WHO European Centre for Environment and Health

1. WHO European Centre for Environment and Health WHO European Centre for Environment and Health Strengthening health-environment policy-making: Towards establishment of pan-European integrated information system Dafina Dalbokova, Michal Krzyzanowski WHO ECEH, Bonn Office http://www.euro.who.int/EHindicators ISEE Central and Eastern European Chapter Meeting 4-6September, Balatonföldvár, Hungary, 2003

2. WHO European Centre for Environment and Health Policy processes across Europe: the NEHAPs, the EU Public Health action programme, EU EH Strategy, the WSSD, the Water and Health Protocol, THE PEP… call for Environment and Health Information System • To measure environmental health situation, its determinants and the trends at national scale and across Europe • To enable Member States and international organisations to make comparative assessments • To facilitate monitoring, evaluation and planning of the policies and actions

3. WHO European Centre for Environment and Health Environment and Health Information System in the policy cycle Implementation POLICY Performance evaluation &monitoring Formulation EHInformation System

4. WHO European Centre for Environment and Health WHO Europe develops and tests methodology for EH Information System: Enable evidence – based evaluation and policy making of the most relevant to health environmental risks Provide guidelines for analysing and communicating useful information – health argument in intersectorial policies Support monitoring and evaluation of policies on local, national and international scale Use existing data systems, facilitate report streamlining and setting priorities for datacollection

5. WHO European Centre for Environment and Health WHO/Europe EH information system - a collaborative process (1999-2003) Armenia, Bulgaria, Czech Republic, Estonia, Finland, Germany, Hungary, Lithuania, Netherlands, Poland, Romania, Slovakia, Spain, Switzerland Participating countries: EH indicators for EU countries EC-DG SANCOfundedproject: Public Health Monitoring Programme Austria, Belgium, Denmark, France, Finland, Germany, Italy, The Netherlands, Portugal, Spain, Sweden Partner countries: European Environment Agency

6. Policy review Evidence review HIA / SIA Data generation WHO European Centre for Environment and Health Structure of the Environment and Health Information System Clearinghouse Assessment Indicators Communication & Reporting

7. WHO European Centre for Environment and Health The WHO EH Indicator System

8. Air Quality Home • Housing • Traffic accidents • Noise Work Ambient • Radiation • Waste and contaminated lands • Water & sanitation • Food safety • Chemical emergencies • Workplace WHO European Centre for Environment and Health WHO EH Indicator SCOPE: Ten Topics Health-relevant environmental issues (physical, living, working) evidence, scale, severity Policy relevance, implications for actions and possibility for interventions Policy action programmes (e.g. NEHAPs) Sectorial activities e.g. transport Global issues e.g. climate change Broader issues in the context of SD

9. D P S A E E WHO European Centre for Environment and Health WHO EH Indicator System STRUCTURE Interlinked information - each part is clearly related to the various processes: upstream determinants, environmental risks and health effects, actions The DPSEEA cause-effect framework

10. Overview of the WHO EH indicators core set* *http://www.who.dk/document/E76979.pdf WHO European Centre for Environment and Health

11. WHO European Centre for Environment and Health The role of indicators is Communication!!! The analysis and interpretation and also the way of presentation is considered Population exposure PM10, 1999

12. http://www.who.dk/document/E76979.pdf WHO European Centre for Environment and Health The WHO EH indicators system • Methodology developed in seven WG meetings, involving a wide range of multidisciplinary expertise and several MS • Set of ‘core’ EH indicators agreed, tested for feasibility in 14 MS • Methodology – updated

13. Integration of EH database Scale: 3 territorial units Data exchange facility • Indicator calculation and visualization WHO European Centre for Environment and Health Tools and Methods for Data Gathering (1) ‘EuroIndy’ Software

14. Living environment: Indoor Air Quality Respiratoty health Housing Focus: Noise Children http://www.who.dk/document/E79048.pdf WHO European Centre for Environment and Health Tools and Methods for Data Gathering (2) Survey methods for EH assessment • reviewed • selected for implementation

15. WHO European Centre for Environment and Health Applying the EH indicator system Assessment, reporting and communication

16. Keymessage EH context Policy context Assessment WHO European Centre for Environment and Health Methods and tools: The EH Indicator Fact-sheet Standard and clear format of presentation Utility for decision-making: policy context and relevance Effective use and re-use of data and information

17. Background Evidence for health - environment link Key issues: upstream determinants and policy instruments Realistic potential for change through active interventions Environmental status and population exposure Trends, interlinkages - main drivers, pressures, exposure Where are we at the moment, why? Is the situation improving and where? WHO European Centre for Environment and Health A framework for integrated EH assessment and thematic indicator reporting (1)

18. Specific Health impact assessment: attributable burden of ill health; population ‘at risk’ – distribution in risk categories Vulnerabililty/ equity in relation to exposure ‘User windows’ special population’s health – children’s HE Potential for improvement - health gains Scenarios, success stories - case examples WHO European Centre for Environment and Health A framework for integrated EH assessment and thematic indicator reporting (2)

19. WHO European Centre for Environment and Health Communication and reporting Multiple layers of information in which indicators and fact-sheets play a key role Web-based prototype enables acess to different level of details Data <=> Indicators <=> Fact-sheets …

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22. EH indicators for EU countries: DG SANCO project European Community Health Monitoring Programme WHO European Centre for Environment and Health Test applicability of the WHO EH Indicators in supporting policies and actions on health protection and risks prevention A screening of the WHO EH Indicators vis-à-vis the EC legislation Focus on the reporting obligations: data sources measures taken to enact legislation evaluation of implementation

23. Applying clearing house mechanisms … examples The role of the networks of thematic expert groups as well as the WHO Technical Programmes WHO European Centre for Environment and Health

24. WHO European Centre for Environment and Health Towards the Budapest Ministerial Conference Technical process Methodology, guidelines, products Pilot indicator-based report: ‘Environment and Health in Europe’ Endorsement Policy process Towards European EHIS establishment MS commitments Mechanisms for international collaboration This ongoing process requires full involvement of all partners

25. Contribute through the WHO networks todevelopment of methodology, providing: cost-effective and feasible methods for population-relevant monitoring, information analysis and interpretation Active involvement in testing and implementation: identifying the most relevant information effective analysis to support policy evaluation promote best practices in EH reporting WHO European Centre for Environment and Health Role of the health professionals, our role Advocate the need for EH information system using the harmonised methodology To build the EuropeanEH information base foundations

26. WHO European Centre for Environment and Health We must reach….

27. WHO European Centre for Environment and Health ….look out, be inquisitive…

28. WHO European Centre for Environment and Health …and not be afraid to tackle Elephant tasks.

29. WHO European Centre for Environment and Health Thank You

30. WHO European Centre for Environment and Health