Health Policy and Environmental Strategies

1. Introduction

Every European Citizen has a right to an environment that does not endanger his or her health and to a high level of human health protection. This is implicit in the Charter of Fundamental Rights of the European Union (2000/C364/01), and since the Treaty of Lisbon, has become legally binding.

The overall aim of professionals working in the area of environment and health (E&H) is to minimize the environmental burden of disease (mortality and morbidity) by reducing negative environmental impacts; but also by maintaining and improving health and well-being through a well-managed and stimulating natural environment and access to green spaces.

The environment plays a crucial role in people's health and social well-being. The World Health Organization (WHO) Regional office for Europe defines “environment and health” as including “both the direct pathological effects of chemicals, radiation and some biological agents, and the effects (often indirect) on health and well-being of the broad physical, psychological, social and aesthetic environment, which includes housing, urban development, land use and transport.

Health is a major driver for environment policy. Progress has been made towards a cleaner environment in recent decades but efforts need to be continued and strengthened to meet policy targets and to reduce the negative impact of environment on health to a level which is neither harmful to humans nor to the environment.

Covering the main environmental determinants of health requires concerted actions across a wide range of policies and areas of responsibility. Beyond the classical environment policies for clean air, water and safe chemicals, the impact of other policy sectors on environment and health is very diverse and complex, e.g., in the areas of resources, energy, transport, urban design and planning, and land use. Although the ultimate aim is to protect human health, the legislation and measures in the field of environment and health (E&H) are often not under the responsibility of the health sector.

Life expectancy in the EU has been progressing over the past decades to 76.4 years for men and 82.4 years for women in 2008. By contrast, the average number of healthy life years has been progressing at a much slower pace: 60.9 years for men and 62 years for women. WHO Europe estimates that the burden of disease caused by environmental stressors in the European region (53 countries) lies between 15 and 20 % of total deaths and 18 to 20 % of disability-adjusted life years (DALY = Years with lost quality of life by morbidity and loss of years through premature death) with a relatively high burden in the eastern regions. The health budget is about 12 to 15 % of public expenditure in Member States.

There are many estimates of the costs and gains of policy actions in E&H. The ban of leaded gasoline provided immediate and significant human health benefits. Considering the environment and health costs caused by air pollutants alone, €20 to 45 billion will be saved each year once the future targets of EU legislation are met. Who estimated in 2011 that at least one million healthy life years are lost every year from traffic-related noise in the western part of Europe.

But costs and benefits occur in different sectors. Therefore cross-sectoral consideration and collaboration among environment and health experts as well as the embedding of health issues in environmental policies (which is also in line with the Lisbon treaty article 168 health protection in all Union policies and activities) is necessary. Including health aspects at an early stage of planning legislation and activities in various sectors will reduce negative health impacts as well as saving costs.

Overall objective 2020: All EU Member States have implemented environment policy to the extent necessary to bring a significant decrease in the environmental burden of disease

Overall vision 2050: All citizen of Europe live in a healthy environment with a high quality of life, notably exemplified by green cities.

2. First cycle of European E&H Strategy

Any further phase of the European Environment and Health Strategy will need to take into account the experience of the first cycle, particularly lessons learnt from the European Environment & Health Action Plan 2004-2010.

For the first cycle of the European E&H Strategy, the European Environment & Health Action Plan 2004-2010 (EHAP) was launched. Main objectives were to improve the information chain, fill the knowledge gaps as well as to review policies and improve communication. To support a number of EU policies, e.g., in the field of chemicals or nanomaterials, a large amount of research on environment and health was funded by the EU research framework programmes, greatly expanding the scientific knowledge base and building a European research area in E&H. Ongoing activities included, among others, projects on harmonizing human bio monitoring on a large scale in Europe, activities for information collection (ENHIS - European Environment and Health Information System: SEIS - Shared Environmental Information System, INSPIRE - Infrastructure for Spatial Information in the European Union), and research together with a strategic framework to address indoor air quality.