29 December 2010

Health 2020 - new World Health Organization Europe Initiative

International experts in public health met on 14 October 2010 to map out the broad goals and targets of the new European health policy, HEALTH2020, at a meeting in Copenhagen, Denmark.

Discussion focused on four key questions.
  • What is today’s context for health policy in a fast-changing Europe?
  • What is the scope of the policy, including its target audiences and main products?
  • What values, guiding principles and evidence base should support HEALTH2020?
  • What process should be used to develop the policy, which includes involving partners and identifying key milestones?

The policy is being developed to accelerate progress towards achieving the European Region’s health potential by 2020 by addressing key public health and health policy challenges. WHO/Europe seeks to engage and consult with a diverse range of stakeholders to ensure that a spectrum of views informs the development of the policy and can sustain it in the longer term.

A draft policy framework is expected to be presented at the next meeting of the WHO Regional Committee for Europe in 2011, and finalized in 2012.

Health 2020 aims to confirm the underlying values and principles, and provide for an integrated and consistent framework to address the recent challenges to health and health equity in Europe.

A new study on health inequalities in Europe will provide a basis for this health policy. This study will analyze the social determinants of health, in particular as they affect the health divide in Europe, as well as the social gradient in societies, vulnerable population groups, gender and the impact of all these aspects on health policies and actions by governments. It will also address all the other determinants of health, such as lifestyles, the environment and climate change, and food safety.

see WHO Europe news item

see Zsuzsanna Jakab, WHO Regional Director for Europe's speech and presentation on Health 2020 at the World Health Summit

Courtesy of the European Public Health Alliance

24 December 2010

Research Priorities for Assessing Health Effects from the Gulf of Mexico Oil Spill: A Letter Report

The US National Academy of Sciences has just reported back on what they consider are the key research priorities and issues that need to be taken forward in relation to oil spills and human health.

Click here to go to the page and download a free pdf of the report (after registering).

The 5 research priorities they identified are:

Research priority 1
Evidence about the psychological and behavioral effects of the Gulf of  Mexico oil spill. Policymakers and health officials can use such evidence to guide efforts to improve the health status of individuals affected by the Gulf of Mexico oil spill, as well as contribute to the prevention and treatment of similar health outcomes in future disasters. The research should identify factors associated with either vulnerability or resilience to situations such as oil spills and other disasters.

Research priority 2
Obtaining information that is as comprehensive as possible about exposure to the oil, dispersants, and by-products of the controlled burns.

Research priority 3
Assessing seafood safety in both the near term and long term and clearly communicating results to the affected communities.

Research priority 4
Research to evaluate and compare communication and engagement methods to determine which are the most effective for disaster and disaster-preparedness research.

Research priority 5
Research on the framework needed to deploy a rapid research response for future oil spills and other potential disasters.

Image courtesy of Wikipedia from an original NASA photo. Click here to go to the Wikipedia page.

21 December 2010

Converting streets into running tracks: 'Ready Steady Go'

'Ready. steady. go!', is an installation by austrian architects Sandra Janser and Elisabeth Koller which is meant to provide a visual frame within the Jakomini district of Graz, Austria.

The intention of the project is to define the streets of jakoministra├če and klosterwiesgasse, by marking them as a significant design area within the city.

Check out more photos and details at Designboom by clicking here.

19 December 2010

Real world reviews: a beginner’s guide to undertaking systematic reviews of public health policy interventions

Very interesting article  in the Journal of Epidemiology and Community Health on undertaking useful systematic reviews when time and resources are limited.

My Favourite Quotes:

Systematic reviews are interested in locating and synthesising the ‘best available evidence’(not all available evidence); this means that the hierarchy of
evidence does need to be applied albeit in a pragmatic way. 

‘Pragmatist’ systematic reviews therefore focus on a handful of ‘first-line’ health and social science databases, or supplement this with the use of a subject specialist one, while ‘purist’ systematic reviews have tended to search every available and potentially relevant electronic database.

The systematic review is becoming an increasingly popular and established research method in public health. Obtaining systematic review skills are therefore becoming a common requirement for most public health researchers and practitioners. However, most researchers still remain apprehensive about conducting their first systematic review. This is often because an ‘ideal’ type of systematic review is promoted in the methods literature.

This brief guide is intended to help dispel these concerns by providing an accessible overview of a ‘real’ approach to conducting systematic reviews. The guide draws upon an extensive practical experience of conducting various types of systematic reviews of complex social interventions.

The paper discusses what a systematic review is and how definitions vary. It describes the stages of a review in simple terms. It then draws on case study reviews to reflect on five key practical aspects of the conduct of the method, outlining debates and potential ways to make the method shorter and smarterdenhancing the speed of production of systematic reviews and reducing labour intensity while still maintaining high methodological standards.

There are clear advantages in conducting the high quality pragmatic reviews that this guide has described: (1) time and labour resources are saved; (2) it enables reviewers to inform or respond to developments in policy and practice in a timelier manner; and (3) it encourages researchers to conduct systematic reviews before embarking on primary research. Well-conducted systematic reviews remain a valuable part of the public health methodological tool box. 

16 December 2010

More scepticism about the value of HIA

"In the absence of more information and public policy debate, it is difficult to image how the HIA process can add any value beyond the current environmental process. As currently proposed the methodology and results are likely subjective, qualitative, and ultimately speculative. Neither is it likely that the HIA process will result in any additional mitigation beyond what the ports already provide given the extensive list of regulatory requirements and port adopted mitigation programs, such as the SPBCAAP (San Pedro Bay Clean Air Action Plan), and the WRAP (Water Resources Action Plan)."

A quote from the Vice President, Pacific Merchant Shipping Association in a news item in The Cunningham Report about the US Environmental protection Agency's work on considering whether HIA should also become part of the set of assessments undertaken by developers.

Click here to go to the news item.

While understanding his underlying frustration at onerous and burdensome regulations (as he sees them) particularly in its potential to block further development, given the earlier post on shipping and its emissions I guess I would have to agree to disagree on the value of HIA in such contexts as those listed above. Plus HIA looks for both the positives and negatives and in this context would show both the benefits and costs to human health of port developments e.g. employment, wider economic regeneration and development, air pollution, noise, etc.

12 December 2010

HIA of mining article: Of mines and men

A nice short article on the value of Health Impact Assessment in the context of mining projects in the Malaysian newspaper The Sun by Andrew MacKenzie of the International Council on Mining and Metals.

Click here to read the article.

My favourite quote:

"Companies should use health impact assessments with a simple goal in mind: to leave communities healthier than when they found them. A mine cannot be successful without a healthy local workforce and the support of the community in which it operates. Protecting the health of our neighbours around the world isn’t just good business. It’s also the right thing to do."
Disclosure: Salim led the writing of the ICMM 2010 guide on HIA. Click here to go to the ICMM HIA guide webpage.

Image courtesy of nanosmile through Wikipedia and the Wikimedia Commons.

9 December 2010

US National Health Policy Forum Session on HIA

On the 3rd December 2010, the National Health Policy Forum, at George Washington University had a seminar on "HIA: What, Why, How, Who, Where?"

Health Impact Assessments: What, Why, How, Who, Where?
Michele J. Orza, ScD (Coordinator)

Increasingly, a wide range of people from economists to epidemiologists are taking a broad-based, comprehensive approach to improving the public’s health and working on many fronts simultaneously.  An important means for implementing this approach, often characterized as "health in all policies," is the health impact assessment (HIA). These assessments are intended to bring a health focus to policies, programs, and projects in other sectors, such as agriculture, energy, and transportation, where the effects of the proposed action on health might not be adequately considered—or considered at all.  HIAs are a vehicle for supporting policymaking intended to advance the public's health by making explicit the health effects of the various alternatives under consideration.
This Forum session provided an introduction to health impact assessments, examined several examples and their effect on policy and health outcomes, and discussed future opportunities and challenges for this burgeoning health policy practice.


Aaron Wernham, MD, Director, The Health Impact Project, The Pew Health Group, The Pew Charitable Trusts;
Catherine L. Ross, PhD, Director, Center for Quality Growth and Regional Development, Harry West Professor, School of City and Regional Planning, Georgia Tech College of Architecture;
Suzanne K. Condon, MSM, Associate Commissioner for Health, Director, Bureau of Environmental Health, Massachusetts Department of Public Health

Slides from the presentations by Dr. Wernham, Dr. Ross, and Ms. Condon are available for download (click on the names).

Related materials:

The Health Impact Project brief "Health Impact Assessment: Bringing Public Health Data to Decision Making" was distributed at the session.

AcademyHealth also provides a brief, "Research Informing Policy: The Potential of Health Impact Assessments."

And the Centers for Disease Control and Prevention's web page on Health Impact Assessment provides basic background and links to a variety of resources.

See also other Forum products, including
"High Hopes: Public Health Approaches to Reducing the Need for Health Care" (Background Paper No. 78, September 27, 2010);
"Unusual Suspects: Focusing on Nonmedical Determinants to Improve the Nation's Health" (Forum Session, November 5, 2010); and
"Getting Real: Data Sources, the Evidence Base, and Strategies for Improving the Health of Communities" (Forum Session, September 24, 2010).

6 December 2010

Health impacts of shipping pollution have been 'underestimated'

This is an interesting Guardian article that I've only just come across on the underestimation of the health impacts of shipping (which of course ferries all the goods we want and need from oil and gas to electronics and food.

Read the full article by clicking here.


  • One giant ship can emit air pollution equivalent to 50 million cars.
  • US academic research shows that pollution from the world's 90,000 cargo ships leads to 60,000 deaths a year in the US alone and costs up to $330bn per year in health costs from lung and heart diseases. The US Environmental Protection Agency estimates the buffer zone [of 230 miles], which could be in place by next year, will save more than 8,000 lives a year with new air quality standards cutting sulphur in fuel by 98%, particulate matter by 85% and nitrogen oxide emissions by 80%.
  • Danish government environmental agency suggests that shipping emissions cost the Danish health service almost £5bn a year, mainly treating cancers and heart problems. A previous study estimated that 1,000 Danish people die prematurely each year because of shipping pollution.


  • The world's biggest container ships have 109,000 horsepower engines which weigh 2,300 tons.
  • Each ship expects to operate 24hrs a day for about 280 days a year
  • There are 90,000 ocean-going cargo ships
  • Shipping is responsible for 18-30% of all the world's nitrogen oxide (NOx) pollution and 9% of the global sulphur oxide (SOx) pollution.
  • One large ship can generate about 5,000 tonnes of sulphur oxide (SOx) pollution in a year
  • 70% of all ship emissions are within 400km of land.
  • 85% of all ship pollution is in the northern hemisphere.
  • Shipping is responsible for 3.5% to 4% of all climate change emissions

Courtesy of Slashdot.com

3 December 2010

Beauty is a part of healthy urban planning

One of the things I learned in medicine was that form follows function and that some of the most aesthetically elegant and beautiful biological objects, processes and organisms occur when physical biological structures are closely aligned to function.

Similarly, as a new report by  the UK Commission for Architecture and the Built Environment found, people want and need beauty in their physical environment - both built and natural. there is potentially innate aesthetic sensibility which is attracted to beautiful things (though these differ between individuals, communities and societies).

Check out the video and the series of essays and online discussions at the CABE website by clicking here or the links below.

Seven essays on beauty

Check out the other useful healthy urban planning related work of CABE at www.cabe.org.uk