A pragmatic and integrative approach to evaluation of the environment combines ecosystem sciences, health sciences, and social sciences. Each has a crucial role to play: the ecosystem sciences provide information on the complex dynamics of ecosystems as they are influenced by stress and disturbance; the health sciences provide a methodology for systematic diagnosis of pathology, taxonomy of ills, and models for preventive as well as rehabilitative modes; the social sciences bring to the fore the importance of human values which are part and parcel of any health evaluation. The complexity of stress-response systems precludes anything approximating a complete understanding of mechanisms underpinning ecosystem transformations. However, the loss of ecosystem services and management options appears to be a general phenomenon that permits an overall evaluation of ecosystem health in both aquatic and terrestrial systems. Such blanket indicators take into account both the impairment of ecosystem function and societal values. This is illustrated by the history of ecosystem transformation in the Laurentian Lower Great Lakes and in the overharvested forest ecosystems of Eastern Canada. In both cases, cultural stress resulted in losses in highly valued ecosystem services and management options. These losses have been partially compensated for by new technologies that have permitted commercial use of the remaining lower quality resources. This process itself, however, may be pathological, reinforcing a degradation sequence rather than serving to restore ecosystem health.