Comparative public policy. Health, transport and the environment. Does European and UK policy support effective joint action?

Abstract

Background: There is growing recognition of the importance of links between health, transport and the environment. Complex interrelationships demand effective intersectoral collaboration and community participation and policy should therefore support this. The UK has a number of key policy documents representing public health, environmental health and transport perspectives. The purpose of this review is to assess how well these policies are integrated and the extent to which joint action and participation are supported. Review: Reviewing global and European influences on UK policy identifies two main themes: the new public health agenda arising from the Health for All (HFA) Strategy and a more traditional environmental health approach. However, there are fundamental aspects in common, in particular the underlying theme of sustainable development. To date, public health and environmental health ‘traditions’ have been inadequately integrated. This is demonstrated in a number of ways, including approaches to implementation, the choice of indicators and targets and a general failure to define the roles that different sectors can best play in tackling transport, environment and health issues. The revised national health strategy, ‘Our Healthier Nation’, places emphasis on local planning through interagency partnership and joint responsibilities, but it remains to be seen how well this will work in practice. Conclusions: Recent years have seen convergence of environmental and public health policies, but further integration is required. National policy could do more to facilitate explicitly local joint action and community participation. Because of the influence that environment and transport issues have on health, national health strategy has a particularly important part to play in achieving this.