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

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

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

5. WHO European Centre for Environment and Health WHO Europe develops and tests methodology for EH Information System: 2.Provide guidelines for analysing and communicating useful information – health argument in intersectorial policies 4.Use existing data systems, facilitate report streamlining and setting priorities for data collection 1.Enable evidence – based evaluation and policy making of the most relevant to health environmental risks 3.Support monitoring and evaluation of policies on local, national and international scale

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

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

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

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

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

11. WHO European Centre for Environment and Health EH ISSUEDriving Forces PressuresStateExposureEffectActions Air (indoor and ambient) Quality #### ######## # Housing and Settlements ####### Traffic Accidents #### Noise #### # Waste and Contaminated Lands ### Radiation ## Water (drinking, recreational) and Sanitation ####### #### #### # # Food Safety ##### #### Chemical Emergencies ########## Workplace ###### # Overview of the WHO EH indicators core set* * http://www.who.dk/document/E76979.pdfhttp://www.who.dk/document/E76979.pdf

12. 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

13. 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 http://www.who.dk/document/E76979.pdf

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

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

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

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

18. WHO European Centre for Environment and Health A framework for integrated EH assessment and thematic indicator reporting (1) 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?

19. WHO European Centre for Environment and Health A framework for integrated EH assessment and thematic indicator reporting (2) Potential for improvement - health gains Scenarios, success stories - case examples 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

20. 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 …

21. WHO European Centre for Environment and Health

23. 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 EH indicators for EU countries: DG SANCO project European Community Health Monitoring Programme

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

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

26. 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 Contribute through the WHO networks to development 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 To build the European EH information base foundations

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

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

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

30. WHO European Centre for Environment and Health