Abstract

The goal of this discussion is to draw attention to the regrettable fact that health repercussions are not being addressed in policy setting. This absence covers a spectrum from policies as technically focused as that governing water quality, where the health dimensions are well known, to policies as broad as those dealing with global warming, where the health dimensions are still being defined. This situation is likely to worsen unless the environmental health community accepts the responsibility to do more outreach. The presentation also gives examples of how inclusion of environmental health in policy deliberations can increase economically quantifiable benefits and can help justify investments that are otherwise considered too costly. Despite advances in environmental health, many, if not most, important decisions affecting human health are being made without the input of health specialists. At best, considerations of environmental health are afterthoughts in the policies of business, commerce, industry, and many government agencies that are involved—even if inadvertently—with creating most environmental health problems, and by implication, are potentially responsible for their solutions. Examples of situations where the health dimensions are well known, such as with water quality, are provided from some 200 past World Bank projects in water supply, waste disposal, transportation, housing, urban development, and telecommunications, designed mainly by engineers and economists. The absence of health input is not necessarily detrimental if agency policies or environmental reviews can compensate for the absence of direct health input by other means such as environmental assessments, which currently do not systematically include health.