Models of environmental health indicators

Models of environmental health indicators
Dr.Ahmed-Refat AG Refat Community Medicine Dept. FOM-ZU APRIL 2016 Environmental Health Indicators Models
www.SildeShare.net/AhmedRefat2 Environmental Health Indicators Models “Indicators are a way of seeing the big picture by looking at a small piece of it” (Environment Canada, 2001). Ahmed-Refat April 2016
www.SildeShare.net/AhmedRefat3 Contents  Definitions , uses and types of indicators  Features of the good indicator  Limitations of indicators  Conceptual Frameworks for Indicators  PSR –Model  DSR –Model  DPSIR –Model  DPSEEA –Model  MEME –Model
PART- I ********* INDICATORS DEFINITIONS AND CONCEPTS www.SildeShare.net/AhmedRefat4
www.SildeShare.net/AhmedRefat5 It is estimated that about 23% of the world’s total DALY burden is associated with environmental factors.
www.SildeShare.net/AhmedRefat6 There are links between development, health and the environment.
Complex Interrelated Links www.SildeShare.net/AhmedRefat7
www.SildeShare.net/AhmedRefat8 Indicators were developed to measure the complex relations among environment , development and health issues
Definitions www.SildeShare.net/AhmedRefat9
Definitions www.SildeShare.net/AhmedRefat10 https://stats.oecd.org/glossary/detail.asp?ID=830
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Definitions www.SildeShare.net/AhmedRefat12 Indicator Index Parameter Health Indicator Environmental Health Indictor
Indicator www.SildeShare.net/AhmedRefat13 A key statistic that indicates or points to another measure.
Indicator www.SildeShare.net/AhmedRefat14 “A summary measure that aims to describe - in a few numbers as much detail as possible- about a system to help understand, compare, predict, improve, and innovate.” DEF + USES !!!!!
Definition & Terminology www.SildeShare.net/AhmedRefat15 Indicator: A parameter, or a value derived from parameters, which points to, provides information about, describes the state of a phenomenon/ environment/area, with a significance extending beyond that directly associated with a parameter value.
Definition & Terminology www.SildeShare.net/AhmedRefat16 Index A set of aggregated or weighted parameters or indicators.
Definition & Terminology www.SildeShare.net/AhmedRefat17 Parameter A property that is measured or observed..
Health Indicator www.SildeShare.net/AhmedRefat18 Health indicator are … summary measures that are designed to describe particular aspects of health or health system performance.
Environmental Health Indicator www.SildeShare.net/AhmedRefat19 An expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form, which facilitates interpretation for effective decision making”
Related Terms www.SildeShare.net/AhmedRefat20 Leading Indicator Lagging Indicator Proxy Indicator Hybrid Indictor Composite & Compound Indictor Indicator’s Typology  Metrics of Indicators
Leading indicators www.SildeShare.net/AhmedRefat21 Leading indicators are associated with proactive activities that identify hazards and assess, eliminate, minimize and control risk
Leading indicators www.SildeShare.net/AhmedRefat22  Before-the-fact indicators.  Activities indicators  Upstream indicators  Inputs indicators  Do not reach the threshold of causality to create an incident  Measure safety-relevant activity, not safety per se
Leading indicators www.SildeShare.net/AhmedRefat23 are conditions, events or measures that precede an undesirable event and that have some value in predicting the arrival of the event, whether it is an accident, incident, near miss or undesirable safety state.
Lagging indicators www.SildeShare.net/AhmedRefat24 Also known as Outcome indicators, Down-stream , and After-the-fact indicators .
Lagging indicators www.SildeShare.net/AhmedRefat25 Measure the extent of harm that has occurred ( Past performance - Reactive) Provide historical information about health and safety performance . Measure unexpected failures occurring in normal operations . Measure real failed … outcomes
Proxy Indicator www.SildeShare.net/AhmedRefat26 Sometimes, it is too hard to get data for an indicator. That indicator can be replaced with another easier-to-obtain one that gets close to what we’re interested in. The alternate measure serves as a proxy /a “stand-in”. Example : uses school absenteeism as a proxy for (possible) influenza outbreaks.
Hybrid Indicators www.SildeShare.net/AhmedRefat27 Exposure-effect indicators Combine information on the outcomes and their determinants. Examples : ‘incidence of work accidents due to falling’ ‘incidence of occupational diseases due to exposure to asbestos’.
Simple vs Composite Indicators www.SildeShare.net/AhmedRefat28 A simple (non-composite) indicator summarizes information only on one aspect of the phenomena under study. A composite indicator summarizes information on related simple indicators describing the same phenomena. = index
Simple vs Compound Indicators www.SildeShare.net/AhmedRefat29 Simple ind. Ind.target a specific element of the system.eg Hospital admissions for acute respiratory infs. Compound ind., Inds. that combine different elements into a single measure. Example : overall air quality index - obtained by combining concentrations of particulates, nitrogen oxides, benzene and ozone).
Typology OF Env. Indicators www.SildeShare.net/AhmedRefat30 Type A Descriptive indicators Type B Performance indicators Type C Efficiency indicators Type D Total welfare indicators THE EUROPEAN ENVIRONMENT AGENCY (EEA)
www.SildeShare.net/AhmedRefat31 Type A Descriptive indicators - what is happening to the environment or human health, (e.g., emissions and concentrations of pollutants) Typology OF Env. Indicators
www.SildeShare.net/AhmedRefat32 Type B Performance indicators linked to a reference value or policy target, illustrating how far the indicator is from a desired level are is increasing Typology OF Env. Indicators
www.SildeShare.net/AhmedRefat33 Type C Efficiency indicators illustrating the efficiency of production and consumption processes, for example energy consumption per unit of output Typology OF Env. Indicators
www.SildeShare.net/AhmedRefat34 Type D Total welfare indicators which aggregate together economics, social and environmental dimensions to illustrate whether, overall, welfare is increasing Typology OF Env. Indicators
www.SildeShare.net/AhmedRefat35 Metrics can be of three types: • Descriptive – a condition measured at a certain point in time • Threshold – compares data from descriptive metric to tolerance levels • Trended – change in descriptive metric over time Metrics OF Indicators
Uses of health indicators www.SildeShare.net/AhmedRefat36 Indicators quantify information so its significance is more readily apparent; Indicators simplify information about complex phenomena to improve communication
Uses of health indicators www.SildeShare.net/AhmedRefat37 1. Indicators are used to support planning (identify priorities, develop and target resources, identify benchmarks) and track progress toward broad community objectives 2. Indicators are powerful tools for monitoring and communicating critical information about population health. 3. .
Uses of health indicators www.SildeShare.net/AhmedRefat38 3. Engagement of partners into a collaborative action (build awareness of problems and trends, generate interventions). 4. Inform policy and policy makers, and can be used to promote accountability among governmental and non- governmental agencies.
Database of Environ & PH Indicators www.SildeShare.net/AhmedRefat39 International Roles in Metrics Development
Database of Environ & PH Indicators www.SildeShare.net/AhmedRefat40  World Health Organization (WHO)  The United Nations (UN)  TheWorld Bank (WB)  Organization for Economic Cooperation and Development (OECD)  United Nation’s Children’s Fund (UNICEF)  Food and Agriculture Organization (FAO)  United States Environmental Protection Agency (USEPA)  World Resources Institute (WRI)  Worldwatch Institute  International Institute for Sustainable Development (IISD).  Pan American Health Organization (PAHO)
Database of Environ & PH Indicators www.SildeShare.net/AhmedRefat41 WHO Classification  Health Status Indicators: Mortality Health Status Statistics: Morbidity Health Services Coverage Statistics Risk Factors Statistics Health Systems Statistics http://www.who.int/whosis/indicatordefinitions/en/index.html
Database of Environ & PH Indicators www.SildeShare.net/AhmedRefat42 
Database of Environ & PH Indicators www.SildeShare.net/AhmedRefat43 EC Classification 88 Indicator  Demography and socio-economic situation  Health status  Determinants of health  Health interventions: health services  Health interventions: health promotion
The Organization for Economic Co- operation and Development (OECD) www.SildeShare.net/AhmedRefat44 OECD has developed: 1.Core environmental In. 2. Key environmental In. 3.Sectoral environmental In.
The Organization for Economic Co- operation and Development (OECD) www.SildeShare.net/AhmedRefat45
OECD set of key environmental indicators www.SildeShare.net/AhmedRefat46
The Organization for Economic Co-operation and Development www.SildeShare.net/AhmedRefat47 1.core env. indicators – a set of 50 indicators designed to track environmental progress and analyze performance of environmental policies in OECD member countries
The Organization for Economic Co-operation and Development www.SildeShare.net/AhmedRefat48 2. key env.indicators - a subset of Core environmental indicators that inform the public and provides key signals to policy makers on important environmental issues and trends
The Organization for Economic Co-operation and Development www.SildeShare.net/AhmedRefat49 3.sectoral env.indicators – a set of indicators intended to help integrate environmental concerns into sectoral policies, such as transportation, energy, and agriculture.
UN-CSD www.SildeShare.net/AhmedRefat50 UN Commission on Sustainable Development (UN CSD) Has developed indicators of sustainable development (A set of 58 Indicators)
UN-CSD www.SildeShare.net/AhmedRefat51 UN CSD developed a "theme based Ind. ” 1.social, 2.environmental, 3.economic, and 4. institutional Each of these four themes is broken down into sub-themes and associated indicators
WBDI www.SildeShare.net/AhmedRefat52 World Bank Development Indicators (WBDI) more than 900 indicators in over 80 tables organized in 6 sections:
World Bank Development Indicators (WBDI) www.SildeShare.net/AhmedRefat53 Sections ofWBDI : 1. world view; 2. people; 3. environment; 4. economy, 5. states and markets; 6. and global links.
Indicator’s Limitations www.SildeShare.net/AhmedRefat54 No indicator tells us all we need to know  We cannot develop indicators for everything To be effective, information must be selective (target the key issues and communicate concisely)
www.SildeShare.net/AhmedRefat55 The Global Reference List of 100 Core Health Indicators
www.SildeShare.net/AhmedRefat57 The Global Reference List of 100 Core Health Indicators is a standard set of 100 indicators prioritized by the global community to provide information on the health situation and trends, including responses at national and global levels.
Criteria for Selecting health Indicatorswww.SildeShare.net/AhmedRefat60
7 Core Quality Criteria www.SildeShare.net/AhmedRefat61 1. Policy relevance 2. Availability of data 3. Simplicity 4. Sensitivity 5. Specificity. 6. Validity 7. Reliability
MORE Quality Criteria www.SildeShare.net/AhmedRefat62
www.SildeShare.net/AhmedRefat63  Credible—based on a known link between climate and health  Relevant to an issue of policy or practical concern  Sustainable—able to provide data for the next 20–30 years  Consistent and comparable over time and space  Scalable—capable of being used at different scales  Robust and unaffected by minor changes in methodology, scale or data  Unbiased and representative of the conditions and area of concern  Explicit—identify specific adaptation responses  Accurate—based on data of a known and acceptable quality  Understandable, applicable, and acceptable to stakeholders and potential users  Measurable—based on available data and manageable methods with retrospective data available to provide a baseline, against which change can be measured  Cost-effective—capable of being constructed and used at an acceptable cost- benefit ratio  Selective—in that they help to prioritize key issues in need of action
PART II ********* Conceptual Models “Frameworks” www.SildeShare.net/AhmedRefat64
Framework www.SildeShare.net/AhmedRefat66 a hypothetical description of a complex process
Conceptual Models www.SildeShare.net/AhmedRefat67 Conceptual models are useful tools for issue framing and to communicate complex relationships to a wider, non-specialist audience.
Commonly used frameworks www.SildeShare.net/AhmedRefat68 Project-based framework (the Input-Output-Outcome- Impact framework), A framework based on environmental issues or themes.
Conceptual Models vs logical frameworks www.SildeShare.net/AhmedRefat69 A logical frameworks only provides a hierarchical description of a project’s activities ,whereas a conceptual model often represents the entire system, including connections not being addressed through a project.
A project-based framework www.SildeShare.net/AhmedRefat70
Indicators Framework www.SildeShare.net/AhmedRefat73 A conceptual framework is needed to: Structure diverse env. information Make it more comprehensible to decision makers and the general public. Reveal data gaps, thus guiding data collection .
www.SildeShare.net/AhmedRefat74 The advantages of using LFA  It guides systematic and logical analysis of the interrelated key elements of the environmental health issues .  It provides a better basis for planning , systematic monitoring and analysis of the environmental health issues.  It facilitates common understanding and better communication between decision-makers, managers and other parties involved in the issue.  It provides standardized procedures for collecting and assessing information.  Widespread use of the LFA format makes it easier to undertake both sectoral studies and comparative studies in general..
Common Environmental Health Models / Frameworks75 www.SildeShare.net/AhmedRefat
www.SildeShare.net/AhmedRefat76 Common Environmental Health Frameworks 1. E.PH.I Framework…….. .(CDC) 2. P.S.R Framework …......(OECD) 3. D.S.R Framework ……..(UN ) 4. D.P.S.I.R Framework…..(EU) 5. D.P.S.E.E.A Framework. (WHO – Env Health) 6. M.E.M.E Framework (WHO-Child Env Health)
www.SildeShare.net/AhmedRefat77 Environmental Health Frameworks 1-CDC Hz.Ex.He.I. Model
www.SildeShare.net/AhmedRefat78 Hazard indicators Exposure indicators Health effect indicators Intervention indicator CDC-EPHI- Types of indicator
CDC-EPHI- Types of indicator www.SildeShare.net/AhmedRefat79 Hazard indicators: Conditions or activities that identify the potential for exposure to a contaminant or hazardous condition.
www.SildeShare.net/AhmedRefat80 Exposure indicators: Biologic markers in tissue or fluid that identify the presence of a substance or combination of substances that could harm an individual. CDC-EPHI- Types of indicator
CDC-EPHI- Types of indicator www.SildeShare.net/AhmedRefat81 Health effect indicators: Diseases or conditions that identify an adverse effect from exposure to a known or suspected environmental hazard. CDC-EPHI- Types of indicator
CDC-EPHI- Types of indicator www.SildeShare.net/AhmedRefat82 Intervention indicator: Programs or official policies that minimize or prevent an environmental hazard, exposure, or health effect. CDC-EPHI- Types of indicator
www.SildeShare.net/AhmedRefat83 The tier suggests the importance of the indicator with respect to policy or program considerations. Tiers include : Core, Optional, and Developmental measures. Tiers of indicator
www.SildeShare.net/AhmedRefat84 A core indicator should be included in a state health department’s basic environmental public health surveillance program. Measurements for these indicators may be available or could be made readily available Tiers of indicator - Core Indicators
www.SildeShare.net/AhmedRefat85 An optional indicator  may be part of a basic environmental public health program for some states, depending on individual needs, priorities, and data availability.An indicator in the optional tier must have at least one optional measure but can also have developmental measures.When a core measure is identified, the indicator will change from optional to core. Tiers of indicator - Optional Ind
www.SildeShare.net/AhmedRefat86  Developmental:A developmental indicator or measure is one that may have environmental public health relevance, but the measurements either have not yet been established or pose significant interpretation challenges.An indicator in the developmental tier can have only developmental measures. If optional or core measures are identified, the indicator will be reclassified. Tiers of indicator - Developmental ind
www.SildeShare.net/AhmedRefat87  Topics  Air,Ambient (Outdoor)  Air, Indoor  Disasters Lead (Pb)  Noise  Pesticides  Sentinel Events Sun and Ultraviolet Light  Toxics andWaste  Water,Ambient  Water, Drinking Topics of indicator
www.SildeShare.net/AhmedRefat88 2- OCED P.S.R Model Environmental Health Frameworks
PSR Model www.SildeShare.net/AhmedRefat89 Pressure-State-Response Framework PSR- framework was developed in 1993 by the Organization for Economic Co-operation and Development
PSR Model www.SildeShare.net/AhmedRefat90 Three angles of environmental issues. Based on a concept of causality
www.SildeShare.net/AhmedRefat91 The PSR framework is based on a concept of causality:  Human activities exert pressures on the environment and change its quality and the quantity of natural resources (the "state”)  Society responds to these changes through environmental, general economic and sectoral policies (the "societal response").
www.SildeShare.net/AhmedRefat92 Pressures (mainly from human activities), which cause changes in the State of the environment, and in turn led to policy Responses.
PSR: Application examples from OECD www.SildeShare.net/AhmedRefat94
WASTE: www.SildeShare.net/AhmedRefat95
Issue : OZONE LAYER DEPLETION www.SildeShare.net/AhmedRefat96
Issue : Air Quality www.SildeShare.net/AhmedRefat97
PSR & Environmental Issues www.SildeShare.net/AhmedRefat98
www.SildeShare.net/AhmedRefat99 Sectors&PSR , Env. Issues
www.SildeShare.net/AhmedRefat100 A development of the P.S.R framework . Adopted by the UN Commission on Sustainable Development. 3-D. S. R Model
www.SildeShare.net/AhmedRefat101 Driving Force State Response D. S. R Model
D.S.R Model www.SildeShare.net/AhmedRefat102 Driving Force-State-Response Framework  Driving force—human activities, processes, and patterns that impact on sustainable development;  State—the ‗state‘ of sustainable development;  Response—policy options and other responses to changes in sustainable development.
D.S.R Model www.SildeShare.net/AhmedRefat103 Driving Force-State-Response Framework  The term “pressure” is replaced with ‗driving force‘ to accommodate more accurately the addition of social, economic, and institutional indicators.  The term -driving force‘ also allows for the impact on sustainable development to be positive or negative as is often the case for social, economic, and institutional indicators
4- D.P.S.I.R Model www.SildeShare.net/AhmedRefat104 Driving Force Pressure State Impact Response
DPSR Frame work www.SildeShare.net/AhmedRefat105
D.P.S.I.R Model www.SildeShare.net/AhmedRefat107 Driving Force-Pressure-State- Impact-Response Framework A further development of the PSR and DSR frameworks is the European Union-developed DPSIR framework, which provides an overall mechanism for analyzing environmental problems.
D.P.S.I.R Model www.SildeShare.net/AhmedRefat108 Driving Force-Pressure-State-Impact- Response Framework Driving forces —such as industry and transport, produce; Pressures —on the environment, such as polluting emissions, which then degrade the; State —of the environment, which then; Impact —on human health and ecosystems, causing society to RESPOND;
www.SildeShare.net/AhmedRefat110 5-WHO D.P.S.E.E.A Model Environmental Health Frameworks
5- D.P.S.E.E.A FRAMEWORK www.SildeShare.net/AhmedRefat111 -Driving Force -Pressure -State -Exposure -Effect -Action
DPSEEA FRAMEWORK www.SildeShare.net/AhmedRefat115 -In the early 1990s the WHO developed a framework that incorporates transparent linkages between various one- dimensional environment or health indicators and places the focus on public health
DPSEEA FRAMEWORK www.SildeShare.net/AhmedRefat116 covers the full spectrum of potential forces and resulting actions and brings together professionals, practitioners, and managers from both environmental and public health fields to help orient them in the larger scheme of the problem.
6-M.E.M.E FRAMEWORK www.SildeShare.net/AhmedRefat117 The Multiple Exposures-Multiple Effects framework  is a further development of the DPSEEA framework for use in the context of children‘s environmental health.  This framework emphasizes the complex relationships between environmental exposures and child health outcomes
Quizes www.SildeShare.net/AhmedRefat119 By Using DPSEEA Model What is the position ( in DPSEEA model ) of each indicator in the following lists
THANK YOU www.SildeShare.net/AhmedRefat130

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