Pathways to Planetary Health: Integrating Systems Thinking and Futures Approaches in Engineering Education to Address the Health-Environment Nexus.

As scholars and professionals expand their understanding of anthropogenic environmental changes threatening human and planetary well-being, they must engage with interconnected social, economic, and environmental issues. This requires acquiring new knowledge and skills to deepen their understanding of the complex and reciprocal relationship between human well-being and the health of the natural systems upon which it relies. Designers and engineers play a critical role as change agents by their capacity to design systemic interventions that drive climate action. Given the ongoing environmental and health crises, it is crucial for them to develop competencies in systems-based, future-oriented, and integrative approaches to health. Nevertheless, the existing literature reflects a limited number of attempts to explore the implementation of such holistic and integrative approaches, aiming at preparing design and engineering students to contribute to pathways toward planetary health futures. A narrative review was conducted on systems thinking, strategic foresight and integrative approaches to planetary health education and practice, with the aim of supporting the development and implementation of a systemic design methodology within engineering education. In addition, critical analyses of pedagogical practices and the student learning process are presented, informed by observations of design activities and outcomes, which reflect on the challenges and opportunities encountered in a graduate course delivered by the authors. Moreover, we correlate these experiences with existing literature in the field, thereby establishing connections that underscore best practices and identify areas for improvement. The results demonstrate how students address planetary health challenges using a project-based pedagogical approach, emphasising interdisciplinary collaboration within small groups as they engage with complex real-world problems. The findings reveal the implications of adopting the methodology Systemic Design for Planetary Health, exploring various challenges encountered, and providing recommendations for improving course design, content and future iterations. The findings of the study hold significant value for educators who are integrating planetary health, systems thinking, and futures thinking into design and engineering curricula, as well as for professionals aiming to implement systems practice to address challenges within the health-environmental nexus. From a broader perspective, these findings contribute to advancing future research and educational practices within the realm of planetary health education.