Impact assessment: Social, technological and health systems DEEP DIVE LATERAL LEARNING PROGRAM ON INCLUSIVE ENERGY SOLUTIONS The University of Melbourne Department of Electrical and Electronic Engineering A/Prof Peter Annear Nossal Institute for Global Health September 2, 2016
Themes of this lecture Health and health systems Complex adaptive systems Developing countries: economic and social change Engineering as a social and environmental agent ideas, concepts and approaches
www.thelancet.com Published online July 16, 2015 http://dx.doi.org/10.1016/s0140-6736(15)60901-1
Access to health care is essential to sustainable development (the ability to learn and to work) Sustainable development can improve health (transport, housing, energy, agriculture) Health indicators measure the success of inclusive and sustainable development WHO (2011), Public Health & Environment Department, Health, Security & Environment Cluster, Geneva www.who.int/phe/en www.who.int.hia/green_economy/en/index.html
Complexity Health systems are complex adaptive systems: Large, multi-dimensional, many different inputs, many different actors, many different outcomes So, how do we understand these systems, manage them and anaylse them?
CAS principles Self-organization, complexity, emergence, interdependence, space of possibilities, co-evolution, and self-similarity Contrasted with ordered and chaotic systems by the relationship that exists between the system and the agents that act within it Within CAS the system and the agents co-evolve in a self-organizing system The system lightly constrains agent behaviour, but the agents modify the system by their interaction with it
Previous approaches In the early 20th century, organizations were often viewed as a machine, which meant large amounts of bureaucracy, hierarchy, and standardization From the 1950s the planned approach that looked at operational practices and effectiveness was dominant Organizations would deal with change incrementally by focusing on one problem or goal at a time From the 1980s onward the emergent approach argued that change is continuous and unpredictable Impact assessment therefore requires a theory of change
CAS and engineering Complex Adaptive Systems Engineering improving our understanding of complex systems and reducing their risk* Taking a longer and broader view of CAS improves our ability to reduce the risks they face and create. CAS and engineering This approach has been successfully applied to national planning for pandemics and other natural disasters, identification of strategies for reducing counteracting monetary policies and reducing uncertainty in forward and backward tracking of food supply chain contamination Impact and risk management Evaluation of what happens to CAS such as ecosystems, societies, infrastructures or economies when their environment changes *Theresa J. Brown, Stephen H. Conrad, Walter E. Beyeler. SAND 2012-464IP, Earth Systems Engineering 2012. Newcastle, United Kingdom.
Systems Thinking Perceive systems as whole made up of parts that interact toward a common purpose Every interpretation of a research result requires a model With assumptions that can be calibrated as data Using a wide variety of scientific methods of investigation David H Peters. 2014. The application of systems thinking in health: why use systems thinking? Health Research Policy and Systems201412:51 DOI: 10.1186/1478-4505-12-51 https://health-policy-systems.biomedcentral.com/articles/10.1186/1478-4505-12-51
Impact assessment Engineering CAS requires complex impact assessment approaches: Social and environmental impact Technological impact Health impact
Social and environmental impact The environment, demography and social change Epidemiology and the aetiology of disease
Demographic changes: pop growth, urbanization, aging, mobility Social changes: institutions, governance, internal codes, cultural diffusion Economic activity: trade, capital movements, labour conditions, wealth creation and distribution, ODA Impacts on population well-being Systematic environmental impacts: degradation of land and water, depletion of resources, ecosystem disturbances, distribution of biogeophysical systems (e.g. climate system) Anthony McMichael.2013. Globalisation, Climate Change and Human Health. New England Journal of Medicine 368:14 April 4.
Technological impact The economic development process Environmental risk transition household-community-regional-global Health transition from communicable to lifestyle diseases 1/4 to 1/3 of the global burden of disease comes from environmental impact
Environmental risks Environmental change is global so health risk and impact are also global CO 2, deforestation, depleted aquifers, over-fishing Pollution in developing countries is less than would be expected with industrialisation But change is often negative Shifting dirty industry from USA to Mexico WTO, SAP and poverty Increased human mobility Climate Change Commission 2009
Exposure events Number of people older than 65 years exposed to heatwave risks Nick Watts. Health and climate change: policy responses to protect public health. The Lancet. June 23, 2015 http://dx.doi.org/10.1016/s0140-6736(15)60854-6
Health impact Development-environment-health Health environmental impact assessment (EIA) Health environmental risk assessment (ERA)
Health EIA Integrated environmental health impact assessment model: 1. project analysis 2. analysis of status quo 3. prediction of impact (including prognosis of health impact; equity) 4. assessment of impact 5. recommendations 6. communication of results 7. evaluation of the overall procedure Rainer Fehr Environmental Health Impact Assessment., Evaluation of a Ten-Step Model Epidemiology September 1999, Vol. 10 No. 5
Health ERA Risk assessment gathers and organises information: risks at a point in time and changes over time assessments of new and different types of risk identification and comparison of different factors that affect the nature and magnitude of the risk issues prioritised according to their levels of risk health guidance values to protect public health comparison of the potential health impacts of various environmental health interventions risk-based policy making and consistent appraisal of public health risks
SDGs: engineering solutions? I End poverty 2 end hunger 3 ensure healthy lives and well being 4 quality education 5 gender equality 6 water and sanitation for all 7 Affordable and sustainable energy 8 decent work for all 9 technology to benefit all 10 reduce inequality 11 safe cities and communities 12 responsible consumption by all 13 stop climate change 14 protect the ocean 15 take care of the earth 16 live in peace 17 strengthen partnerships to reach the goals
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