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How to identify win–win interventions that benefit human health and conservation


To reach the Sustainable Development Goals, we may need to act on synergies between some targets while mediating trade-offs between other targets. But what, exactly, are synergies and trade-offs, and how are they related to other outcomes, such as ‘win–win’ solutions? Finding limited guidance in the existing literature, we developed an operational method for distinguishing win–wins from eight other possible dual outcomes (lose–lose, lose–neutral and so on). Using examples related to human health and conservation, we illustrate how interdisciplinary problem-solvers can use this framework to assess relationships among targets and compare multi-target interventions that affect people and nature.

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Fig. 1: A framework for evaluating intervention outcomes and their associated values.
Fig. 2: ‘Sick care’ and ‘preventative care’ within coupled human and natural systems can each create neutral–neutral outcomes.
Fig. 3: Two complex systems where ecosystem and human health are connected.
Fig. 4: Multiple interventions can be compared on the basis of not only on their qualitative outcomes, but also on their effect sizes and cost-effectiveness.
Fig. 5: Planning and comparing interventions using theory-of-change diagrams.


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The Ecological Levers for Health working group was supported by the Science for Nature and People Partnership (SNAPP). L.H.K. and I.J.J. were supported by NSF Graduate Research Fellowships (nos. DGE-114747 and 1656518). N.N. was supported by the Bing Fellowship in Honor of Paul Ehrlich and the Stanford Data Science Scholars program. A.J.P. was supported by a Queensland Government Accelerate Postdoctoral Research Fellowship and an ARC DECRA fellowship (DE190100710). C.L.W. was supported by a grant from the National Science Foundation (OCE-1829509), an Alfred P. Sloan Foundation Sloan Research Fellowship, and a University of Washington Innovation Award. A.J.L. was supported by a James and Nancy Kelso Stanford Interdisciplinary Graduate Fellowship. A.J.M. was supported by a NSF Postdoctoral Research Fellowship in Biology (no. 1611767). G.A.D.L., A.J.P. and S.H.S. were partially supported by the National Institutes of Health (R01TW010286), the National Science Foundation (CNH1414102), and a GDP SEED grant from the Freeman Spogli Institute at Stanford University. G.A.D.L. was also partially supported by NSF DEB no. 2011179. K.D.L. was supported by the Ecosystem Mission Area of the US Geological Survey. Any use of trade, product, or firm names in this publication is for descriptive purposes only and does not imply endorsement by the US Government.

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S.R.H., K.D.L., S.H.S. and G.A.D.L. designed the framework with input from all authors; N.N. and S.R.H. created the figures with design input from all authors; S.R.H. led the writing, and all authors wrote and revised the drafts. All authors gave final approval for publication.

Corresponding author

Correspondence to Skylar R. Hopkins.

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The authors declare no competing interests.

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Peer review information Nature Sustainability thanks Christopher Golden, Melissa Marselle and Kris Murray for their contribution to the peer review of this work.

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Hopkins, S.R., Sokolow, S.H., Buck, J.C. et al. How to identify win–win interventions that benefit human health and conservation. Nat Sustain (2020).

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