Towards integration and differentiation in environmental health risk governance. An international comparative quick-scan of policies

Over the past decades several shifts can be identified in the field of environmental health risk reduction policies in the Netherlands. In response to the shortcomings of traditional sector-based (environmental) policy, the government has proposed a new approach to deal with health risks that encourages an integrated as well as differentiated approach. This implies an increased desire to enhance cross-sectoral and stakeholder negotiations and achieve greater transparency, take levels of attainability and area -based factors into consideration, and assess the cumulative impact of risks. There is also a strong drive to incorporate cost-benefit assessment and public perception as part of the ‘concern’ assessment in decision-making practices alongside quantitative risk estimates of physical effects. Although some progress has been made in moving towards this new ‘rational’ mentality, it appears that there are still several obstacles in governmental decision -making that need to be overcome (e.g. relating to risk appraisal and the assessment of stakeholder opinions). In the light of recent trends observed in the Dutch context – and the associated problems experienced – it was chosen to conduct an international evaluation of various national approaches to environmental health risk reduction policies, in order to assess whether similar trends (and possible solutions) can be seen elsewhere. The 12 countries included (the United States, Australia and ten nations in different parts of Europe) were evaluated on the basis of a set of indicators that can be used to measure integration and differentiation. In general, this study demonstrates that countries are indeed showing similar shifts in integrated and differentiated risk assessment and risk governance to those witnessed in the Netherlands, although several of these changes are still in the initial phases and could therefore be developed further. A lack of scientific and other data, difficulties in weighing diverging sectoral ambitions, the quantification of health risks, budgetary constraints and insufficient communication (between risk assessors and risk managers; amongst different sectors, and with stakeholders) were mentioned as the primary barriers for implementation of more targeted and differentiated health risk reduction strategies. Most countries also expressed a desire for a more coherent and standardised approach to tackling environmental health risk. This paper therefore outlines the main trends in environmental health risk reduction at the international level, brings forward several elements that could form part of a new approach to risk, and gives some advice for future research. The study should be seen as a quick-scan and should therefore not be considered comprehensive as such