Education And Debate

Environment—a new key area for Health of the Nation?

BMJ 1996; 313 doi: (Published 09 November 1996) Cite this as: BMJ 1996;313:1197
  1. Alison Walker, senior registrar in public healtha
  1. a Department of Sexually Transmitted Diseases, University College London Medical School, Mortimer Market Centre, London WC1E 6AU

    Later this month the government will be consulting on whether the environment should be adopted as a new key area for their Health of the Nation strategy. It is proposing to have five topic areas and to adopt 10–15 environmental targets. This would reaffirm its commitment to linking environmental policy and health policy following publication earlier this year of its environmental health action plan. Critics may respond to the consultation document with suggestions for more far reaching targets—based, for example, on the “Health for All” targets from the World Health Organisation, or those arising out of Agenda 21 from the earth summit in Rio De Janeiro. Whatever the criticism, this move will be a chance to link environmental and health agendas at both national and local level.

    Four years on, England's health strategy the Health of the Nation has become a cornerstone of government health policy.1 Now there are plans to expand it. Later this month the government will consult on whether the environment should be added to the strategy as a new, sixth, key area. This, at last, should address the effects that physical and social environments have on people's health2—but will it?

    In advance of publishing its consultation paper, the Department of the Environment has already outlined proposals for the key area: there will be no new policy—instead, a chance to implement existing environmental policy via the health strategy; there will be no new money—only more creative use of existing resources; and there will be no new health targets—instead, a carefully selected handful of environmental targets that relate to health. How, then, can adopting the environment as a key area add anything to what already exists? The answer must lie in the importance of linking environmental and health policy.

    Linking environmental and health policy

    Health has driven much of environmental …

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