Environmental sustainability and human well-being indicators from the ecosystem perspective in the Middle Paraíba Region, Rio de Janeiro State, Brazil Indicadores de sustentabilidade ambiental e de bem-estar em perspectiva ecossistêmica na Região do Médio Paraíba, Rio de Janeiro, Brasil

Population urbanization is a global trend, and socioeconomic activities in urban areas cause changes that affect the environment and human well-being beyond the specific territories, thus connecting urban to non-urban areas and creating city-regions. This article’s objective, from an ecosystem perspective, is to gather a set of information on municipalities (counties) belonging to the Middle Paraíba River Valley Region in the State of Rio de Janeiro, Brazil, in order to identify conditions and trends in environmental sustainability and well-being. The conceptual framework adopted here was that of the Millennium Ecosystem Assessment, identifying direct and indirect driving forces that affect human wellbeing, with health as a component of the latter. We used a set of available public-domain data and information sources on the municipalities, grouped by socioeconomic and environmental conditions and the soundness of institutional structural well-being for sustainability. The indicators used here point to a process of degradation in the ecosystem services that has still not been prevented by the prevailing institutional structure, thus increasing constraints on well-being and the spread of socio-environmental impacts in the middle and long terms. Environmental Indicators; Health Indicators; Sustainable Development Indicators Introduction The changes that occurred in land ecosystems beginning with the Industrial Revolution are part of the economic growth logic that intensified in the latter half of the 20th century, consolidating the transition to an industrial and urbanized society. The global urban population grew from 200 million in 1900 to 2.9 billion in 2000 (nearly 50% of the world population), and in regions like North America, Europe, and Latin America and the Caribbean the urban population is already more than 70% of the total 1,2. This process involves human migratory flows to urban areas in search of work and better living conditions. These areas, vital to industrialization and economic growth, spawned the availability of cheap labor, scale economies, and shared use of resources, infrastructure, and opportunities for production and commercialization. Meanwhile, they produced huge impacts on local, regional, and global ecosystem services, both through the growing demand for natural resources and energy and the capacity to generate waste and pollution. Activities in urban areas lead to environmental damage that extends beyond their territories, connecting them to non-urban areas, thereby constituting city-regions 3. As noted by Pickett et al. 4, urban sprawl not only converts the areas traditionally studied by ecological approaches into systems that require a clear appreciation of ARTIGO ARTICLE Freitas CM et al. S514 Cad. Saúde Pública, Rio de Janeiro, 23 Sup 4:S513-S528, 2007 the role of humans; spreading urbanization itself is also among the greatest global impacts caused by humans. Given this situation, one of the challenges for Public Health is to build systems of indicators that allow analyses of current conditions and future trends, which point to the progressive degradation of ecosystems services that support life, health, and human well-being. The indicators simplify the complexity of a set of available data and information and more clearly and directly expose to managers and the general public the problems related to sustainability, as well as the direct and indirect driving forces at their origin, thus contributing to the formulation, implementation, and monitoring of planning and management strategies 5. The objective of this article, from an ecosystem perspective, is to gather a set of public-access information on the municipalities (counties) belonging to the Middle Paraíba Region (hereinafter MPR), in order to identify conditions and trends in environmental sustainability and well-being. The MPR consists of twelve municipalities in an area that has undergone profound environmental changes since the 18th century, which increased in the 19th century with the Coffee Cycle, and further intensified in the 1930s with the beginning of a growing industrialization and urbanization process. Environmental sustainability and health indicators from an ecosystem perspective As noted by Bellen 6, there are difficulties in precisely defining the conditions for the sustainability of development without considering the existing difficulties for capturing sustainability’s dynamics in a detailed or precise way. The current article assumes that sustainability should be based on the ethical principle of equity in relation to present and future generations, incorporating aspects of economic sustainability (employment, income, inequalities) and environmental sustainability (ecosystem services) together with human well-being 6,7. Based on this principle, the indicators were grouped according to the conceptual framework proposed in the Millennium Ecosystem Assessment (MEA) 2, seeking to establish a relationship between ecosystem services and human well-being, based on a positive concept of health. This structure allows one to avoid treating “healthcare” and “health” as synonyms or encouraging the idea that medical care for disease is equal to health, reduced merely to the absence of diseases. From this perspective, the collected information integrated the economic and environmental dimensions that affect human well-being and health, incorporating aspects like employment and income distribution, living conditions, the state and sustainability of the environment, socio-environmental conflicts, and institutional conflict-resolution structures with social participation, as well as others that affect collective and individual well-being 8,9. With regard to human well-being, the conceptual framework of the MEA 2 includes: • Basic materials for a good life, involving the possibility of access to resources to sustain decent living. • Health, involving the capacity to remain adequately fed and free of avoidable diseases and to live in a healthy environment. • Security, or the possibility to live in a secure environment and to reduce the vulnerability to ecological shocks and stresses. • Good social relations, involving the opportunity to observe, study, and learn about the ecosystems and express aesthetic, cultural, and spiritual values and mutual respect and social cohesion. • Freedom of choice and action: opportunity for individuals to achieve what is valuable to them. This component is a pre-condition for reaching others and is also affected by them. When we assume that sustainability should be based on the ethical principle of equity, it follows that the greater the social exclusion and the less the human development (affecting the components of human well-being), the more the population groups in the municipalities and the MPR become vulnerable to environmental and health problems 10. Greater vulnerability not only violates the ethical principle, but also restricts the opportunities for these same populations to contribute to environmental sustainability. Meanwhile, in a vicious circle, the degradation of ecosystem services tends to worsen the populations’ living conditions and well-being, inducing further environmental exploitation and degradation in the struggle to guarantee daily survival. Precisely because populations become more vulnerable, they suffer in a more intense and expanded way the negative effects of environmental degradation caused by numerous economic activities that are increasingly connected to the global market, leaving a trail of environmental and health destruction where industrial processes and/or waste disposal are located 7,11. Further in keeping with the MEA conceptual framework 2 (Figure 1), the indirect driving forces affect not only the direct driving forces that alter ecosystem services, but also directly and indirectly affect human well-being. In turn, when ENVIRONMENTAL SUSTAINABILITY AND HUMAN WELL-BEING INDICATORS S515 Cad. Saúde Pública, Rio de Janeiro, 23 Sup 4:S513-S528, 2007 Figure 1 Conceptual framework for the interaction between human well-being, ecosystem services, and direct and indirect driving forces in ecosystem changes. Source: Millennium Ecosystem Assessment 2. human well-being is affected, it ends up impacting the indirect driving forces, feeding back positively or negatively into the socio-environmental system. This process simultaneously involves different interconnected spatial (local, regional, and global) and temporal scales (short and long-term changes). In this conceptual framework, the effects on health can be direct and indirect and may only occur after a long, complex network of events and situations combined on different spatial and temporal scales 12 (Table 1). This means that changes in ecosystems, coupled with given social and economic structures, can result in Human well-being and poverty reduction • Material minimum for a good life