In Search for the Value of Connectivity: Accountable Citizens Fostering Accountable Governance via Connectivity: The Case of Environmental Health Policies

Abstract

This article rises from the consideration that the increasing connectivity of our urban communities is changing how citizens participate to their city's governance. This renovated participation brings about a new way of conceiving the citizenship, as an accountable citizenship, willing to participate to the governance of the city via new technological channels. The citizens are becoming able to track, monitor, and assess the compliance of policy-makers with their needs, reflected in their data. They demand an accountable governance, a policy-making that takes into account the inputs deriving from the grassroots, often manifested under the form of data sharing. At the same time, the citizens are controlled by the city's smart apparatus. This occurs through thousands of connected devices pervading our cities and our bodies. The data collected by these smart devices is increasingly crucial in orienting certain public policies. I take the case of environmental health policies. My first aim is to understand whether data derived from the city environmental monitoring could be analysed in combination with this crowd sourced medical data, in order to investigate the link between environmental factors and human conditions. The question here is what degree of coupling between these two sets of data is appropriate in order to better direct the city's environmental health governance. My second aim is to assess citizens' contribution in researching the impact of environmental factors on human health. I focus on real examples of citizens' engagement by analysing their involvement in reporting environmentally caused/exacerbated ailments and diseases via eHealth/mHealth systems (e.g. apps, and wearable devices). Nowadays, environmental factors are recognized to be a root cause of a significant burden of global diseases, especially in urban areas. These same urban areas are becoming more and more smart, which should mean a city that implements advanced technologies to positively impact on local community. Moreover, this benefit should be achieved through participatory actions of the smart city's dwellers. However, this is scarcely the case. The urgency of studying health data and environmental parameters in combination, and to engage the civil society in this process is evident. Starting from the aforesaid considerations, I investigate the opportunity of combining individuals' eHealth/mHealth systems with the smart environmental monitoring systems installed in the city. I wonder whether this combination of systems and datasets could be performed through the active participation of the citizens/users of the ubiquitous devices pervading our cities. Subsequently, I assess whether this participatory data collection can push the governments to take into consideration citizens' input when formulating policies, favouring a preventive approach in environmental health governance. Furthermore, I investigate how to guarantee that the incorporation of IoT in the city does not result in an excessive of the state on individuals, masked under the common good. Ultimately, I draw some recommendations aimed to build a regulatory framework enabling an effective participatory governance of public health challenges via health data sharing, safeguarding individuals' autonomy and privacy. The outcomes of my study can be summarized as follows: the interconnection between health and environmental data through citizens' engagement can foster an effective bottom-up governance of environmental health issues. However, many challenges have to be overcome, namely technical (shortage of interoperable devices and shared databases), legal (the potential threats to citizens' privacy), social (the citizens' delegation attitude, the barriers faced by non-users), and governmental (the reluctance of the state to engage citizens in policies, the difficulty to control the controllers, the risk of capture by commercial suppliers).