Assessments are to change the world

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This is the page for Mikko V. Pohjola's doctoral thesis. The text was originally written in Heande. The final book is here. The structure follows the THL thesis template. The draft version of the dissertation sent for pre-examination can be found as pdf-files in related files at the end of this page. Also a pdf of the article 2 is available in related files.

Väitöstiedote

Ympäristöterveysarviointien vaikuttava hyödyntäminen edellyttää päätöksenteolta avoimuutta, läpinäkyvyyttä ja yhteistyötä

Ympäristö ja terveys ovat tärkeitä miltei kaikille yhteiskunnan jäsenille. Siksi on tärkeää, että ympäristöä ja terveyttä koskevassa päätöksenteossa huomioidaan paitsi asiantuntijoiden ja päättäjien myös sidosryhmien ja kansalaisten tiedot, näkemykset ja tarpeet. Ympäristöterveysarviointi on tieteeseen perustuvaa päätöksenteon tukemista, joka tarkastelee miten ympäristö vaikuttaa terveyteen, etenkin erilaisten päätösten ja toimenpiteiden seurauksena.

Tietoverkkojen ja sosiaalisen median kehittyminen on luonut valmiuksia avoimemmalle tiedon hankinnalle ja hyödyntämiselle yhteiskunnallisesti merkittäviä päätöksiä tehtäessä ja toimeen pantaessa. Uudet ympäristöterveysarvioinnin menetelmät ja työkalut mahdollistavatkin laajan ja kiinteän yhteistyön tiedon tuotannon ja käytön välillä. Perinteiset asiantuntijoiden, päättäjien ja sidosryhmien eriyttämiseen sekä tiedon panttaamiseen perustuvat käytännöt ovat kuitenkin yhä vallitsevia niin arvioinnin, päätöksenteon kuin kansalaisosallistamisenkin parissa. Näin ollen ympäristöä ja terveyttä koskevat päätökset eivät useinkaan pohjaudu parhaaseen olemassa ja saatavilla olevaan tietoon. Vaikuttavaan ympäristöterveysarviointiin ja päätöksentekoon tarvitaan menetelmien ja työkalujen lisäksi kulttuurinen muutos kohti avoimuutta, läpinäkyvyyttä ja yhteistyötä.

Useita lähestymistapoja arviointiin

Koska ympäristöterveysarviointiin liittyy monenlaista monenmutkaisuutta, on olemassa useita lähestymistapoja ympäristöä ja terveyttä koskevaan arviointiin. Teoreettisista ja käytänöllisistä eroista huolimatta ne kaikki pyrkivät tarjoamaan tieteeseen pohjautuvaa tukea yhteiskunnallisesti merkittäviä asioita koskevalle päätöksenteolle. Useimmiten arviointeihin sisältyy myös matemaattista tai ainakin käsitteellistä mallinnusta. Lisäksi sidosryhmien ja kansalaisten osallistuminen on tunnistettu useissa lähestymistavoissa tärkeäksi asiaksi, mutta käytännössä se koetaan yhä taakaksi ja usein toteutetaan erillisenä prosessina arvioinnin ja päätöksenteon ohessa.

Edelleenkään ympäristöterveysarviointien onnistumista ei useimmiten tarkastella niiden aikaansaamien vaikutusten, eli asiantuntijoiden toimintapiirin ulkopuolisessa maailmassa tapahtuvien muutosten mukaan, vaikka sen tarve on kylläkin tunnistettu. Arvioinnit pyrkivät ennemminkin työntämään asiantuntijatietoa päättäjille ja muulle yleisölle kuin vastaamaan päätöksenteon käytännöllisiin tarpeisiin. Nykytilannetta muilla ympäristöön, terveyteen ja hyvinvointiin liittyvillä arvioinnin aloilla voi luonnehtia varsin samanlaiseksi.

Kohti yhteistyössä oppimista ja jaettua ymmärrystä

Uusissa arvioinnin lähestymistavoissa on nähtävissä suuntaus kohti a) tiiviimpää vuorovaikutusta asiantuntijoiden, päättäjien ja sidosryhmien välillä, b) käytännöllistä merkittävyyttä sekä c) arvojen parempaa huomioimista tiedon ohella. Tämä on myös käytännössä mahdollista mm. kollaboratiivisten tietokonesovellusten, sosiaalisen median ja kollektiivisen oppimisen teorioiden kehityksen myötä. Esimerkiksi Terveyden ja hyvinvoinnin laitoksessa kehitetty avoimen arvioinnin menetelmä ja sitä tukeva Opasnet tietojärjestelmä (www.opasnet.org) tarjoavat asiantuntijoille, päättäjille ja kaikille asiasta kiinnostuneille verkkotyötilan, jossa voi käynnistää ja seurata arviointeja sekä niihin osallistumalla vaikuttaa päätöksentekoon. Opasnetin informaatorakenne ja toiminnallisuudet toteuttavat tieteellisen tiedonhankinnan menetelmiä myös käytännöllisten päätösongelmien ratkaisemiseen, ei vain niihin liittyvien ympäristön ja terveyden yhteyksien analysointiin.

Käytäntöjen kehittäminen haasteena

Vaikka kokemukset laajamittaisesta osallistumisesta ovatin velä vähäisiä, Opasnetin soveltaminen ja sen tarkastelu on osoittanut, että avoin yhteistyö on mahdollista ympristöterveysarvioinnissa. Avoimuutta ja läpinäkyvyyttä arvostetaan, mutta esteiden poistamisesta huolimatta laajan aktiivisen osallistumisen aikaansaaminen, etenkin päättäjien osalta, voi olla haasteellista. Tulevassa kehitystyössä huomio tulee kiinnittää erityisesti tiedon soveltamisen käytäntöihin päätöksenteossa.

Tässä tutkimuksessa on tarkasteltu tiedon käyttöä ja hyödyntämistä erityisesti ympäristöä ja terveyttä koskevassa arvioinnissa, päätöksenteossa ja osallistumisessa. Tunnistetut ominaispiirteet, haasteet ja ratkaisut ovat kuitenkin yleistettävissä ja sovellettavissa tieteen ja päätöksenteon vuorovaikutukseen laajemminkin.

Väitösuutinen

Väitös: Vaikuttavaan ympäristöterveysarviointiin tarvitaan kulttuurinen muutos kohti avoimuutta ja yhteistyötä

Ympäristöä ja terveyttä koskevat päätökset eivät useinkaan pohjaudu parhaaseen olemassa ja saatavilla olevaan tietoon. Perinteiset asiantuntijoiden, päättäjien ja sidosryhmien eriyttämiseen sekä tiedon panttaamiseen perustuvat käytännöt ovat yhä vallitsevia päätöksenteossa. Vaikuttavaan ympäristöterveysarviointiin ja päätöksentekoon tarvitaan menetelmien ja työkalujen lisäksi kulttuurinen muutos kohti avoimuutta, läpinäkyvyyttä ja yhteistyötä. Ympäristöä ja terveyttä koskevassa päätöksenteossa tulisi huomioida paitsi asiantuntijoiden ja päättäjien myös sidosryhmien ja kansalaisten tiedot, näkemykset ja tarpeet, korostaa Mikko Pohjola väitöstutkimuksessaan.

Ympäristöterveysarviointi tarkastelee miten ympäristö vaikuttaa terveyteen, etenkin erilaisten toimenpiteiden seurauksena. Arvioinnein saatava tieteeseen perustuva tieto on tarkoitettu tukemaan erityisesti yhteiskunnallisten päättäjien, mutta myös liike-elämän päättäjien ja tavallisten kansalaisten päätöksiä.

Ympäristöterveysarviointien onnistumista ei useimmiten tarkastella niiden aikaansaamien vaikutusten perusteella. Arvioinnit pyrkivät ennemminkin työntämään asiantuntijatietoa päättäjille ja muulle yleisölle kuin vastaamaan päätöksenteon käytännöllisiin tarpeisiin. Sidosryhmien ja kansalaisten osallistuminen on tunnistettu useissa lähestymistavoissa tärkeäksi asiaksi, mutta käytännössä se koetaan yhä taakaksi ja usein toteutetaan erillisenä prosessina arvioinnin ja päätöksenteon ohessa.

Uusissa arvioinnin lähestymistavoissa on nähtävissä suuntaus kohti tiiviimpää vuorovaikutusta asiantuntijoiden, päättäjien ja sidosryhmien välillä, käytännöllisyyttä sekä arvojen huomioimista tiedon ohella. Tämä on myös käytännössä mahdollista muun muassa yhteistoiminnallisten tietokonesovellusten, sosiaalisen median ja kollektiivisen oppimisen teorioiden kehityksen myötä.

Yhtenä uutena lähestymistapana väitöstutkimuksessa tuodaan esiin THL:ssä kehitetty avoimen arvioinnin menetelmä ja sitä tukeva tietojärjestelmä Opasnet (www.opasnet.org). Erityisesti asiantuntijoille ja päättäjille suunnattu menetelmä ja järjestelmä tarjoavat verkkotyötilan, jossa voi käynnistää ja seurata arviointeja sekä niihin osallistumalla vaikuttaa päätöksentekoon. Vaikka kokemukset laajamittaisesta osallistumisesta ovat vielä vähäisiä, Opasnetin soveltaminen ja sen tarkastelu on osoittanut, että avoin yhteistyö on mahdollista ympäristöterveysarvioinnissa. Laajan aktiivisen osallistumisen aikaansaaminen on kuitenkin yhä vaikeaa, vaikka avoimuutta ja läpinäkyvyyttä sinänsä arvostetaankin. Arvioinnin menetelmien kehittämisessä erityistä huomiota tulee kiinnittää erityisesti tiedon soveltamisen käytäntöihin päätöksenteossa.

DI Mikko Pohjolan väitöskirja tarkastetaan perjantaina 10.5.2013 klo 10:00 Itä-Suomen yliopistossa Mediteknian audotoriossa (MET), Yliopistonranta 1 B, Kuopio. Vastaväittäjänä Professori Roland Bal Erasmus University Rotterdamista, kustoksena Tutkimusjohtaja Pertti Pasanen Itä-Suomen yliopistosta.

Lähde Mikko Pohjola: Assessments are to change the world – Prerequisites to effective environmental health assessment. http://urn.fi/URN:ISBN:978-952-245-883-4

Lisätietoja

Mikko Pohjola
vieraileva tutkija
Terveyden ja hyvinvoinnin laitos (THL)
p. 040 7364234
etunimi.sukunimi@thl.fi

Lektio

max 20 minutes (min 10 min)

"Honourable custos, honourable opponent, dear listeners."

  • definition of EHA
  • background
    • OA, Opasnet, THL, monia (EU-)projekteja
  • research questions
    • what is EHA?
    • how is EHA?
    • how EHA should be?
    • how to develop EHA?
  • book structure (how are the questions answered)
    • review & synthesis of approaches to EHA, other related assessment fields, participation, evaluation/performance
    • development and application of methods and tools for collaborative knowledge creation in EHA and policy
  • conclusions (answers to questions)
    • purpose: better knowledge-based decision
    • contemporary approaches limit serving the purpose: physical, organizational and/or intellectual separation of assessment, policy and participation
      • problems in ass-pol interaction → separation of ass-pol was based on misinterpretation, problem was lack of openness and transparency
    • openness, transparency & collaboration → evaluation & management of the whole chain from knowledge to outcomes
    • methods and tools for open collaboration already exist (ICT, social media, learning theories), but a cultural change from disengagement and withholding of knowledge to openness, transparency and collaboration is needed.
  • implication for further research/practice
    • the emphasis should be set particularly on the practices of applying knowledge in policy making
    • when the demand exists, the supply will adapt to the need
  • broader significance to science-policy interaction
    • situation similar in most knowledge-policy interaction
    • examples sote- & kuntauudistus, IPCC & climate policy, Finnish research reform?

"I ask you, honourable professor, as the appointed opponent, to present those remarks, which you consider my thesis will require."

Title

Assessments are to change the world - Prerequisites for effective environmental health assessment

Foreword

Abstract

This thesis presents the main results of the research conducted in support of developing the open assessment method (http://en.opasnet.org/w/Open_assessment) and the Opasnet web-workspace (http://www.opasnet.org) at the National institute for health and welfare (THL) during 2006 – 2012.

Environmental health assessment is science-based support to decision making. It looks into the characteristics of our living environments, analyses and models how they affect human health, and considers how different decisions and actions influence the environment-health relationships. The information provided by assessments is intended to support knowledge-based decisions and actions particularly in public policy, but also e.g. by decision-makers in business and individual members of the society. In principle, environmental health assessment is a pragmatic endeavor of applying scientific knowledge and means for practical needs.

Due to many complexities related to environmental health assessment, there are several different assessment approaches addressing environment and health. Despite theoretical and practical differences, they share the idea of providing science-based support to decisions on issues of societal relevance. However, many approaches are more based on pushing expert knowledge than responding to the practical needs of decision making. Consequently, tendencies towards i) increased assessment-policy interaction, ii) broad, yet practical, framing and iii) explicit consideration of values have emerged in the recent development of environmental health assessment. Similar characteristics and challenges exist in assessments within other fields related to environment, health and well-being.

Participation of stakeholders and public is a central topic in environmental health assessment and policy. It is seen as essential for democracy, but also as a means for improving assessments and policy making. In practice, participation is still mostly perceived as a burden and it often takes place as a separate process alongside assessment and policy. However, environment and health are relevant to virtually all members of the society, which makes anyone a potentially relevant participant, and openness a necessity. Openness brings about some challenges, but they are mostly practical rather than fundamental in their nature.

The success of environmental health assessments is increasingly considered in terms of their outcomes, i.e. the changes in the world outside the walls of the expert-domain. An outcome-oriented turn is taking place in assessment and its evaluation. Most perspectives to evaluation and management of performance still focus primarily on the assessment procedures and outputs and their technical features. Extending the perspective to cover their practical use and its effects requires a thorough account of the interrelations between knowledge and action in a social context. Unfortunately, these aspects are barely even recognized in most approaches to environmental health assessment and modeling.

Broad collaboration and tight linkage with practical implementation of knowledge are essential to effective environmental health assessment, i.e such that contributes to decisions, their implementation as well as outcomes. However, only few serious developments building on pragmatism and collaboration have emerged following the development of collaborative software, social media, as well as the theories of collective learning. As an example, open assessment method and the Opasnet web-workspace provide an arena for experts, policy makers as well as anyone interested to initiate, follow and contribute to environmental health assessments and policy making. They implement the methods of scientific knowledge creation also in the development of practical solutions to decision problems, not only in the analysis of the underlying environment-health relationships. Easily re-usable modular information objects of Opasnet also reduce work and increase efficiency in future assessments on related topics.

The application and evaluation of Opasnet has shown that open collaboration is feasible in environmental health assessment, although experiences from broad collaboration are still scarce. Openness and transparency are highly appreciated, but even despite the lack of barriers, broad active participation in assessment can be difficult to obtain. Particularly engagement of the intended users of assessment results, e.g policy makers or industrial decision makers, remains a challenge.

The emerging methods and tools of environmental health assessment make broad collaboration and tight linkage between production and application of knowledge possible. In addition, the development of digital networks and social media has paved the way for open knowledge in the society. However, a broad cultural change from disengagement and withholding of knowledge towards openness, transparency and collaboration is still needed for effective environmental health assessment and policy. The future development should focus particularly on the practices of using knowledge in policy making.

The focus of this research is in environmental health assessment. However, the emphasis is on the creation and application of knowledge in the processes of assessment, policy making and participation. Correspondingly, the characteristics, challenges and solutions identified here are mostly generalizable and applicable to science-policy interaction in general.

Keywords:
environmental health assessment, open assessment, Opasnet, effectiveness, evaluation, science-policy interaction, evidence-based policy, collaborative learning

Tiivistelmä

Tämä väitöskirja esittää terveyden ja hyvinvoinnin laitoksella vuosina 2006 – 2012 tehdyn avoimen arvioinnin (http://en.opasnet.org/w/Open_assessment) ja Opasnet verkkotyötilan (http://www.opasnet.org) kehitystyön tueksi tehdyn tutkimuksen päätulokset.

Ympäristöterveysarviointi on tieteeseen perustuvaa päätöksenteon tukemista. Se huomioi elinympäristömme ominaisuuksia, analysoi ja mallintaa niiden vaikutuksia ihmisten terveyteen ja tarkastelee kuinka päätökset ja toimenpiteet vaikuttavat ympäristön ja terveyden yhteyksiin. Arvioinnein saatava informaatio on tarkoitettu tukemaan tietoon perustuvia päätöksiä ja toimenpiteitä erityisesti yhteiskunnallisten päättäjien, mutta myös esim. liike-elämän päättäjien ja yksittäisten kansalaisten, toimesta. Periaatteessa ympäristöterveysarviointi on pragmaattista tieteellisen tiedon ja tieteen menetelmien soveltamista käytännön tarpeisiin.

Koska ympäristöterveysarviointiin liittyy monenlaista monimutkaisuutta, on olemassa useita lähestymistapoja ympäristöä ja terveyttä koskevaan arviointiin. Teoreettisista ja käytännöllisistä eroista huolimatta niille on yhteistä ajatus tarjota tieteeseen perustuvaa tukea yhteiskunnallisesti merkittäviä asioita koskevalle päätöksenteolle. Monet lähestymistavat kuitenkin pyrkivät enemminkin työntämään asiantuntijatietoa kuin vastaamaan päätöksenteon käytännöllisiin tarpeisiin. Tämän seurauksena viimeaikaiseen ympäristöterveysarvioinnin kehitykseen on ilmaantunut pyrkimyksiä i) arvioinnin ja päätöksenteon suurempaan vuorovaikutukseen, ii) arviointien laajaan, mutta käytännölliseen, rajaukseen ja iii) arvojen eksplisiittiseen huomioimiseen. Vastaavia ominaisuuksia ja haasteita on myös muissa ympäristöön, terveyteen ja hyvinvointiin liittyvissä arvioinneissa.

Sidosryhmien ja kansalaisten osallistuminen on keskeinen aihe ympäristöterveysarvioinneissa ja päätöksenteossa. Se nähdään oleellisesti demokratiaan kuuluvana, mutta myös keinona parantaa arviointeja ja päätöksentekoa. Käytännössä osallistuminen kuitenkin yhä koetaan taakaksi ja usein toteutetaan erillisenä prosessina arvioinnin ja päätöksenteon ohessa. Ympäristö ja terveys ovat kuitenkin lähes kaikkia kansalaisia koskettavia asioita, jonka vuoksi kuka tahansa saattaa olla merkityksellinen osallistuja, ja avoimuus on siksi välttämätöntä. Avoimuus tuo mukanaan joitain haasteita, mutta ne ovat luonteeltaan ennemminkin käytännöllisiä kuin perustavanlaatuisia.

Ympäristöterveysarviointien onnistumista tarkastellaan lisääntyvässä määrin niiden aikaansaamien vaikutusten, eli asiantuntijoiden toimintapiirin ulkopuolisessa maailmassa tapahtuvien muutosten, mukaan. Arvioinnissa ja sen evaluoinnissa on tapahtumassa käännös vaikutuspainotteisuuteen. Useimmat suorituskyvyn evaluoinnin ja hallinnan näkökulmat kuitenkin yhä kohdistuvat pääasiassa arvioinnin proseduureihin ja tuotoksiin sekä niiden teknisiin ominaisuuksiin. Näkökulman laajentaminen kattamaan niiden käytännöllisen käytön sekä sen vaikutukset edellyttää perinpohjaista tiedon ja toiminnan yhteyksien tarkastelua sosiaalisessa viitekehyksessä. Valitettavasti näitä seikkoja tuskin edes huomioidaan useimmissa ympäristöterveysarvioinnin lähestymistavoissa.

Laajamittainen yhteistyö ja kiinteä yhteys tiedon soveltamiseen ovat oleellisia vaikuttavalle, eli päätöksiin, niiden toimeenpanoon sekä seurauksiin vaikuttavalle, ympäristöterveysarvioinnille. Kuitenkin vain joitain pragmatismiin ja yhteistyöhön pohjautuvia vakavasti otettavia kehitelmiä on ilmaantunut kollaboratiivisten sovellusten, sosiaalisen median ja kollektiivisen oppimisen teorisoiden kehityksen myötä. Yhtenä esimerkkinä avoimen arvioinnin menetelmä ja Opasnet verkkotyötila tarjoavat asiantuntijoille, päättäjille ja kaikille asiasta kiinnostuneille areenan, jolla käynnistää ja seurata arviointeja sekä osallistumalla niihin vaikuttaa päätöksiin. Ne toteuttavat tieteellisen tiedonhankinnan menetelmiä myös käytännöllisten päätösongelmien ratkaisemiseen, ei vain taustalla olevien ympäristön ja terveyden yhteyksien analysointiin. Lisäksi, Opasnetin helposti uudelleen käytettävät modulaariset informaatio-oliot vähentävät työtä ja lisäävät tehokkuutta tulevissa vastaavaa aihetta käsittelevissä arvioinneissa.

Opasnetin käyttö ja evaluointi on osoittanut, että avoin yhteistyö on mahdollista ympäristöterveysarvioinnissa, vaikka kokemukset laajasta osallistumisesta ovatkin vielä vähäisiä. Avoimuutta ja läpinäkyvyyttä arvostetaan suuresti, mutta esteiden puuttumisesta huolimatta laajan aktiivisen osallistumisen aikaansaaminen voi olla vaikeaa. Erityisesti arviointitulosten aiottujen käyttäjien, esim. yhteiskunnallisten tai teollisten päättäjien, sitouttaminen on edelleen haasteellista.

Uudet ympäristöterveysarvioinnin menetelmät ja työkalut mahdollistavat laajan yhteistyön ja kiinteän yhteyden tiedon tuotannon ja käytön välillä. Lisäksi, digitaalisten tietoverkkojen ja sosiaalisen median kehittyminen on tasoittanut tietä avoimelle tiedolle. Vaikuttavaan ympäristöterveysarviointiin ja päätöksentekoon kuitenkin tarvitaan kultturinen muutos sitoutumattomuudesta ja tiedon salailusta kohti avoimuutta, läpinäkyvyyttä ja yhteistyötä. Tulevassa kehitystyössä huomio pitää kiinnittää erityisesti tiedon käytön käytäntöihin päätöksenteossa.

Tämä tutkimus keskittyy ympäristöterveysarviointiin. Painopiste on kuitenkin tiedon käytössä ja hyödyntämisessä arvioinnin, päätöksenteon ja osallistumisen prosesseissa. Vastaavasti, tunnistetut ominaisuudet, haasteet ja ratkaisut ovat yleistettävissä ja sovellettavissa tieteen ja politiikan vuorovaikutukseen yleisesti.

Avainsanat:
ympäristöterveysarviointi, avoin arviointi, Opasnet, vaikuttavuus, evaluointi, tieteen ja politiikan vuorovaikutus, näyttöön perustuva politiikka, kollaboratiivinen oppiminen

List of original papers

  1. Pohjola, M.V., Leino, O., Kollanus, V., Tuomisto, J.T., Gunnlaugsdόttir, H., Holm, F., Kalogeras, N., Luteijn, J.M., Magnusson, S.H., Odekerken, G., Tijhuis, M.J., Ueland, Ø., White, B.C., Verhagen, H., 2012. State of the art in benefit–risk analysis: environmental health. Food Chem. Toxicol. 2012, 50:40-55. http://dx.doi.org/10.1016/j.fct.2011.06.004
  2. Tijhuis, M.J., Pohjola, M.V., Gunnlaugsdóttir, H., Kalogeras, N., Leino, O., Luteijn, J.M., Magnússon, S.H., Odekerken, G., Poto, M., Tuomisto, J.T., Ueland, Ø., White, B.C., Holm, F., Verhagen, H., 2012. Looking beyond Borders: Integrating best practices in benefit-risk analysis into the field of food and nutrition. Food Chem. Toxicol. 2012, 50:77-93. http://dx.doi.org/10.1016/j.fct.2011.11.044
  3. Pohjola, M.V., Tuomisto, J.T., 2011. Openness in participation, assessment, and policy making upon issues of environment and environmental health: a review of literature and recent project results. Environmental Health 10:58. http://dx.doi.org/10.1186/1476-069X-10-58
  4. Pohjola, M.V., Tainio, M., Pohjola, P., Tuomisto, J.T. Process, output or outcomes? Perspectives to model and assessment performance. Submitted manuscript.
  5. Pohjola, M.V., Pohjola, P., Paavola, S., Bauters, M., Tuomisto, J.T., 2011. Pragmatic Knowledge Services. Journal of Universal Computer Science 17:472-497. http://dx.doi.org/10.3217/jucs-017-03-0472
  6. Sandström, V. Tuomisto, J.T., Majaniemi, S., Rintala, T., Pohjola, M.V. Evaluating effectiveness of open assessments on alternative biofuel sources. Submitted manuscript.

Abbreviations

AMET atmospheric model evaluation tool
ANOVA analysis of variance
ANT actor-network theory
BENERIS Benefit–risk asessment for food: an iterative value-of-information approach (research project)
BEPRARIBEAN Best practices for risk-benefit analysis of foods (research pro-ject)
BRAFO Risk-benefit analysis of foods (research project)
CSA chemical safety assessment
CSCL computer supported collaborative learning
CO2 carbon dioxide
CVD cardiovascular disease
DALY disability adjusted life year
DIS distributed interactive simulation
EADI European Association of Development Research and Training Institutes
EC European Community
ECHA European Chemical Agency
ECLAC Economic Commission for Latin America & the Caribbean
EEC European Economic Community
EFSA European Food Safety Authority
EIA environmental impact assessment
EMS environmental modeling and software
EU European Union
FAO Food and Agriculture Organization of the United Nations
GHG greenhouse gas
HIA health impact assessment
HEIMTSA Health and environment integrated methodology and toolbox for scenario assessment (research project)
HTA health technology assessment
HTML hypertext markup language
IAEA International Atomic Energy Agency
IARU International Alliance of Research Universities
IEHIA integrated environmental health impact assessment
IIED International Institute for Environment and Development
IKM information and knowledge management
IM implementation model
INTARESE integrated assessment of health risks of environmental stress-ors in Europe (research project)
IPCC Intergovernmental Panel on Climate Change
ISO International Organization for Standardization
ITRC Interstate Technology & Regulatory Council
IRGC International Risk Governance Council
KPE Knowledge Practices Environment
KP-Lab Knowledge practices laboratory (research project)
LCA life cycle assessment
MNP Netherlands Environmental Assessment Agency (current ac-ronym for the agency is PBL)
NCM Nordic Council of Ministers
NEA Nuclear Energy Agency
NGO non-governmental organization
NIBR Norwegian Institute for Urban and Regional Research
NRC National Research Council (USA)
ODI Overseas Development Institute
OECD Organization for Economic Co-operation and Development
PBT persistent, bioaccumulative, and toxic
PSSP purpose, structure, state, performance
REA relational evaluation approach
QA quality assurance
QALY quality adjusted life year
QC quality control
REACH egistration, evaluation, authorization, and restriction of che-mical substances (EU)
RCN Research Council of Norway
RIVM National Institute for Public Health and the Environment (the Netherlands)
SAIC Scientific Applications International Corporation
SMAA stochastic multicriteria acceptability analysis
SYTYKE Doctoral programme in environmental health, University of Eastern Finland
TEKES National Technology Agency of Finland
TEKAISU Assessment of environmental health impacts into all planning and policy making (research project)
THL National institute for health and welfare (Finland)
UNECE United Nations Economic Commission for Europe
UNEP United Nations Environment Programme
USA United States of America
U.S. EPA United States environmental protection agency
vPvB very persistent, very bioaccumulative
VWA Dutch Food and Consumer Product Safety Authority
WHO World Health Organization
YVA Ympäristövaikutusten arviointi (Finnish for environmental impact assessment)

1. Introduction

1.1 Environmental health assessment

Environmental health is a scientific discipline that studies the characteristics of our living environments, and how these characteristics affect human health (Frumkin, 2010, Knol 2010). Environmental health assessment applies the knowledge provided by environmental health research, considers how different decisions and actions influence the environment-health relationship, and provides that information to support policy making (Pohjola et al. 2012). The results of environmental health assessments are intended to influence the knowledge-involving decisions and actions particularly in public policy, but also e.g. by decision-makers in business as well as individual members of the society. The purpose of environmental health assessment is thus to improve deliberate plans of actions that guide decisions aiming for desired outcomes (cf. Jones 2009). As is discussed in subsequent chapters, there are several different, more or less overlapping, assessment approaches that address issues relevant to environment and health. These approaches have certain differences e.g. in emphasis, scope, theoretical basis, and context of development and application, but they all share the basic idea of science-based support for decision making on issues of societal relevance.

Fundamentally, environmental health assessment can be characterized as a pragmatic endeavor of applying scientific knowledge and means for supporting the practical needs of decision making upon societally relevant issues related to environment and health. Here, scientific refers to the simple ideas of scientific knowledge creation that all claims are considered tentative, subject to revision on the basis of new evidence, and should be exposed for testing and critrique by other investigators. Environmental health assessments typically focus on the issues of interest in environmental health research, but in order to be useful, the information provided to support decision making often needs to be embedded in a context of other relevant influences of decisions and actions and take into account the needs and capabilities of the society also beyond the scope of environmental health. In addition, the issues of environmental health are important to virtually all members of the society, which makes anyone a potentially relevant stakeholder in environmental health assessment and policy. Consequently, there are many kinds of complexities related to the substance, making, communication as well as the implementation of assessments and the information they produce. Due to these complexities, achieving effective environmental health assessments, i.e. such that conrtibute to policy decisions, their implementations as well as outcomes, can be very challenging.

"Buttons are to keep people warm" is one of the seemingly funny, but fundamentally wise, definitions in the classic children's book A hole is to dig (Krauss and Sendak 1952, Hughes 2009). In essence, it says that the function of a button to fit through a buttonhole gets its meaning from the practical need of keeping jackets closed and thereby protecting people from cold. Thus, buttons are to keep people warm. Although at first it may seem that this little sentence has nothing to do with the topic of this thesis, the following chapters will show how it actually entails an important lesson for the practice and development of environmental health assessment.

1.2 Structure of the thesis

Chapter 2 presents the questions and aims that have been guiding the research described in this thesis. Each of the chapters from 3 to 8 consist of individual articles published in or submitted to scientific journals, thereby comprising the main content of this thesis.

In chapter 3, approaches to environmental health assessment are reviewed and analyzed in order to describe the contemporary state of the art in environmental health assessment as well as identify existing tendencies for further development of the field. In this article, the author of this thesis participated in choosing the approaches to be reviewed, designed the framework for analysis, characterized five of the eight approaches, and was the main responsible for compiling the characterizations, drawing conclusions as well as writing the article.

Chapter 4 compiles and compares the results of chapter 3 with five corresponding state of the art reviews from different fields and identifies opportunities for developing the analysis of benefits and risks to support policy making. In this article, the author of this thesis characterized the state of the art in environmental health assessment, was the main responsible for designing the framework for analysis, engaged actively in the identification and description of development opportunities, and took part in writing the final article together with the first author.

Chapter 5 reviews the literature on participation in environmental and environmental health assessment and policy making and proposes a dimensions of openness framework for the scrutiny of limitations and possibilities for effective participatory assessment. In this article, the author of this thesis has made the review and writing of the article. He is also the main developer of the proposed framework.

Effectiveness is further elaborated in chapter 6, which reviews currently common perspectives to model and assessment performance and discusses their limitations to supporting evaluation and management of model and assessment effectiveness. Also in this article, making of the review, design of the framework for analysis, drawing of conclusions as well as writing of the article have been mainly conducted by the author of this thesis.

Chapter 7 proposes collective knowledge creation and learning as the conceptual basis for considering environmental health assessment as well as other endeavors of policy support and scrutinizes three novel information systems that build on the idea of collective knowledge creation and learning. In this article, the author of this thesis characterized Opasnet, one of the scrutinized information systems, designed the framework for analysis, and was the main responsible for compiling different parts and writing the article.

Chapter 8 is a case study compiling many aspects brought up in previous chapters. It looks into two assessments on alternative biofuel sources, which apply the principle of openness discussed in chapter 4 by means of Opasnet web-workspace analyzed in chapter 7. The assessments are evaluated according to the dimensions of openness framework proposed in chapter 4 as well as the properties of good assessment framework mentioned in chapter 6. Feasibility and applicability of openness, Opasnet as well as the evaluation frameworks is discussed. In this article, the author of this thesis was responsible for identifying research questions, describing the applied approach to and evaluation of effectiveness, designing the questionnaire, statistical analysis of results, and aiding the first author in compiling different parts and writing the article.

Chapter 9 takes an epistemological perspective to environmental health assessment and discusses the implications of the research in the broader context of interaction between science and policy. Chapter 10 then provides conclusions in the form of brief answers to the research questions presented in chapter 2.

References

Frumkin, H., 2010 (Ed.). Environmental Health: From Global to Local. 2nd edition. Jossey-Bass, San Fran-cisco.

Hughes, J., 2009. An artifact is to use: An introduction to instrumental functions. Synthese, 168, 179-199.

Jones, H., 2009. Policy-making as discourse: a review of recent knowledge-to-policy literature. A joint IKM Emergent-ODI Working Paper No 5. IKM Emergent Research Programme, European Association of Development Research and Training Institutes (EADI), Bonn, Germany.

Knol, A., 2010. Health and the environment: assessing the impacts, addressing the uncertainties. Thesis Utrecht University, Utrecht, the Netherlands.

Krauss, R., Sendak, M., 1952. A hole is to dig. HarperCollins.

Malhotra, Yogesh. (1994). On Science, Scientific Method And Evolution Of Scientific Thought: A Philoso-phy Of Science Perspective Of Quasi-Experimentation [WWW document]. http://www.brint.com/papers/science.htm

Pohjola, M.V., Leino, O., Kollanus, V., Tuomisto, J.T., Gunnlaugsdόttir, H., Holm, F., Kalogeras, N., Luteijn, J.M., Magnusson, S.H., Odekerken, G., Tijhuis, M.J., Ueland, Ø., White, B.C., Verhagen, H., 2012. State of the art in benefit–risk analysis: environmental health. Food Chem. Toxicol 50, 40-55. http://dx.doi.org/10.1016/j.fct.2011.06.004

2. Aims of the study

This thesis summarizes some of the most essential results of the research regarding environmental health assessment that has been conducted in support of the development of open assessment method (http://en.opasnet.org/w/Open_assessment) and Opasnet web-workspace (http://www.opasnet.org) at the National institute for health and welfare (THL) during the years 2006-2012. The research has been guided by the following four research questions:

  1. What is environmental health assessment?
  2. How is environmental health assessment being made?
  3. How environmental health assessment ought to be made?
  4. How can environmental health assessment be developed from how it is made to how it ought to be made?

All these questions can be seen as underlying all parts of this thesis. However, the contents are ordered according to the questions so that the chapters in the beginning, starting from Introduction, primarily address questions 1 and 2, while the emphasis in the later chapters moves towards addressing questions 3 and 4.

Specific methods and frameworks of analysis are described in more detail within each individual article (chapters 3-8), but overall the perspective adopted in this research can be characterized as pragmatic, in the sense of pragmatism e.g. by Charles Sanders Peirce and James Dewey. In brief, it means that theory and practice are not perceived as separate entities, but instead the question in consideration is whether practices are intelligent or uninformed. Knowledge and action are thus seen as deeply intertwined. Altogether, the thesis aims to provide a comprehensive pragmatic account of environmental health assessment and guide the way for its future development and practice, for the purpose of enhancing health and well-being in the society.

3. State of the art in benefit–risk analysis: environmental health

State of the art in benefit–risk analysis: Environmental health

4. Looking beyond Borders: Integrating best practices in benefit-risk analysis into the field of food and nutrition

5. Openness in participation, assessment, and policy making upon issues of environment and environmental health: a review of literature and recent project results

Openness in participation, assessment, and policy making upon issues of environment and environmental health: a review of literature and recent project results

6. Process, content or outcomes? Perspectives to model and assessment performance

Evaluating performance of environmental health assessments

7. Pragmatic Knowledge Services

Pragmatic knowledge services

8. Evaluating effectiveness of open assessments on alternative biofuel sources

Evaluating effectiveness of open assessments on alternative biofuel sources

9. Discussion

The previous chapters have explored the traditions of and future insights in environmental health assessment as well as other fields of assessment relevant to environment and health. The considerations have addressed several aspects of environmental health assessment including assessment-policy relationship as well as the roles of participation, modelling and information systems in serving the purpose of assessments, i.e. producing and providing scientifically sound knowledge support to societal decision making. The aim of this work has been to identify the essential characteristics that either enable or delimit environmental health assessments in serving their purpose, i.e. being effective. The main findings are summarized and discussed here.

9.1 Environmental health assessment as collaborative learning

By considering the contents of previous chapters from an epistemological point of view, environmental health assessments can be characterized as means to ends (von Wright, 1963) and their information outputs as intentional artifacts (Hughes 2009), where the intention is to influence the end of health and well-being through societal decisions and actions. As such, assessments can take the form of ex ante, ex tempore, ex nunc as well as ex post evaluation of policies (cf. Hänninen and Junnila 2012, Pope et al. 2004). The knowledge about environment-health relationships and the actions to influence them are thus tightly interconnected in the idea of environmental health assessment. However, as was shown in previous chapters, surprisingly often this idea is all but missing in the currently common practice of environmental health assessment. In some approaches, such as the so-called Red Book risk assessment (NRC 1983), the disengagement is even considered as one of the cornerstones of assessment.

The interconnectedness of knowledge and action also means that the intended uses and use plans of assessment results and communication thereof are essential in the design and making as well as the application of environmental health assessments (cf. Vermaas and Houkes 2006, Houkes 2006, Franssen 2006). Environmental health assessment cannot be considered only as communication of results from environmental health research to policy making or the public. Identification of purpose and meaningful contextualization according to a practical assessment problem is required.

However, considering environmental health assessment as mere information production about environment-health relationships is not sufficient either. It should rather be perceived as an endeavor of collective learning regarding desirable actions that influence the environment-health relationships in order to help dealing with them. In essence, environmental health assessment is intentional development of shared belief systems (cf. Hilpinen 1995) among those to whom these environmental health relationships are of relevance. Effective environmental health assessment thus necessitates collaboration between environmental health experts and relevant decision makers, but also those affected by or otherwise interested in the issues at hand. In addition, an arena for such a collaboration to take place, as well as means to guide the collaboration towards practical solutions, is needed.

The idea of social learning has been brought up also previously in discourses on public participation in assessment and policy. It has, however, been often considered mostly in the sense of educating stakeholders and the public to better understand the recommendations by experts and decisions by policy makers (e.g. Steyart et al. 2007, Webler 1995), than in terms of equipping policy makers with knowledge to be applied in decisions and actions (cf. Sanderson 2002). Altogether, the idea of learning has had little effect on the methods, tools, and practices of assessment and policy making, as well as the assessment-policy-public interaction in practice.

If aiming for effective science-based support to practical decision making in environmental health, the principles of scientific knowledge creation should be applied also in the exploration of problems and the search for solutions to them, not only in the underlying analysis of environment-health relationships. This calls for openness, transparency and broad collaboration in environmental health assessment.

Altogether, the essence of environmental health assessment can be described by means of an analogy with the pragmatic children's logic presented in the introduction: The scientific characterizations of the relationships between environment and health by environmental health experts get their meaning from their practical application in the decisions and actions that influence health and well-being in the society. In short, assessments are to change the world. The fundamental and practical purposes cannot be neglected in the practice and development of environmental health assessment. Instead, they should be explicitly recognized and implemented along the whole chain from scientific research to societal outcomes in order for the knowledge obtained through research to effectively influence the world. Assessments and their interactions with policy need to be designed starting from the purposes and knowledge needs of decision making and managed so that they become satisfied (figure 1).

Figure 1. Framework for effective assessment and knowledge-based policy. It emphasizes collaborative production and provision of knowledge to support decisions as well as evaluation and management of decision making over the whole chain from assessment to outcomes.

9.2 Implications to science-policy interaction in general

The above considerations are not specific only to assessment and decision making regarding environmental health, but are generalizable and applicable to virtually all application of knowledge in policy as well as other practical decision making. Similar characteristics and challenges as discussed in previous chapters can easily be identified e.g. in the discourses on science-policy interfaces as well as evidence-based policy.

On global scale, the science-policy interaction has traditionally been based on the idea of producing scientific assessments in expert bodies such as the Intergovernmental Panel on Climate Change (IPCC) and pushing the knowledge to policy and public. In order to overcome the limitations identified in the effectiveness of such efforts, improved policy relevance of scientific assessments as well as the underlying research has been called for (Perrings et al. 2011). Towever, this alone has been claimed as insufficient as it overlooks the reality and needs of policy making and neglects often important non-scientific local knowledge (Briggs & Knight 2012, Hulme et al. 2011). Altogether, the progress of the discourse resembles closely what was discussed in previous chapters regarding environmental health assessment.

Evidence-based policy has been a subject of remarkable interest for more than a decade, but it has recently become a hot topic in Finland. In evaluations of policy effectiveness, it has been identified that the demand and supply of information do not meet optimally, and both the policy relevance of research and the use of research results in policy making need to be improved (Lankinen et al. 2012, Junnila 2012). Correspondingly, it has been investigated that the municipalities in Finland can be characterized at best only modestly active in applying impact assessments to support municipality-level decision making (Kauppinen 2012). Interestingly, however, the main mechanisms recently suggested to promote the strengthening of the evidence-base of policies are a comprehensive reform of sectoral state research institutes and state research funding (Lankinen et al. 2012, Junnila 2012) as well as enhanced education of science communication within doctoral programs (Treuthardt and Nuutinen 2012). Similar indirect efforts attempting to address the challenges in the use of science-based knowledge in decision making have been common also in the context of environmental health assessment as was discussed in the previous chapters. However, as the history of environmental health assessment shows, such attempts alone have not been sufficient for resolving the challenges in effective provision and use of knowledge in policy making.

Generally it is desired that policies are based on sound knowledge and reasoning, but it may be questioned whether the applied means and the attempts to improve them really serve their purposes. In the end the most of the discourses addressing interaction between science and policy on different levels and within different contexts seem to boil down to calling for "better knowledge input" to policy as well as different kinds of bodies or arrangements to provide such input. Little emphasis is put on the practices of making use of the knowledge inputs in the policy processes. Correspondingly, much of the work dealing with knowledge and policy focus on the production of knowledge (Jones 2009), and the role of policy making is typically delimited to at most creating a demand to drive the so called policy relevant assessments and research.

On the other hand, it is also often reminded that science-based knowledge is only one (minor?) input among all other inputs to societal decision making (e.g. Briggs & Knight, 2012, Krohn & Wilskman 2012). Altogether, science and policy remain perceived as distinct entities (van Egmond et al. 2011) and the effective practices of obtaining and using knowledge in policy making are not paid any more attention than in the discourses on environmental health assessment (cf. Potter and Harries 2006, Almeida and Báscolo 2006). In fact, it appears that environmental health assessment could be considered as a forerunner in developing methods and tools for science-based support to policy making. The emphasis in the development of environmental health assessment is shifting towards design, management and facilitation of effective practices in intertwined production and use of knowledge as an essential part of policy making, and it looks like the other branches of science-policy interaction should follow.

9.3 Implementation in practice?

How can such assessment-policy interaction be realized? After all, environmental health assessment, as suggested above, may sound very idealistic. However its implementation is for the most part it is already possible in practice, as has been indicated by the development and application of open assessment and Opasnet discussed e.g. in chapters 3, 5, 7 and 8 (see also http://en.opasnet.org/w/Category:Assessments for more assessment examples in Opasnet). On the other hand, it must be noted that the experiences from practical implementation of these ideas, methods, and tools in intimate interaction with policy making and broad public participation are still limited. It should also be reminded that open assessment and Opasnet are only examples attempting to apply the ideas of effective environmental health assessment discussed above. Their functionalities and practices are thus inevitably imperfect, yet developing, manifestations of the ideas. Correspondingly, this thesis presents a theoretically founded conceptual basis for effective environmental health assessment, as well as science-policy interaction in general, rather than a ready solution for its implementation.

Despite the limitations in the currently common methods and practices of environmental health assessment, there already exists a lot of potential in the emerging assessment approaches. In addition, the development of digital networks and the rise of the social media have prepared the society for open production and sharing of knowledge during the last decades. Consequently, the knowledge supply side of the assessment-policy interaction can be considered to be in a relatively good order as regards practical implementation. Correspondingly, it appears that the greatest bottleneck for effectiveness of environmental health assessment is in policy making, the knowledge demand side. Particularly the commonly adopted practices of obtaining and using existing and available knowledge in decision making do not seem to make use of the knowledge supply by experts as well as non-experts. As a result, the best available knowledge does not become properly embedded in decisions, their implementations, and outcomes (cf. Figure 1).

However, also encouraging examples exist, indicating that effective science-policy interaction is possible. For example, in the context of evidence-based health policy in the Netherlands, it has been possible to demonstrate productive interaction between researchers and policy makers in co-production of research and health policy (van Egmond et al. 2011, Bekker et al. 2010). This has required learning and adapting to each other’s needs from both policy makers as users of knowledge and researchers as suppliers of knowledge (van Egmond et al. 2011) as well as intentional blurring of the boundary between science and policy. In addition, such co-production of research and policy does not just happen, but explicit coordination as well as mediating infrastructures are needed for its realization (Bekker et al. 2010). However, knowledge can only effectively contribute to the policy making process, if policy makers and researchers together negotiate available evidence and interpret its value for policy making (Bekker et al. 2010).

The characteristics of effective practices in the Dutch science-policy interaction are close to what is proposed for environmental health assessment in this thesis. They also resemble the conceptual basis of the on-going Tekaisu-project (http://en.opasnet.org/w/Tekaisu, Pohjola et al. 2012) for developing knowledge-based municipality-level decision making in Finland, particularly addressing impacts to environment and health (mentioned also in chapter 6). From a theoretical perspective, the main aims of the Tekaisu-project are to design and implement effective and sustainable practices for collaborative needs-driven decision support as well as evaluation and management of decision making over the whole chain from knowledge creation to societal outcomes (see Figure 1).

What is necessary to realize in implementation of such practices for effective environmental health assessment and policy, is that they necessitate acceptance and involvement of not only environmental health and other experts in charge of assessments, but also policy makers on different levels of governance as well as the members of society at large. In fact, a broad cultural change is needed. Fundamentally the question is only about ensuring the existence of well-reasoned and applicable knowledge where and when practical decisions and actions take place. However, in the current situation, where many common practices and attitudes are based on separation of experts, lay-people, and policy makers as well as withholding of knowledge, there are many practical limitations to implementing practices that build on openness, transparency and collaboration. If, and when, these ideas become implemented in everyday assessment-policy interaction, it can be considered a comprehensive reform of knowledge practices in policy making.

References

Almeida, C., Báscolo, E., 2006. Use of research results in policy decision-making, formulation, and imple-mentation: a review of the literature. Cadernos de Saúde Pública Reports in Public Health 22, S7-S33.

Bekker, M., van Egmond, S., Wehrens, R., Putters, K., Bal, R., 2010. Linking research and policy in Dutch healthcare: infrastructure, innovations and impacts. Evidence & Policy 6, 237-253.

Briggs, S.V., Knight, A.T., 2011. Science-policy interface: Scientific input limited. Science 333, 696-697.

van Egmond, S., Bekker, M., Bal, R., van der Grinten, T., 2011. Connecting evidence and policy: bringing researchers and policy makers together for effective evidence-based health policy in the Netherlands: a case study. Evidence & Policy 7, 25-39

Franssen, M., 2006. The normativity of artefacts. Studies in History and Philosophy of Science 37, 42-57.

Hilpinen, R., 1995. Belief systems as artifacts. Monist 78, 136-155.

Houkes, W., 2006. Knowledge of artefact functions. Studies in History and Philosophy of Science 37, 102-113.

Hulme, M., Mahony, M., Beck, S., Görg, C., Hansjürgens, B., Hauck, J., Nesshöver, C., Paulsch, A., Vandewalle, M., Wittmer, H., Böschen, S., Bridgewater, P., Diaw, M.C., Fabre, P., Figueroa, A., Heong, K.L., Korn, H., Leemans, R., Lövbrand, E., Hamid, M.N., Monfreda, C., Pielke Jr., R., Steittele, J., Winter, M., Vadrot, A.B.M., van den Hove, S., van der Sluijs, J.P., 2011. Science-policy interface: Beyond assessments. Science 333, 697-698.

Hughes, J., 2009. An artifact is to use: An introduction to instrumental functions. Synthese 168, 179-199.

Hänninen, S., Junnila, M., 2012. Poliittinen vaikuttaminen ja politiikkatoimien vaikuttavuusarviointi demok-ratiassa. In Sakari Hänninen & Maijaliisa Junnila: Vaikuttavatko politiikkatoimet?. National institute for health and welfare, Tampere. http://urn.fi/URN:ISBN:978-952-245-527-7

Jones, H., 2009. Policy-making as discourse: a review of recent knowledge-to-policy literature. A joint IKM Emergent-ODI Working Paper No 5. IKM Emergent Research Programme, European Association of Development Research and Training Institutes (EADI), Bonn, Germany.

Junnila, M., 2012. Tutkimustiedon kysynnän ja tarjonnan kohtaaminen. In Sakari Hänninen & Maijaliisa Junnila: Vaikuttavatko politiikkatoimet?. National institute for health and welfare, Tampere. http://urn.fi/URN:ISBN:978-952-245-527-7

Kauppinen, T., 2012. Ennakkoarviointi kuntien päätöksenteon tukena. In Sakari Hänninen & Maijaliisa Junnila: Vaikuttavatko politiikkatoimet?. National institute for health and welfare, Tampere. http://urn.fi/URN:ISBN:978-952-245-527-7

Krohn, M., Wilskman, K., 2012. Kuntapolitiikkaan vaikuttaminen. In Sakari Hänninen & Maijaliisa Junnila: Vaikuttavatko politiikkatoimet?. National institute for health and welfare, Tampere. http://urn.fi/URN:ISBN:978-952-245-527-7

Lankinen, T., Hagström-Nasi, C., Korkman, S., 2012. State research institutes and research funding: pro-posal on a comprehensive reform. Prime Minister’s Office Publications 3/2012. Edita Prima, Helsinki.

NRC, 1983. Risk Assessment in the Federal Government: Managing the Progress. The National Research Council. National Academy Press, Washington, DC. Perrings, C., Duraiappah, A., Larigauderie, A., Mooney, H., 2011. The biodiversity and ecosystem services science-policy interface. Science 331, 1139-1140.

Pohjola, M., Pohjola, P., Tuomisto, J., 2012. Ympäristö- ja terveysvaikutuksia koskeva tieto kunnallisessa päätöksenteossa (in Finnish). Ympäristö ja Terveys 10/2012.

Pope, J., Annandale, D., Morrison-Saunders, A.,2004. Conceptualising sustainability assessment. Environ-mental Impact Assessment Review 24, 595-616.

Potter, C.C., Harries, J., 2006. The determinants of policy effectiveness. Bulletin of the World Health Or-ganization 84, 843.

Sanderson, I., 2002. Evaluation, policy learning and evidence-based policy making. Public Administration 80, 1-22.

Steyart, P., Barzman, M., Billaud, J-P., Brives, H. Hubert, B., Ollivier, G., Roche, B., 2007. The role of knowledge and research in facilitating social learning among stakeholders in natural resources manage-ment in the French Atlantic coastal wetlands. Environmental Science & Policy 10, 537-550.

Treuthardt, L., Nuutinen, A., 2012. Tieteen tila 2012. Publications of the Academy of Finland 6/12. Acad-emy of Finland, Helsinki. http://www.aka.fi/Tiedostot/Tieteentila2012/Tieteentila2012.pdf

Vermaas, P.E., Houkes, W., 2006. Technical functions: a drawbridge between the intentional and structural natures of technical artefacts. Studies in History and Philosophy of Science 37, 5-18.

Webler, T., Kastenholz, H., Renn, O., 1995. Public Participation in Impact Assessment: A social learning Perspective. Environmental Impact Assessment Review 15, 443-463.

von Wright, G.H., 1963: Practical inference. The Philosophical Review 72, 159-179.

10. Conclusions

Based on above considerations, following brief answers can be provided to the research questions presented in chapter 2:

  1. In principle, environmental health assessment is development and delivery of knowledge, not mere information, to the processes where decisions and actions that have influence on environment and health are being made. The purpose of environmental health assessment is to enhance health and well-being in the society.
  2. The currently common practices of assessment and policy are insufficient for serving the purpose of environmental health assessment effectively. Societally relevant decisions upon issues of environmental health are often unoptimal and not based on best existing and available knowledge.
  3. Environmental health policy making based on best available knowledge requires tight and transparent linkage of assessment and decision making, inclusion of all relevant stakeholders, practical problem framing, and application of the scientific methods of knowledge creation also in exploration of problems and development of solutions, not only in analysis of the underlying environmental health phenomena. Effectiveness of assessments and policy making must be evaluated and managed across the whole chain from obtaining knowledge to the oputcomes of decisions and their implementation.
  4. An outcome-oriented turn is already taking place in the development and practice of environmental health assessment. The methods and tools of collaborative knowledge creation already enable pragmatic openness in environmental health assessment. The development of digital networks and the social media have prepared the society for open production and sharing of knowledge. What is still needed is a broad cultural change from disengagement and withholding of knowledge towards openness, transparency and collaboration for effective environmental health assessment and policy. The focus of future development shall be set on particularly developing practices of effective use of knowledge in policy making.

These conclusions apply primarily to environmental health assessment, but are also generalizable to the interaction between science and policy in general.

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