who european centre for environment and health environment and health information system:...

WHO European Centre for Environment and HealthWHO European Centre for Environment and HealthWHO European Centre for Environment and HealthWHO European Centre for Environment and Health

Environment and Health

Information System:

achievements, challenges and

future prospects

ISEE Central and Eastern European Chapter Meeting

4-6 September, Balatonföldvár, Hungary, 2003

Dafina Dalbokova, Michal Krzyzanowski

http://www.euro.who.int/EHindicators



WHO European Centre for Environment and HealthWHO European Centre for Environment and Health

The WHO EH indicators system

Combines both ‘top-down’ and ‘bottom-up’ approach:

useful for the individual countries as well as enables

international comparisons‘Scalable’ - used at different geographical scales

(local, state …)

Takes into account existing international indicator

sets

Based on a valid exposure-effect relationship


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Framework and overview of the core setISSUE/ TOPIC Driving

ForcesPressures State Exposure Effect Actions

• Air Quality #

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• Housing # # # #

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• Traffic Accidents

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• Noise #

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Waste and Con- taminated lands

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• Radiation # #

• Water and Sanitation

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Food Safety # #

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• Chemical Emergencies

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Workplace #

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EH INDICATOR


EH reporting tools: The EH Indicator fact-EH reporting tools: The EH Indicator fact-sheetsheet

Key message

EH context

Policy context

Assessment

Effective use and re-use of data and information

Standard and clear format of presentation

Experiences from pilot MS


Key message: synthetic and clear description

Smiley to help communication

Visualization:

An information layer!!

0

5

10

15

20

25

1990 1995 2000 2005 2010 2015

data

baseline

target

‘easy-to –catch’

WHO European Centre for Environment andWHO European Centre for Environment and HealthHealth

Evidence for health-environment link on the topic/ indicator

Key upstream determinants

Evidence of possibility to risk reduction by active intervention

Environmental Health 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

Policy Context:

Assessment (i): Interlinks within the DPSEEA

Link to ongoing policies (policy context)


Assessment (ii)

causes

causes

at tr ibuta b

le t o

at tr ibuta b

le t o

Health outcome

Exposure Environmental Health Linkage analyses DPS Ex<=>EA;

Indication on policy effectiveness

Health Impacts (‘ideal’) Applying HIA,BoD (caution!!)

Environmental – quantitative targets Monitoring performance – ‘distance to target’


Policy not implemented

Countries, regions

Ex1 Exposure

Health Impact

Estimate

Assessment (iii): an example

Needs systematic review and analysis of the policies!!


Assessment (iv): Population ‘at risk’

(Pilot EHI project, J. Thelen, UBA, GERMANY)

Urban population exposure to PM10


Data quality, comparability

Data completeness

Data issues

Meta-data: data-about-the data

To document in a transparent way: Entire procedure and criteria in choosing the approach Example: air pollution exposure indicator

Data differences

To serve monitoring and comparative assessments


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


Using predefined variables and territorial units

Standard” database structure (MS Access 2000)

Added functionality to easily import and export data

Allows uniform data collection and “easy” access/ exchange by:

Allows EH indicators calculation and visualisation

‘EuroIndy’: the EH Indicators Software

Meta-data


Territorial units based on 1st 3 Eurostat NUTS levels + towns > 100000 inhabitants

Indicators are grouped by “theme”and “topic”

Data collection 1Data collection 1 ‘field by field’

“metadata”


(Tabular entry) DataData collectioncollection 2 2


Products for the Budapest Conference:

Pilot indicator report:

On-going work

four thematic chapters:

Tools: web-based EHIS, ‘EuroIndy’

Air pollution and healthWater and sanitationTraffic accidentsNoise

collection of (inter)- and national EH indicator fact-sheets


What’s next

Mechanisms for data reporting:

Mechanisms for inter-agency co-operation: EEA EIONET

Methodological developments:

Flexibility: ‘User windows’ on children’s health (CEHAPE)

Policy review and analysis – towards a ‘responsive’ system!

Indicators and assessment mechanisms (e.g. CRA)

From predefined EuroIndy concept towards priority

data-flows and shared information infrastructure concept


Methodological limitations in quantifying EH impacts

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

Data and information needs:

Challenges in EH Indicator Reporting


Assessment (v): Composite indicator on ETS policies

(Pilot EHI project, WHO – ECEH, Bonn)


EH indicators are more than depiction of data

They are only meaningful as a framework story

They must be considered in policy context and their relevance to a concrete measure - specified

They summarize the evidence and knowledge on health-environmental linkages in a meaningful and measurable way that is amenable to action


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The DPSEEA cause-effect framework

• What is the problem?

- in health terms

• What/who is causing it?

- economic activities, sectors

• Is the problem being solved?

- what has been done?

- is it effective?


Population X Exposure

Population X health status

Exposure - Response

IMPACT ESTIMATEIMPACT ESTIMATEFOR POPULATION XFOR POPULATION X

who european centre for environment and health environment and health information system:...

Documents

data set data source

pm10 data quality

reuse of data

data collection description

issue indicator

legal policy context

healthenvironment link

health information system