Table 1
Selected direct and indirect risks, benefits, and opportunities for human health and wellbeing from interactions with the ocean.
| BENEFIT/OPPORTUNITY | HEALTHY OCEAN BENEFIT | POTENTIAL HUMAN HEALTH AND WELLBEING BENEFIT | CITATIONS |
|---|---|---|---|
| Climate and weather | The ocean is critical to the fight against climate change. | Prevention of injury, death, and mental health impacts from extreme weather | Villasante et al. 2023 [3]; Falkenberg et al. 2023 [4] |
| Heat and CO2 sink | The ocean absorbs 25% of all CO2 emissions and more than 90% of excess atmospheric heat. | Prevention of extreme heat, crop loss, starvation | Hoegh-Guldberg et al. 2023 [2] |
| Oxygen | The ocean sustains all life on earth by providing 50% of the oxygen produced on earth each year and 80% of all the oxygen ever created. | Prevention of crop and other biodiversity loss | Grégoire et al. 2023 [1] |
| Biodiversity (including marine protected areas [MPAs]) | Emerging research with communities living in/around MPAs and other areas designated as protected; diverse human health and wellbeing benefits; and collaborative and effective management with ongoing involvement of local communities is essential toward creating and sustaining these ocean and human health benefits. | Livelihoods, improved nutrition, decreased overall national mortality, and improved child health as well as positive ecosystem impacts | Winther et al. 2020 [5]; Madarcos et al. 2021 [6]; Haque et al. 2023 [7]; Nowakowski et al. 2023 [8]; Ban et al. 2019 [9]; Gollan and Barclay 2020 [10]; Rasheed 2020 [11] |
| Livelihoods and economics | The ocean is a source of wealth. The ocean economy is estimated to generate US $1.5–2.5 trillion annually and to provide jobs for more than 30 million people. | Seafood as nutrition and prevention of NCDs and mental health impacts | OECD 2016 [12]; Ocean Panel 2020 [13] |
| Marine Biotechnology (including marine drugs) | Thirty thousand unique molecules and 10% of currently known natural products have been discovered in marine life; 23 approved pharmaceutical agents have been developed from marine molecules, and an additional 33 are in clinical trials. The ocean is a source of new medicines and biotechnologies, from essential pain medicines to plastic alternatives to essential DNA libraries. | Development of treatments for inflammation, immune system disorders, skin pathologies, infectious diseases, NCDs, and cancers Alternatives to plastics and creation of sustainable other biomaterials | Antunes et al. 2023 [14]; Bouley et al. 2023 [15]; CHEMnetBASE 2023 [16]; Pascual Alonso et al. 2023 [17] |
| Seafood and food security | For more than 3 billion people, nearly 40% of the world’s population, the ocean is an essential source of food and livelihood. | Prevention of starvation, childhood stunting, NCDs | FAO Duke University & WorldFish 2022 [18]; Maycock et al. 2023 [19] Golden, et al. 2021 [17]; Tigchelaar et al. 2022 [20]; Naylor et al. 2021 [21]; Golden et al. 2016 [22] |
| Blue spaces (including culture) | Interactions with the ocean and with other blue spaces enhance the physical health and mental wellbeing of humans from infancy to old age. | Support culture, physical health, and mental wellbeing | White et al. 2020 [23]; Fleming et al. 2019 [24] |
| Threat | Unhealthy Ocean Risks | Potential Human Health and Wellbeing Risks | Citations |
| Heat | As the ocean absorbs more heat, the sea surface temperature rises: increased frequency of extreme weather, polar ice melting, sea level rise, and coastal flooding; migration of fish stocks from dependent communities; increased harmful algal blooms (HABs); and pathogen spread. | Death Injury Infectious diseases Starvation HAB illnesses Mental health NCDs Disrupt cultural integrity | Nash et al. 2017 [25]; Falkenberg et al. 2023 [4] |
| Acid | Increased atmospheric CO2 is absorbed by the ocean; low pH dissolves coral, shellfish, and calcium-containing microorganisms that sustain the entire marine web, and impacts fisheries. | Starvation Obesity Mental health NCDs Disrupt cultural integrity | Nash et al. 2017 [25]; Falkenberg et al. 2023 [4] |
| Deoxygenation | Dissolved ocean oxygen decreases as oceans become warmer and more acidic: oceanic ‘dead zones’ impact fisheries. | Starvation Obesity Mental health NCDs Disrupt cultural integrity | Grégoire et al. 2023 [1]; Falkenberg et al. 2020 [26] |
| Overfishing | Destructive industrial fishing practices, with rising temperatures and pollution, damage ocean ecosystems and biodiversity, and deplete fisheries. | Starvation Obesity Mental health NCDs Disrupt cultural integrity | FAO Duke University & WorldFish 2022 [18]; Maycock et al. 2023 [19]; Golden, et al. 2021 [17]; Tigchelaar et al. 2022 [20]; Naylor et al. 2021 [21]; Golden et al. 2016 [22] |
| Oil and gas extraction | Fossil fuel extraction and transport release toxic hydrocarbons, increasing climate change; oil spills injure and kill marine organisms, destroy biodiversity, and impact fisheries. | Death Injury Mental health Increased NCDs Disrupt cultural integrity | Nash et al. 2017 [25]; Landrigan et al. 2020 [27]; Lelieveld et al. 2019 [28] |
| Deep-sea mining | Deep-sea mining may damages the seabed and vulnerable habitats, releases radiation, and impacts fisheries. | Obesity NCDs Cancer Starvation Disrupt cultural integrity | Landrigan et al. 2020; [27] Hamley 2022 [29]; Miller et al. 2021 [30] |
| Pollution | Eighty percent of pollution arises on land from human activities: plastics, heavy metals, petroleum waste, manufactured chemicals, pesticides, radiation, and nutrients (including sewage); these pollutants damage ecological health and biodiversity, and impact fisheries. | HAB illnesses Neurotoxicity Foetal/developmental toxicity Reproductive toxicity Mental health NCDs Cancer Disrupt cultural integrity | Landrigan et al. 2020 [25]; Landrigan et al. 2023 [27]; Short et al. 2021 [31] |
| Economics | Profit-driven, ocean-based economic development offers short-term economic gain, with no concern for ocean health, the health and wellbeing of marginalised coastal communities, biodiversity, and marine degradation. | Occupational injury and death Starvation Mental health Disrupt cultural integrity | Germond-Duret et al. 2022; Das 2023 [32,33] |
Figure 1
The Ocean Pollution-Berg: Plastic waste is just the tip of a larger ocean pollution problem (source: artist Will Stahl-Timmins; Landrigan et al. 2020 [27]).
Figure 2
A tangled net: complexity of selected interconnections between human health and activities in and around seas and oceans (Source: artist Will Stahl Timmins; Fleming et al. 2019 [24]).
Figure 3
Seaweed-based biomaterial used to 3D print inhaler prototype (front), set against a jar of the seaweed, used as an alternative feedstock to fossil fuels used in current medical device manufacturing (back). Source: with permission: Symbio-tex (https://www.symbio-tex.com/).
Table 2
Hypothetical health impacts of international marine laws (source: Carvalho et al. 2023 [101]).
| LEGAL FRAMEWORK/CONVENTION | IMPACT |
|---|---|
| Exclusive Economic Zones (EEZ) under United Nations Convention on the Law of the Sea (UNCLOS) | Equitable distribution of ocean resources and marine protections between nations for energy production, food distribution, and other sovereign uses of the seas |
| South China Sea (SCS) Arbitration | Suppression of potential conflict between nations that would precipitate a humanitarian crisis for many Pacific and Southeast Asian countries |
| Convention on International Trade in Endangered Species (CITES) | Protection of endangered species critical to the global food web |
| Convention on Biological Diversity (CBD) | Conservation of environmental resources and governance of genetic resources for equitable distribution among human populations |
| Port State Measures Agreement (PSMA) | Decreasing illegal, unreported, and unregulated fishing of stocks necessary for the subsistence of multiple human populations |
| International Whaling Commission (IWC) | Regulation of whaling for native populations while protecting endangered species |
| Convention for the Conservation of Antarctic Marine Living Resources (CCAMLR) | Prevention of overfishing in the Antarctic and conservation of fish stocks essential to the nourishment of populations |
| United Nations Framework Convention on Climate Change (UNFCCC) | Dissuasion of fossil fuel usage to decrease pollution levels and increases in global warming |
| UN High Seas Marine Protected Areas/Areas Beyond National Jurisdiction (ABNJ) | Exploration of marine genetic resources for use in medicines |
| Pandemic preparedness treaty and future treaty on plastic pollution prevention | Global health security to prevent future public health emergencies of international concern (PHEIC), as well as direct effects of marine plastic pollution on human health |
Figure 4
The Ocean Panel (https://oceanpanel.org/) A) A Sustainable Ocean Economy can Create a Triple Win for People, Nature and the Economy. (Originally published in: Stuchtey et al. 2020 Ocean Solutions that Benefit People, Nature and the Economy [107]); and B) the 5 Key Areas of Transformation: Health, Equity, Knowledge, Wealth, Finance (Originally published in: High Level Panel for a Sustainable Ocean Economy. 2020. Transformations for a Sustainable Ocean Economy: A Vision for Protection, Production and Prosperity. Washington, DC: World Resources Institute [13]).
Table 3
Tabulation of opportunities for action to support both ocean health and human health and wellbeing in a changing planetary environment. All actions need to be initiated immediately (source: Fleming, Landrigan et al. 2024 [108]).
Figure 5
Opportunities for action to support both ocean health and human health and wellbeing in a changing planetary environment. Circles are plotted by feasibility (Y axis – the ability to carry proposed action to completion considering resources, government, and culture) and time to realise benefits (X axis – the duration required to realise benefits of proposed action). The relative size of the circle reflects the magnitude of impact of the action (in terms of overall benefit to ocean and human health globally). All actions need to be initiated immediately. Note that this figure is included primarily as a visual aid for readers. It is based on the expert opinion of authors employing best available evidence, not a quantitative analysis of all available information (Fleming, Landrigan et al. 2024 [108]).