DEVELOPING POLICIES FOR A HEALTHY ENVIRONMENT

The health of a population is largely determined by factors outside th e jurisdiction of health ministries and health services. Although it i s widely recognised that policies in 'non-health' areas need to take h ealth into account, it is nuclear how this should best be achieved. Th e analogous problem, of laking environmental criteria Into account in general policy implementation, is addressed by preparing an Environmen tal Impact Statement (EIS) on projects such as the building of a new p ower station or a motorway. This is a legal requirement in mast countr ies, at least for major projects. Although health ir mentioned in most of the legislation, in practice health impacts are rarely systematica lly included. It is suggested that, in future, EISs should include hea lth impacts, and that in other situations where an EIS is not appropri ate, mt analogous process should be carried out to examine health effe cts. This would be more appropriate if carried out at a higher level t han specific projects, and at rm earlier stage, in the formulation of policies, programmes or plans. Quantitative health risk assessment is a necessary part of the process. The starting point should be a list o f possible options for addressing an identified health need: a multidi sciplinary statement should be prepared, that includes economic and so cial impacts, ecological analysis, and issues of public information an d consultation, as well as technical and scientific issues.