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1 18 January 2012
HiAP initiatives in the Netherlands-
Environmental health, transport, & planning
eHIA, tools, knowledge & information systems
Hanneke Kruize
Brigit Staatsen
Anne KnolNational Institute for Public Health and the Environment (RIVM)
Bilthoven, the Netherlands
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Contents
● Health in all policies in the Netherlands- transport, environment & planning
● Our activities on environmental health, transport and planning
● Examples of knowledge and information projects and systems
● Examples of eHIA tools
● Discussion & questions
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Health in all policies in the Netherlands-environmental health, transport, planning
● Ministry of Infrastructure and the Environment (IenM)
– National Action Plan on Environment and Health
– Housing, spatial planning & health
– Transport and health
● Ministry of Public Health, Welfare and Sport (VWS)
– Neighbourhoods & physical exercise
– Integrated Health Policy
– (Health inequalities)
● Ministry of the Interior and Kingdom Relations (BZK)
– Health in 40 disadvantaged neigbourhoods
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Environmental health, transport & planning● International (WHO, EEA, EU), national (ministries) and local level (municipal health services, municipalities)
● Sectoral (air pollution, noise, emf) and intersectoral topics (climate change, green space, indoor air quality & energyefficiency, healthy transport, healthy design)
● Examples of questions:
– What are the health effects of environmental pollution/roadtraffic?
– What is the health impact of a spatial plan/transportationpolicy?
– Where does accumulation of problems occur (‘hot spots’) ?
● But also:
– Development of eHIA tools (qualitative and quantitative)
– Integration of knowledge and information on healthydesign/environmental health
● Limited attention for health equity (WHO, RIVM project)
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●
Current political trend in NL: Government hesitant to interfere in personal choices & spatial planning decentralised to municipalities…
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How many cases?How severe?
How long?Are you sure?
How much earlier?
Methods for HIA (2)
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Transport-related health effects: some key figures EU127,000 deaths and 2.4 127,000 deaths and 2.4
million injuries/yearmillion injuries/yearAir pollution costs EU Air pollution costs EU
citizens 8 months of their citizens 8 months of their
liveslives
Physical inactivity : Physical inactivity :
600,000 deaths/year600,000 deaths/year
More than 30%More than 30% of the of the
EU15 population EU15 population
exposed to noise levels > exposed to noise levels >
55 dB(A) 55 dB(A)
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Environmental burden of disease
●Environmental health problems are often incomparable
●Integrated health measures (such as Disability Adjusted Life Years -DALYs)
–uses the same denominator for all health effects
–quantifies and summarizes (environment-related) health effects
–makes it possible to compare areas, plans or measures
–offers insight in what domain the largest health gain can be found
●DALYs indication of the (potential) number of healthy life years lost due to premature mortality or morbidity: DALYs = YLL+ YLD
●DALY calculation:
–Number of people with environment-related morbidity or mortality x
–Severity factor (0 = healthy, 1 = death) x
–Duration of disease (years of life lost for mortality)
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European Environmental Burden of Disease Studyhttp://www.euro.who.int/__data/assets/pdf_file/0018/113265/EBODE_1stMtg.pdf
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ExampleExample HIA HIA traffictraffic relatedrelated burdenburden of of diseasedisease
beforebefore and and afterafter introductionintroduction of 80 km speed limit of 80 km speed limit
0
100
200
300
400
500
600
700
800
900
Before After Before After Before After
Road traffic noise Traffic-related airpollution
Traffic accidents
DA
LY
s (
abso
lute
)
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ExampleExample eHIAeHIA and and spatialspatial distributiondistribution
DALYs air pollution highways
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Integrated Environmental Health Impact Assessmenthttp://www.integrated-assessment.eu/
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Impact pathway
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Example of integrated risk assessment: Traffic circulation plan, the Hague
Traffic
model
dose -response functions
Noise model
Physical
activity
model
Air quality
model
Health
outcome
Accident
model
Traffic circulation
plan
Monetary
valuation
environmental
equity analyses
population data
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Overall Health Impact of VCP, The Hague
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Change in situation per income categoryNoise Income level Low
<1400 euro p.m.
Middle 1400-2100 euro p.m.
High >2100 euro p.m.
Total
Noise situation… - Improves 19 52 63 44 - No difference 5 0 1 2 - Declines 77 48 36 54 NO2 Income level Low
<1400 euro p.m.
Middle 1400-2100 euro p.m.
High >2100 euro p.m.
Total
NO2 situation… - Improves 20 56 62 46 - No difference 5 7 10 7 - Declines 75 37 28 47
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Knowledge and information projects & systems
– The-PEP
– Atlas Living Environment
– Healthy design Guide
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The-PEP: toolbox on transport,environment & health
EVIDENCE BRIEFINGSon key issues transport
KEY MESSAGES: what works?
Links toPROJECTS AND TOOLSe.g. HIA , CBA, Checklists
National, regional, local perspectivesuser workshops
PROMISING PRACTICESselected on positive health impacts
THE PEP CLEARING HOUSE
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Healthy Design Guide
● Product of several ministries
● Tool for professionals to create a healthy, liveable environment
● For policymakers, (urban) planners, architects, health and other professionals
● Healthy design in relation to sports and playgrounds; green space, adaption to climate change, water; indoor environment; public space; environmental pollution; and healthy transportation
● Contains practical tips, inspiring examples, organizations, instruments and tools, and background information
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Examples of eHIA tools
Qualitative tools:
– Health in spatial planning
– Database eHIA tools ‘Healthy plans’
Quantitative tool:
– HEAT-CO
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Health in spatial planninghttp://rivm.ibase.info/isurveyuk/
– Online guide to systematically screen possible broad health impacts in the initial
phase of a spatial plan process
– An instrument that promotes discussion among initiators on possible health
effects
– An information source on broad determinants of health:
* classic environmental health indicators (e.g. noise, air and water pollution)
* social determinants: Income, age distribution, work, education,
* life styles: Sport and recreation
* access to health care
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HEATCO
http://heatco.ier.uni-stuttgart.de● Developing Harmonised European Approaches for Transport Costing
and Project Assessment 2004-2006
● Results/ products:
– a set of harmonised guidelines for project assessment and transport costing on the EU level;
– convergence of national guidelines;
– surveys for selected impacts;
– contingent-valuation studies for valuing noise annoyance and travel time changes;
– case studies on major European transport infrastructure projects.
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