Improving the health of people and animals as well as improving the health, integrity and sustainability of ecosystems are both laudable and important activities. Can we do both? Clearly, if we wish to have health in the future, then the integrity of ecosystems, which make our lives possible, is relevant. To say we can have sustainable population health without sustainable ecosystems is like saying that we can have a sustainable, healthy heart without a sustainable body, which gives it life and meaning. Yet linking health and ecosystems grammatically – a common and generally well-received notion these days – will do little to link them in real life. Some people would argue that the only ecosystem with integrity is one with no people in it. These people seldom use the word health because they think that health involves value judgements, and integrity is value-free. If anything, integrity is more value-laden, and indeed legally moralistic (which is why it attracts some environmental regulators), than health. Nature may well be value-free, but there is no way to evaluate our status in nature, or to talk about progress, without reference to values. It seems best to some of us to accept this and try to deal with it head-on. There are, quite frankly, no ecosystems that do not, in one way or another, bear the imprint of human meddling.