Planetary health security?: critical scoping review of conceptual linkages between ‘health security’ and ‘planetary health’

Background ‘Health security’ — the subjection of health to ‘security’ frameworks — and ‘planetary health’— the study of human health impacts of the degradation of planetary ecosystems — have emerged in the last decades as prominent global health fields. However, limited literature connects them, particularly incorporating critical perspectives. We explored interactions between these approaches conceptually, institutionally, and empirically, aiming to chart a conceptual genealogy of these interactions. Methods We conducted a scoping review using Arksey and O’Malley’s method and Levac’s revisions, exploring the health, security, and ecology literatures. We identified 75 eligible sources of 10,352 screened and synthesised findings inductively using Braun and Clarke’s thematic approach. Findings We generated five themes across these literatures: (1) environmental health as security issue; (2) biosecurity and non-traditional security; (3) institutional connections; (4) militarisation and environmental health; and (5) emerging risk-management methods and technologies. We found multiple descriptions of environmental health as ‘crisis’ and ‘security’ issue, yet health security’s scope was primarily limited to containing emerging infectious diseases, rather than prevention or broader health concerns. Conclusion This initial exploration across disciplinary literatures of conceptual interactions between planetary health and health security showed both mobilising the language of ‘security’ to frame health issues, while raising concerns over inequitable experiences for some populations resulting from this framing. An overt emphasis on containment over prevention and tacit commitments to the protection of some lives over others could result in asymmetrical health experiences, rendering some geographies and populations ‘sacrificial’ in their health risks.