Environment and health indicators system. Page updated

An environment and health (EH) information system is an essential tool to support policy-making, allowing priorities to be set on the basis of evidence, enhancing access to information and facilitating communication with the public. WHO/Europe established and runs ENHIS, a harmonized and evidence-based information system on environment and health to support public health and environmental policies in the WHO European Region. It consists of a set of 22 indicators. These indicators on exposure, health effects, and policy actions were selected for their relevance towards EH factors. These developments are important elements for the European Environment and Health Strategy.

In the Fifth Ministerial Conference on Environment and Health (Parma, Italy, 2010) the main focus was the protection of children's health in a changing environment. To this aim, the conference selected Regional Priority Goals (RPG) to monitor the children's health and adopted five time-bound commitments. A set of 18 EH indicators to be integrated into ENHIS will measure progress. Further work on definitions and methodologies is needed to refine each indicator. These indicators are necessary to monitor current policies and actions, in particular, the Children's Environment and health Action Plan for Europe (CEHAPE) and the European Environment and Health Strategy.

The Parma Conference has also identified that protecting health and the environment from climate change is a priority. Under the Climate, Environment and Health Action Plan Information System (CEHAPIS) project, WHO/Europe and the European Commission recommend a set of 17 indicators defined as health relevant climate change indicators.

These different sets of EH indicators are listed in the annexes of the WHO/Europe document 'Tools for the monitoring of Parma Conference commitments'.

The road to ENHIS is the result of joint efforts by WHO/Europe and the European Commission based on the experience of former projects:
- the ECOEHIS project 'Development of EH indicators for EU countries' recommended the first list of health indicators on exposure, effects, and actions for immediate implementation;
- The ENHIS project implementing a 'Environmental and Health Information System in Europe';
- The ENHIS 2 project establishing an ENHIS supporting policy-making in Europe.

More information

See the EU Environment and Health Action Plan 2004-2010
See the Shared Environmental Information System (SEIS) by European Commission DG Environment

See the Indicators and fact sheets about Europe's environment developed by the European Environment Agency (EEA)

When drafting health proposals, policymakers require data on a wide range of factors affecting health, such as the social, economic and administrative environment.

The EU compiles indicators on many of these issues outlined below.

Sustainable development indicators

In 2016 the European Commission launched a Communication on Next steps for a sustainable European future [COM(2016)739]. It maps the policies contributing to the 17 United Nations Sustainable Development Goals (SDGs), in particular for the SDG 3 to ensure healthy lives and promote well-being for all at all ages.

Yearly EU monitoring is based on the EU SDG indicator set. The following 6 indicators were selected for Goal 3 on health and well-being:

In addition, indicators for other SDG Goals have also been attributed to Goal 3 as 'multi-purpose indicator' such as:

Some of these indicators are common to the European Core Health Indicators (ECHI) shortlist.

Evaluating progress

The European Commission evaluates progress towards the agreed goals in a yearly report on SDG monitoring. Last report is available together with several additional tools to assess the EU situation.

European Pillar of Social Rights

The European Pillar of Social Rights is to deliver on a more social and fair Europe and is a key priority for the European Commission. The Public support / Social protection and inclusion strand includes indicators on health care:

Self-reported unmet need for medical care
Out-of-pocket expenditure on healthcare
Healthy life years at 65.

EU Youth health indicators

The EU Youth Strategy sets out a framework for cooperation from 2020-2027. It focuses on three core areas of action, around the three words: Engage Connect Empower, while working on joined-up implementation across sectors. Eleven European Youth Goals identify cross-sectoral areas that affect young people’s lives and point out challenges, including mental health and wellbeing.

EU Youth indicators dashboard

Healthcare quality indicators and patient reported measures

The Health Care Quality Indicators project (HCQI), led by the Organisation for Economic Co-operation and Development (OECD) with European Commission support, aims to measure and compare the quality of health services in different countries. The key areas are:

Typically, the success of health care is assessed on the basis of survival rates, or rates of cure, after treatment. This tends to mask important differences, which only emerge when considering outcomes and experiences reported by patients themselves.

Supported by the Commission, OECD’s Patient-Reported Indicators Survey (PaRIS) will address critical information gaps and build a patient-centred view of health system performance.

Work on accelerating the adoption and reporting of patient-reported indicators in individual disease areas (breast cancer, hip and knee replacements and mental health) and a new international patient survey is being developed (focusing on complex, chronic conditions being treated in primary care).

Details

Publication date: 26 September 2011
Author: Directorate-General for Health and Food Safety