Global health. The current scenario and future perspectives

105 a space of choice and just a few with a very wide margin of decision-making. But changes in land use also have social occupation of spaces and urbanization as factors of change, and although the latter have occurred unevenly globally, their levels of impact are increasing (Rojas et al., 2019). Three-quarters of the population in Latin America live in precarious neighborhoods, concentrated only in three countries: Brazil, Mexico and Peru (Sandoval and Sarmiento, 2018). This is not just a problem associated with the type of housing or socio-economic precarity; we are facing multidimensional poverty, in which the environmental, social and economic environments are also involved. The social fabric is at risk, and the ecological fabric has been transformed and inhabited without any planning. In this sense, ecosystems are no longer seen as a contribution. Urban expansion in LAC goes hand in hand with exposure to danger. Likewise, political and social factors are influencing the vulnerability of the population, which compels, allows or defines the occupation of areas classified as at risk of mass removal, floods and landslides, among others. This reduces resilience and adaptation to climate change, with negative consequences for biodiversity and the most vulnerable (Swyngedouw & Kaika, 2014). We are clearly facing a lack of governability and governance that has become normalized inequality. We aspire to have clean air, clean water for human consumption, healthy food, recreational spaces and other basic needs. All the above areas are related to proper use of biodiversity and rational land use, with collective and individual responsibility. The concept developed by Elinor Ostrom referring to the “tragedy of the commons” (Ostrom 2000, p. 28) is still relevant. We have neglected governance of the main actor: nature. Latin America and the Caribbean have essential attributes to change the current scenario of social, environmental and economic inequality, as well as to address the environmental and social challenges that stem from unsustainable land use. However, we must address the underlying factors that maintain this situation, so treating problems in an integrated manner is more effective. Thus, social and economic issues should be part of an environmental agenda. Biodiversity and human health “A biodiverse natural environment is a resource that promotes health” (Cook et al., 2019, p. 251) The social relationship with biodiversity occurs in different ways, depending on cultures, knowledge and personal or inherited experiences. The interaction between nature and society has been described as a socio-