Integrative policy development for healthier people and ecosystems: A European case analysis

Abstract

There is growing evidence of the interrelationships between ecosystems and public health. This creates opportunities for the development of cross-sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence-implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non-linear and complex nature of the policy-making process. We use these case studies to illustrate some of the key barriers to greater integrative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit-cost trade-offs; and finally a lack of integrative policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or abrupt, to ensure that ecosystems and the health of society are managed so that the interests of future generations, as well as present generations, can be protected.

Health Equity in Climate Change and Health Policies: A Systematic Review

“…Four papers were assessed to be of good quality [32][33][34][35], two of moderate quality [36,37] and two of poor quality [38,39]. The papers assessed as poor quality either weren't researchoriented or lacked methodological detail preventing us from conducting the detailed quality assessment.…”

“…All eight papers included in the review were published between 2010 and 2020, with two papers published in 2010 [38,39] and one every year from 2014 onwards [32][33][34][35][36][37], except in 2019. Two of the papers analyzed policies of multiple European countries [32,35], another one analyzed policies of the USA and China [38], and other papers analyzed policies of the USA [36], Australia [34], Scotland [39], Sweden [33], and India [37].…”

“…The studies also considered different levels of policies for analysis. Two looked at the regional level (comparing national policies of 19 and 5 European countries respectively) [32,35], one analyzed the national level policies [39], and four considered subnational level policies, including policies of municipalities [33,38], states [36] and cities [37]. One study analyzed policies at regional and subnational levels (state) [34].…”

“…Three papers focused on the interconnectedness between the effects of climate change and public health. They shed light on the complexity and barriers to integrating these two in policies [35,36,39], and one compared emission-mitigation authority, drivers, barriers, and activities at the subnational (city) level in two countries [38]. Health wasn't the major focus of this paper, and health promotion co-benefits were explored as a component of wider municipal policy initiatives.…”

Role of Environmentalism in the Development of Green Purchase Intentions: A Moderating Role of Green Product Knowledge

“…Healthy ecosystems are gaining the pivotal importance across the world due to their strong effects on human wellbeing and public health [1]. However, human activities from last many decades have severely destroyed the balance of ecosystems [2].…”