One Health in Primary Care


What if primary care clinicians began to approach health with a consideration for not just the patient in front of us, or that patient’s family, or even just the community where the patient lives, but instead with an awareness of the non-human animals, pets, wildlife, and domestic, living in close proximity?  What sort of bonds exist between the patient and those animals? What could the health of the animals tell human health care providers about the environment that will help them improve the health of the patient, family, and community? What microbes may pass between the animals and the people and the environment, some potentially causing disease but some also potentially stimulating immunity? What about well-being as well as health? 

Think of the many ways these health connections can manifest:

  • Companion animals are increasingly considered “part of the family” and illness or death of an animal can be a major life event for the patient and other family members.
  • Neglect of the animal can be a warning sign of risk for patient neglect.
  • Zoonotic diseases may pass between people, animals, and the environment, animal injuries can be a risk to children and others, and animal allergies may be a significant health problem.
  • Contact with wildlife is increasing in both suburban and urban environments.
  • Other changing environmental conditions (extreme weather including heat and flooding) can affect both animals and humans, and animals can serve as “sentinels” for human health hazards in the environment such as lead poisoning, toxic gases, and infectious risks.
  • Sedentary lifestyles lead to obesity for both pets and people, and interventions to increase exercise can involve both people and their animals.
  • Sometimes people take better care of their animals than themselves, so the care of the animal can be a route to improving care for the person.
  • People can get emotional support, stress reduction, and a sense of wellbeing from spending time in contact with animals.
  • There is evidence that the bacterial “microbiome” may be shared between humans and animals living in close proximity.
  • People who work with animals have unique occupational risks that are unfamiliar to many health care providers.

At present, MDs and other health care providers learn only a rudimentary animal contact history, and electronic medical record systems do not encourage gathering information about the health, well-being, and medical relevance of the animals in and nearby the household. At the same time, such electronic records may hold a key to better sharing of such knowledge between human health care providers and veterinarians.


Peter Rabinowitz, MD MPH

Director, Center for One Heath Research