Environment and Health Information System achievements challenges and

Environment and Health Information System: achievements, challenges and future prospects Dafina Dalbokova, Michal Krzyzanowski http: //www. euro. who. int/EHindicators ISEE Central and Eastern European Chapter Meeting 4 -6 September, Balatonföldvár, Hungary, 2003 WHO European Centre for Environment and Health

The WHO EH indicators system Ø Combines both ‘top-down’ and ‘bottom-up’ approach: useful for the individual countries as well as enables international comparisons Ø‘Scalable’ - used at different geographical scales (local, state …) Ø Based on a valid exposure-effect relationship Ø Takes into account existing international indicator sets WHO European Centre for Environment and Health

http: //www. euro. who. int/EHindicators Framework and overview of the core set ISSUE/ TOPIC Driving Pressures State Exposure Effect Actions # # # D Forces • Air Quality # # # • Housing # • Traffic Accidents # # • Noise # # Waste and Contaminated lands # # # Workplace # # # A E # # # # Food Safety • Chemical Emergencies # # # S # • Radiation • Water and Sanitation P # # # # WHO European Centre for Environment and Health # EH INDICATOR

EH reporting tools: The EH Indicator fact-sheet Key message Standard and clear format of presentation Effective use and re-use of data and information Experiences from pilot MS EH context Policy context Assessment WHO European Centre for Environment and Health

Key message: synthetic and clear description An information layer!! Smiley to help communication Visualization: ‘easy-to –catch’ WHO European Centre for Environment and Health

Environmental Health Context: § Evidence for health-environment link on the topic/ indicator § Key upstream determinants § Evidence of possibility to risk reduction by active intervention WHO European Centre for Environment and Health

Policy Context: § The legal/ policy context associated with the issue/ indicator § The existence of a specific policy target associated with the issue/ indicator § The level/ process (DPSEEA chain) on which the policy/ legislation acts Assessment (i): § Interlinks within the DPSEEA § Link to ongoing policies (policy context) WHO European Centre for Environment and Health

Assessment (ii) § Environmental – quantitative targets Monitoring performance – ‘distance to target’ ca us es § Health Impacts (‘ideal’) Applying HIA, Bo. D (caution!!) attributable to § Environmental Health Linkage analyses DPS Ex<=>EA; Indication on policy effectiveness Exposure Health outcome WHO European Centre for Environment and Health

Assessment (iii): an example Countries, regions Health Impact Policy not implemented Estimate Ex 1 Exposure Needs systematic review and analysis of the policies!! WHO European Centre for Environment and Health

Assessment (iv): Population ‘at risk’ Urban population exposure to PM 10 (Pilot EHI project, J. Thelen, UBA, GERMANY) WHO European Centre for Environment and Health

Data issues To serve monitoring and comparative assessments § Data quality, comparability § Data completeness To document in a transparent way: § Entire procedure and criteria in choosing the approach Example: air pollution exposure indicator § Data differences Meta-data: data-about-the data WHO European Centre for Environment and Health

Main meta-data items: • Synthetic description of the data set • Data source and access: data-provider and access constrains • Data collection description incl. statutory requirement • Methods of data collection • Data coverage: geographical, population • Data completeness over time • Data quality: QA/QC, representativeness • Preprocessing, data manipulation • Consistency with WHO definitions, units of measurement A scoring system over ‘quality’ and ‘completeness’ under development WHO European Centre for Environment and Health

‘Euro. Indy’: the EH Indicators Software Allows uniform data collection and “easy” access/ exchange by: Using predefined variables and territorial units Standard” database structure (MS Access 2000) Added functionality to easily import and export data Allows EH indicators calculation and visualisation Meta-data WHO European Centre for Environment and Health

Data collection 1 ‘field by field’ Territorial units based on 1 st 3 Eurostat NUTS levels + towns > 100000 inhabitants “metadata” Indicators are grouped by “theme”and “topic” WHO European Centre for Environment and Health

Data collection 2 WHO European Centre for Environment and Health (Tabular entry)

On-going work Products for the Budapest Conference: Pilot indicator report: § four thematic chapters: Air pollution and health Water and sanitation Traffic accidents Noise § collection of (inter)- and national EH indicator fact-sheets Tools: web-based EHIS, ‘Euro. Indy’ WHO European Centre for Environment and Health

What’s next Methodological developments: § Indicators and assessment mechanisms (e. g. CRA) § Policy review and analysis – towards a ‘responsive’ system! Mechanisms for data reporting: § From predefined Euro. Indy concept towards priority data-flows and shared information infrastructure concept § Mechanisms for inter-agency co-operation: EEA EIONET Flexibility: ‘User windows’ on children’s health (CEHAPE) WHO European Centre for Environment and Health

Challenges in EH Indicator Reporting Methodological limitations in quantifying EH impacts Data and information needs: § health-relevant environmental monitoring; § surveys on living environment, annoyance; § geographical scale: both local and central level; § data access/ exchange with many data-holders. Integrating EH in Public Health reporting – difficult: No comprehensive framework to account for risk prevention; a focus on ‘first-order’ determinants Linking with policies – difficult: multisectorial policies outside health sector WHO European Centre for Environment and Health

WHO European Centre for Environment and Health

WHO European Centre for Environment and Health

Assessment (v): Composite indicator on ETS policies WHO European Centre for Environment and Health (Pilot EHI project, WHO – ECEH, Bonn)

WHO European Centre for Environment and Health

EH indicators are more than depiction of data They summarize the evidence and knowledge on health-environmental linkages in a meaningful and measurable way that is amenable to action They must be considered in policy context and their relevance to a concrete measure - specified They are only meaningful as a framework story WHO European Centre for Environment and Health

The DPSEEA cause-effect framework • What is the problem? - in health terms D P S A • What/who is causing it? - economic activities, sectors E E • Is the problem being solved? - what has been done? - is it effective? WHO European Centre for Environment and Health

Exposure - Response Population X Exposure IMPACT ESTIMATE FOR POPULATION X Population X health status WHO European Centre for Environment and Health