial for both recreational and commercial purposes. Climate Change Impact on Puget Sound Ecosystem Services Collier then moved to a consideration of climate change and its impact on ecosystem services as it relates to the loss and modification of salmon habitat. Millions of dollars are currently spent each year in an attempt to get salmon to return in greater numbers to the Sound. Climate change is important in that it affects river flows: projections for 2050 river flows show 30 to 50 percent less water in the streams in Puget Sound during the summer months, which is when many juvenile salmon are rearing in freshwater or making their downstream journey. These reduced water flows during the summer result from reduced snowpacks, in essence changing stream hydrology from snow-driven systems to rain-driven systems. Collier stressed that, in order to maintain ecosystem services in these regional recovery programs, planning for climate change is a necessity. Indicators to Assess the Health of Coastal and Ocean Environments The Global Ocean Health Index69is a comprehensive measure that scores ocean health. It provides an assessment of the health and benefits of the global ocean, looking at the types of ecosystem services that are 6 The Global Ocean Health Index is available at: http://www.oceanhealthindex.org (accessed September 9, 2013).

18 ECOSYSTEM SERVICES AND HUMAN HEALTH provided by the coastal oceans (such as food provision, recreation, and so forth). Collier noted that although assigning scores to the various areas is problematic, it is nevertheless a useful exercise, and the data gathered are important. In cooperation with some components of the Puget Sound Partnership, the scientists who created the index will be using their system to assess certain aspects of ecosystem services provided by Puget Sound. Collier pointed out that this system is driven not so much by the state of the ecosystem—as, for instance, biodiversity—but rather is based on what services are provided to humans and is very focused on jobs and other human benefits. In terms of an ocean health index, Collier noted that the Aral Sea would receive an extremely low score (though, as a freshwater lake, it was not actually included in the index). It was once the fourth largest freshwater lake in the world, but with the diversion of water for farming it suffered a devastating loss of ecosystem services and subsequent great harm to human health and prosperity. Predictions of the oncoming environmental disaster were ignored by the Soviets—the Aral Sea is an example of what can go terribly wrong in ocean management. Nobody wishes anything similar to happen in the United States. In order to avert such disaster, a first step is to select good environmental indicators to measure the health of the environment. The Puget Sound Partnership has developed a dashboard of 21 vital signs which is used to report the health of Puget Sound and the effectiveness of its actions (see Figure 2-5). Collier noted that the indicators for the section called “Healthy Human Population” included on-site sewage systems and whether they were properly maintained, and whether swimming beaches and shellfish beds are open or closed (such closures are usually due to fecal contami- nation). He felt that these indicators were not the best ways of assessing human health. Also, the Puget Sound Partnership has not been successful in building robust indices that could measure quality of life or sound behavior (two of the indicators in the “Human Quality of Life” section) and has not been able to find good data for recreational fishing permits and commercial fishing harvests (the two other indicators in this section). Collier admitted that the Partnership could improve the human health and human well-being aspects of this dashboard system. However, he felt that they were progressing in developing indicators that link ecosystem services to a healthy economy. Work still needs to be done in valuing the cultural and the social aspects, but they are making good progress on economic indicators.

CONCEEPTUAL ISSUES 19 FIGUR RE 2-5 Puget Sound S vital sig gns wheel. SOURC nd Partnership, 2012. Vital siigns wheel cennter photo creddit: CE: Puget Soun Flickr/D Diana K. Co ollier concludded his presen ntation by strressing that bbetter indicatoors to link k coastal and d marine conddition to eco system servicces and hum man health and well-beeing are need ded, and askked for any suggestions to furtherr this goal. DIS SCUSSION Ly ynn Goldman n began the diiscussion by pposing the quuestion, what do we neeed to know to o quantify the impacts of eccosystem servvices on healtth, especially economically? Olandeer responded that on the hhealth side theere are very good exam mples of econ nomic valuattion. She offeered air qualiity A Act as onne example where the link protection through the Clean Air

20 ECOSYSTEM SERVICES AND HUMAN HEALTH between ecosystem services protection and health has been assessed and the economic valuation quantified. She noted that it is more difficult to develop direct health outcomes and economic valuations for ecosystem services that are less concrete such as cultural, spiritual, and mental health but that efforts are being made in developing economic valuations for those services. Frank Loy commented that quantification is vital because it helps persuade individuals of the importance of the efforts made to protect ecosystem services. He cautioned, however, that quantification of services such as cultural, peaceful, and spiritual must be credible or one could undermine the ability to get public support for those efforts. Olander responded that there are risks with quantifying many things because of uncertainty in a number of parameters. She noted that there is a move away from valuation to evaluation—where stakeholder values are considered rather than economic valuation. Jack Spengler also addressed the issue of values and how solitude, reflection, and other aspects of how nature is experienced might be quantified. He emphasized that we should not shy away from developing outcomes that are measurable. He mentioned there is work ongoing in Japan and Finland to develop measures for the value of forests, including values that are more difficult to measure. Researchers in these countries have been looking at the restorative functions or therapeutic services provided by forests and at measures such as a reduction in cortisol levels or an increase in serotonin levels. He suggested that the field is a few years away from having the necessary outcomes, but progress is being made in this area. Christopher Portier commented that the ecosystem services impact on human health is much more difficult to measure, quantify, and value because health outcomes are often the result of a number of factors. For example, chronic diseases are often the culmination of a number of small impacts; it is not a one-exposure and one-disease equation. Olander agreed that this is a problem; current economic valuation is conducted only on those services for which a value can be quantified so most valuations are incomplete and they tend to focus on those with the largest quantifiable benefit.

CONCEPTUAL ISSUES 21 REFERENCES Bagstad, K. J., F. Villa, G. W. Johnson, and B. Voigt. 2011. ARIES—Artificial Intelligence for Ecosystem Services: A guide to models and data, version 1.0. The Aries Consortium. Available at: http://unstats.un.org/unsd/env accounting/seeaRev/meeting2013/EG13-BG-7.pdf (accessed September 13, 2013). de Groot, R. S., R. Alkemade, L. Braat, L. Hein, and L. Willemen. 2010. Challenges in integrating the concept of ecosystem services and values in landscape planning, management, and decision making. Ecological Complexity 7(3):260–272. FDA (U.S. Food and Drug Administration). 2013. Deepwater Horizon oil spill: Questions and answers. Available at: http://www.fda.gov/Food/Recalls OutbreaksEmergencies/Emergencies/ucm221563.htm (accessed September 9, 2013). Hanson, C., J. Ranganathan, C. Iceland, and J. Finisdore. 2012. The corporate ecosystem services review: Guidelines for identifying business risks and opportunities arising from ecosystem change. Version 2.0. Washington, DC: World Resources Institute. MEA (Millennium Ecosystem Assessment). 2005. Ecosystems and human well- being: Synthesis. Washington, DC: Island Press. Puget Sound Partnership. 2012. Puget Sound vital signs. Available at: http://www.psp.wa.gov/vitalsigns (accessed September 9, 2013). Sathirathai, S., and E. B. Barbier. 2001. Valuing mangrove conservation in southern Thailand. Contemporary Economic Policy 19(2):109–122. Sherrouse, B. C., J. M. Clement, and D. J. Semmens. 2011. A GIS application for assessing, mapping, and quantifying the social values of ecosystem services. Applied Geography 31(2):748–760. Tallis, H. T., T. Ricketts, E. Nelson, D. Ennaanay, S. Wolny, N. Olwero, K. Vigerstol, D. Pennington, G. Mendoza, J. Aukema, J. Foster, J. Forrest, D. Cameron, E. Lonsdorf, and C. Kennedy. 2010. InVEST 1.004 beta user’s guide. Stanford, CA: The Natural Capital Project. WHO (World Health Organization). 2013. Global environmental change. Available at: http://www.who.int/globalchange/climate/en (accessed September 9, 2013).

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Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health discusses the connection of ecosystem services and human health. This report looks at the state of the science of the role of oceans in ensuring human health and identifies gaps and opportunities for future research. The report summarizes a workshop convened by the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine. Participants discussed coastal waters and ocean ecosystem services in the United States in an effort to understand impacts on human health. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health focuses on key linkages by discussing the ecosystem services provided by coastal waterways and oceans that are essential for human health and well-being; examining the major stressors that affect the ability of coastal waterways and ocean systems to provide essential services; and considering key factors that can enhance the resiliency of these systems.

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