Integrative policy development for healthier people and ecosystems: A European case analysis
Integrative policy development for healthier people and ecosystems: A European case analysis
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DOI：
10.1111/area.12618
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发表时间：
2020-04
期刊：
影响因子：
2.2
通讯作者：
P. White;J. Guégan;H. Keune;S. de Bell;I. Geijzendorffer;Tia Hermans;A. Prieur‐Richard;C. Iroegbu;Dave Stone;S. Vanwambeke;S. Vries;Adriana E. S. Ford;H. Graham
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文献类型：
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作者：
P. White;J. Guégan;H. Keune;S. de Bell;I. Geijzendorffer;Tia Hermans;A. Prieur‐Richard;C. Iroegbu;Dave Stone;S. Vanwambeke;S. Vries;Adriana E. S. Ford;H. Graham
越来越多的证据表明，生态系统与公共健康之间存在相互关系。这为制定跨部门政策和干预措施创造了机会，为公共卫生和自然环境带来双重好处。国家和区域一级的战略文件越来越多地阐述了这些好处，但综合政策在实地的执行仍然有限和分散。在这里，我们使用研讨会的方法来确定一些特征的基础上，在一些西欧国家的政策和实践的证据实施差距。最近采取的一些更加综合性的政策制定和执行行动背后的驱动力表明，各国之间存在重大差异，反映了决策过程的非线性和复杂性。我们使用这些案例研究来说明一些政策分析文献中确定的更大的一体化政策发展的关键障碍。我们发现的具体障碍包括：制度障碍;公共卫生和生态系统管理的时间观不同;对比公共卫生和自然环境学科政策议程的历史发展;将自然环境投资与公共卫生效益联系起来的证据库不完整;缺乏适当的结果措施，包括效益-成本权衡;最后，缺乏跨卫生和自然环境部门的综合政策框架。我们还确定了加强政策一体化的机会和不同国家的良好做法范例。然而，我们注意到，没有一个单一的机制可以在所有国家和所有情况下为更健康的人民和生态系统提供综合政策。国家政府、国家公共机构、地方政府、研究机构和专业机构都有责任确定和抓住影响政策变化的机会，无论是渐进的还是突然的，以确保生态系统和社会健康得到管理，从而保护子孙后代和当代人的利益。
There is growing evidence of the interrelationships between ecosystems and public health. This creates opportunities for the development of cross-sectoral policies and interventions that provide dual benefits to public health and to the natural environment. These benefits are increasingly articulated in strategy documents at national and regional level, yet implementation of integrative policies on the ground remains limited and fragmented. Here, we use a workshop approach to identify some features of this evidence-implementation gap based on policy and practice within a number of western European countries. The driving forces behind some recent moves towards more integrative policy development and implementation show important differences between countries, reflecting the non-linear and complex nature of the policy-making process. We use these case studies to illustrate some of the key barriers to greater inte-grative policy development identified in the policy analysis literature. Specific barriers we identify include: institutional barriers; differing time perspectives in public health and ecosystem management; contrasting historical development of public health and natural environment disciplinary policy agendas; an incomplete evidence base relating investment in the natural environment to benefits for public health; a lack of appropriate outcome measures including benefit-cost trade-offs; and finally a lack of integra-tive policy frameworks across the health and natural environment sectors. We also identify opportunities for greater policy integration and examples of good practice from different countries. However, we note there is no single mechanism that will deliver integrative policy for healthier people and ecosystems in all countries and situations. National governments, national public agencies, local governments, research institutions, and professional bodies all share a responsibility to identify and seize opportunities for influencing policy change, whether incremental or abrupt, to ensure that ecosystems and the health of society are managed so that the interests of future generations, as well as present generations, can be protected.