International Conference of the Central and Eastern International Conference of the Central and Eastern European Chapter of the International Society for European Chapter of the International Society for Environmental Epidemiology, Environmental Epidemiology, Celadna, Czech Republic, 26-29 November 2007 Celadna, Czech Republic, 26-29 November 2007 Development of Environmental Development of Environmental Health Information System in Health Information System in Central and Eastern Europe Central and Eastern Europe Dafina Dalbokova Dafina Dalbokova World Health Organization World Health Organization Regional Office for Europe Regional Office for Europe On behalf of ENHIS project group On behalf of ENHIS project group
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International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, Celadna, Czech Republic,
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International Conference of the Central and Eastern European Chapter International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, of the International Society for Environmental Epidemiology,
Celadna, Czech Republic, 26-29 November 2007Celadna, Czech Republic, 26-29 November 2007
Development of Environmental Health Development of Environmental Health Information System in Central and Information System in Central and
Eastern EuropeEastern Europe
Dafina DalbokovaDafina Dalbokova
World Health OrganizationWorld Health Organization
Regional Office for EuropeRegional Office for Europe
On behalf of ENHIS project groupOn behalf of ENHIS project group
International Conference of the Central and Eastern European Chapter International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, of the International Society for Environmental Epidemiology,
Celadna, Czech Republic, 26-29 November 2007Celadna, Czech Republic, 26-29 November 2007
This presentation:
• Development of European EH Information System (ENHIS): highlights
• Assessment of children’s EH by CEHAPE RPG: situation in Central and Eastern Europe and need for a system
• Next steps and actions needed to advance the EH information system in Central and Eastern Europe
Development of Environmental Health Information System in Central and Eastern Europe
ENHIS – European EH information system: partners
The product of EC-DG Sanco co-sponsored projects: ENHIS (2004 - 5) (SPC2003112) ENHIS 2 (2005 - 7) (SPC2004124)
International process to develop EH Information System in International process to develop EH Information System in Europe, 2004-2007Europe, 2004-2007
Defining the scope of the system Covering four CEHAPE RPGs Focus on health related exposures, health effects and actions
ENHIS web: country profilesENHIS web: country profiles
WHO Environmental Burden of DieseaseWHO Environmental Burden of Diesease
(ENHIS):(ENHIS):
International Conference of the Central and Eastern European Chapter International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, of the International Society for Environmental Epidemiology,
Celadna, Czech Republic, 26-29 November 2007Celadna, Czech Republic, 26-29 November 2007
This presentation:
• Development of European EH Information System (ENHIS): highlights
• Assessment of children’s EH by CEHAPE RPG: situation in Central and Eastern Europe and need for a system
• Next steps and actions needed to advance the EH information system in Central and Eastern Europe
Development of Environmental Health Information System in Central and Eastern Europe
Non-traffic related injuries in early childhood: Over 75,000 deaths per year >10x disparities in death rates between MS Large differences between MS in causes – use info to focus risk reduction
Policies can reduce the risk
0% 20% 40% 60% 80% 100%
Greece*Estonia
United KingdomAustria
Sw eden*Sw itzerland**
Germany*Ireland*
SloveniaSpain*
KazakhstanBulgariaFinland
Italy*Croatia
RussianMalta
CzechiaUkraine
AzerbaijanArmeniaFrance**Portugal
Slovakia**RomaniaNorw ay*Albania*
LatviaRep.of Moldova
LithuaniaHungary
PolandGeorgia*Belarus*
TFYR Macedonia**Kyrgyzstan
Turkey*Uzbekistan**Netherlands
drow ning falls burns poisoning
CEHAPE RPG II: Injuries and physical activity by supportive and safe environments
Physical activity: Excess body weight & obesity: in 5% to 35% of children Over 50% of children not sufficiently active Policy implementation varies among countries
Degree of implementation of 12 policies to reduce excess body weight andobesity in children, 2005 - 2006
Current exposure to ETS contribute to an additional 10,380 asthma attacks in a city with 20,000 children aged 0-14 yrs and 3% of asthma prevalence and 300 asthma attacks per child x year
Decrease of lead exposure due to un- leaded fuels (but plumbing and local industries continue to be of concern)
POPs exposure – the lowest safety margins – monitoring is warranted
Dioxins in human milk
Pb in blood
Implications for human bio-monitoring
Children’s health and the environment in Europe: Children’s health and the environment in Europe: Main messagesMain messages
Health-related environmental conditions around 2004-5:
Big inequalities in health and exposure:– between various parts of the European Region of WHO– between various population groups within the Member States
Substantial differences in policy addressing the risk
Data availability:
International reporting (WHO, EEA, EUROSTAT) facilitates access of
MS to the standardized data for national and international analyses Improved surveillance reveals „unnoticed“ problems Internationally coordinated population-based surveys are important
source of the most relevant data
The need for a system in CEE
International Conference of the Central and Eastern European Chapter International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, of the International Society for Environmental Epidemiology,
Celadna, Czech Republic, 26-29 November 2007Celadna, Czech Republic, 26-29 November 2007
This presentation:
• Development of European EH Information System (ENHIS): highlights
• Assessment of children’s EH by CEHAPE RPG: situation in Central and Eastern Europe and need for a system
• Next steps and actions needed to advance the EH information system in Central and Eastern Europe
Development of Environmental Health Information System in Central and Eastern Europe
On the horizon - 2009
Fifth Ministerial Conference on EH (Rome, fall 2009)
Maintenance of the system -> its ability for policy monitoring & evaluation
• Improvement of geographical coverage (53 WHO/EURO MS)• National extensions of the system (sub-national data; country-specific indicators) & of the EH information network (incl. extension within countries)
Extension of thematic scope to address emerging issues (e.g. climate change)
European Environmental Health Information System: European Environmental Health Information System: integrating regional and local levelintegrating regional and local level
Population groups Adapted from CIHR-IPPH conceptual framework of population health, Annu. Rev. Public Health, 2006, 27
Scal
e
International & National
Local
Generic
Specific
EH ri
sks
Web-based, secure information system that exists at the local, regional,
and national/ international levels System consisting of distributed information systems & a network Enhance the use & re-use of existing data
ENHIS Network – Important system resourceENHIS Network – Important system resource
Responsive partner institutions –mechanism for transfer of knowledge to the MS
Several national workshops on ENHIS: e.g. Slovakia,
Spain, Hungary, Czech Republic …
Increased capacity in preparation & use of EH
information in policy debate in a national context ->
10+ national indicator fact sheets under way
Maintaining communication links getting “everybody on the same page”; ENHIS SharePoint: e-networking & common info space
Member States consider advancing national systems building on ENHIS with network as important resource (possible proposal in early 2008 under EC health action programme 2008-2013)
Join the ENHIS network!!
Activities & needs to advance national EH Activities & needs to advance national EH information systems: together we can make it!!information systems: together we can make it!!
Evaluating of the prospects for development of national EH
information systems using the WHO/ ENHIS methodology
Mapping your own country needs in strengthening public health
capacities -> tailor WHO activities both on technical & policy site
Looking for mechanisms and resources for joint technical projects
Initiated effort on farther transfer of the system in South East
Europe (WHO meeting, Bucharest, 12-13 November 2007)
Necessary actions:
Take an active part in creating a national EH information network
(incl. your country ENHIS partner) to link people, projects,
institutions to the ENHIS one
WHO:
Activities & needs to advance national EH Activities & needs to advance national EH information systems: together we can make it!!information systems: together we can make it!!
Necessary actions:
Stimulating the academia work on system improvement, a.o. conducting
studies using routine indicators and data
Capacity building: introducing EH surveillance in the academic curricula
Intervention studies and accountability research
Human bio-monitoring to improve our knowledge of H-E links
Remote sensing for environmental monitoring and GIS
Research:
International Conference of the Central and Eastern European Chapter International Conference of the Central and Eastern European Chapter of the International Society for Environmental Epidemiology, of the International Society for Environmental Epidemiology,
Celadna, Czech Republic, 26-29 November 2007Celadna, Czech Republic, 26-29 November 2007
Thank youThank you
Background information about the SystemBackground information about the System
Overview of children’s environmental health indicatorsOverview of children’s environmental health indicators
Children vulnerability to environmental hazardsChildren vulnerability to environmental hazards