francesca racioppi: using "health in all policies" framework to integrate safety

Safety201619 September 2016, Tampere, Finland

1

Using “Health in all policies” framework to integrate

safety

Francesca RacioppiWHO Regional Office for Europe

with thanks to Dinesh Sethi, WHO Regional Office for Europe

Heather Adair-Rohani, WHO Headquarters


2

What this talk is about• Health/Safety in all policies• Make it happening

– Change accountability frameworks– The “co-benefit” argument: build on other sectoral agendas

• Energy, • Air pollution• Climate change

– The 2030 agenda for Sustainable Development: a new entry point

– The role of the safety community


3

Injury deaths:

755 000 in 2000 544 000 in 2012

1980 1985 1990 1995 2000 2005 2008 2009 2010 2011 2012 20130

20406080

100120140160180200

European Region EU CIS

Deaths from Injuries, All ages in European Region

Dea

ths

per 1

00 0

00

More needs to be done reduce injuries for a safer and more equitable Europe


4

From “Health in all policies” to “Safety in all policies”

Health in all policies (HiAP) is an approach to public policies across sectors that systematically takes into account the health and health systems implications of decisions, seeks synergies and avoids harmful health impacts, in order to improve population health and health equity2006 2013


5

Taking HiAP forward in Europe: Health 2020

Intersectoral action for

health

Whole-of-governmen

t

Health in all Policies

Governance for Health


6

In which policy domains?

Safety in All

Policies

Transport

Environment

Land use

Housing

Leisure

Sport

Education

Justice

Social policy

Labour

Industry

Health

Road traffic injuries

Fire-related injuries

Poisonings

Drownings

Falls

Occupational injuries

Interpersonal Violence

Child abuse and neglect


7

Integrating safety in other policies: recognizing opportunities

Increasing efficiency

Enhancing sectoral

performance

Reducing inequalities

Reducing preventable

loss

Making safety an

integral part of sectoral

performance


8

Changing accountability frameworksroad traffic injury prevention - 1

2004 20132009 20152011

The transport sector introduced monitoring and public reporting on progress against quantitative road safety targets


9

European facts and Global status report on road safety 2015

Age-standardised road traffic injury mortality rates by quintiles, WHO European Region 2013

85 000

8 8.1%

Road traffic injuries are the leading cause of death in young people aged 5-29 years

Increase efforts to reach target of 50% reduction by 2020

Changing accountability frameworks: road traffic injury prevention - 2


10

Goals in transport policy Sectoral InterestReduce emissions of:

–air pollutants;–greenhouse gases;–Noise

EnvironmentHealthEnergy

Reduce congestion Transport

Reduce road traffic injuries Transport, Health

Reduce investments in infrastructure Transport, Land use

Improve accessibility and quality of urban life Transport, Health

Complement improvements to vehicles and fuels Transport

Increase physical activity through active mobility Health

“Decarbonize” transport Environment, Energy

Improve transport efficiency Transport, Economy, Energy

Promote tourism Tourism and leisure industry

Creation of new jobs Economy, welfare, labour

Bridging across diverging agendas: Developing the “co-benefit” argument


11

The “co-benefit argument”: Example -1Fighting indoor air pollution: Kerosene replacement

• An estimated 265 000 deaths every year are caused by burns• Burns occur mainly in the home and workplace, mostly –in low- and middle-income

countries.• Kerosene is a leading cause of burns and poisonings in low and

middle income countries• Kerosene is a major source of air pollution in and around the home, emitting high

levels of health-damaging pollutants like fine particulates (including black carbon), PAH’s, CO, NO2, SO2, etc

• Many households still rely on kerosene for cooking, heating and lighting• New WHO figures estimate around 200 million people still rely primarily on kerosene

for cooking along and many homes, particularly AFRO rely mainly on kerosene for lighting


12

Percentage of population relying on kerosene as main lighting fuel in three WHO Regions


13

WHO Indoor Air Quality Guidelines: defining “clean” for health?

Normative guidance found in the WHO Guidelines for indoor air quality: household fuel combustion:• Provides emission rate targets for PM2.5, and CO that

determine whether fuel and technology combinations are “clean” for health

• Provides guidance on the policy in transition to the sustained adoption of clean fuels (e.g. LPG) and technologies

• Recommendations made against kerosene and unprocessed coal use

• Emphasizes importance of addressing all main household energy end uses for health benefits


14

Source: World Health Organization, 2011. Health co-benefits of climate change mitigation - Transport sector,

The “co-benefit argument”: Example - 2Mitigating climate change: Promoting cycling and walking


15

The “co-benefit argument”: Example - 3Adapting to climate change: preparing for and preventing the effects of extreme weather events – from reacting to managing risks

Credit: UNDP/Ljubo Stefanov Credit: UNDP/Ljubo Stefanov


16

The 2030 agenda for Sustainable Development: a new entry point for “Safety in all policies”


17

Safety in all policies supports the attainment of SDGs. SDGs support safety in all policies implementation

Safety in all

policies

1.5 By 2030, build the resilience of the poor and those in vulnerable situations and reduce their exposure and vulnerability to climate-related extreme events and other economic, social and environmental shocks and disasters

3.2 End preventable deaths of children under 5 years by 20303.5 Prevention and treatment of substance abuse and harmful use of alcohol3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents

4.a Build and upgrade education facilities that are child, disability and gender sensitive and provide safe, non-violent, inclusive and effective learning environments for all

5.2 Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation5.3 Eliminate all harmful practices, such as child, early and forced marriage, and female genital mutilations

7.1 By 2030, ensure universal access to affordable, reliable and modern energy services

8.8 Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, in particular women migrants, and those in precarious employmen

9.1 Develop quality, reliable, sustainable and resilient infrastructure, including regional and transborder infrastructure, to support economic development and human well-being, with a focus on affordable and equitable access for all

11.1 By 2030, ensure access for all to adequate, safe and affordable housing and basic services and upgrade slums11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons

13.1 Strengthen resilience and adaptive capacity to climate-related hazards and natural disasters in all countries

16.1 Significantly reduce all forms of violence and related death rates everywhere16.2 End abuse, exploitation, trafficking and all forms of violence against and torture of children

17.16 Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources, to support the achievement of the sustainable development goals in all countries, in particular developing countries


18

The role of the safety community• Provide the evidence:

– Of the magnitude of the burden of violence and injury– Of the links to risk factors and protective factors– Of effective policies and interventions

• Advocate “Safety in all policies”– Understand other sectors agenda– Identify and leverage on “co-benefits”– Promote sectoral accountability– Use the economic and development argument

• Build capacities for “Safety in all policies” – Public health approach to violence and injury prevention– Risk assessment and management


19

In conclusion

• “Health in all policies” approaches are amenable to “safety in all policies”

• Health 2020 and the 2030 Sustainable Development Agenda support and offer entry points to “safety in all policies”

• Implementing “safety in all policies” will benefit from: – Shifting sectoral accountability and integrating safety goals in

performance appraisals– Understanding sectoral policies agendas– Identifying opportunities for “co-benefits”– Demonstrating the economic and development benefits of safety in all

policies approaches


20

To get in touch with us:

[email protected]@who.int

http://www.euro.who.int/en/health-topics/disease-prevention/violence-and-injuries

mailto:[email protected]

mailto:[email protected]

francesca racioppi: using "health in all policies" framework to integrate safety

Science