All humans rely on the goods and services from ecosystems for survival and well-being, such as for food, fuel, timber, clean water, flood and climate regulation, and cultural benefits. While rich urban-dwellers rely on local ecosystems they are less directly affected by ecosystem degradation than the rural poor, who have the least ability to cope with changes by obtaining goods and services from further afield.

Changes in the supply of ecosystem services can have complex direct and indirect impacts on human health and well-being. While ecosystem modification can have a positive impact on human health and well-being, such as higher crop yields resulting from agricultural intensification, ecosystem change can lead to degradation of services such as soil fertility, water quality and supplies, regulation of pest outbreaks, and loss of cultural uses and values of the natural environment.

The CBD considered the subject of the health and well-being of communities who depend directly on local ecosystem goods and services to be an important one for the development of indicators, although the relationships are complex. As well as the need to analyse many types of ecosystem services, the definitions of health and well-being of communities are a challenge. Some data on the use of biodiversity resources by fishing communities and forest dwellers is available, but there is limited availability of consistent data which is acceptable to all stakeholders.