Sexton Ken
University of Texas School of Public Health , Brownsville, TX, USA.
J Public Health Res. 2013 Sep 5;2(2):e18. doi: 10.4081/jphr.2013.e18. eCollection 2013 Sep 2.
Significance for public healthRisk-based decision making is a core feature of government actions aimed at protecting public health from the adverse effects of environmental hazards. In the past, it has often been an expert-driven, mostly obscure process used by federal agencies to justify and defend regulatory decisions made outside the public arena. But the nature of decision making has changed as it has become apparent that environmental health problems are more complicated, controversial, and costly to solve than originally thought. Meaningful public engagement is now an inherent component of all phases of the risk assessment - risk management paradigm because it promotes stakeholder buy in, taps into unique stakeholder knowledge, and promotes the concept of environmental democracy.In the United States, the risk assessment - risk management paradigm that underpins federal decisions about environmental health risks was first established in 1983. In the beginning, the importance of public participation was not explicitly recognized within the paradigm. Over time, however, it has become evident that not only must risk-based decisions be founded on the best available scientific knowledge and understanding, but also that they must take account of the knowledge, values, and preferences of interested and affected parties, including community members, business people, and environmental advocates. This article examines the gradually expanding role of public participation in risk-based decision making in the United States, and traces its evolution from a peripheral issue labeled as an external pressure to an integral element of the 21st century risk assessment - risk management paradigm. Today, and into the foreseeable future, public participation and stakeholder involvement are intrinsic features of the emerging American regulatory landscape, which emphasizes collaborative approaches for achieving cooperative and cost-effective solutions to complicated and often controversial environmental health problems.
对公共卫生的意义
基于风险的决策是政府旨在保护公众健康免受环境危害不利影响的行动的核心特征。过去，这往往是一个由专家主导、大多不透明的过程，联邦机构用它来证明和捍卫在公共领域之外做出的监管决策。但决策的性质已经发生了变化，因为很明显，环境健康问题比最初想象的更加复杂、更具争议性且解决成本更高。有意义的公众参与现在是风险评估 - 风险管理范式所有阶段的固有组成部分，因为它促进利益相关者的认同，利用利益相关者独特的知识，并推动环境民主的理念。
在美国，支撑联邦政府关于环境健康风险决策的风险评估 - 风险管理范式于1983年首次确立。一开始，该范式中并未明确承认公众参与的重要性。然而，随着时间的推移，显而易见的是，基于风险的决策不仅必须建立在现有的最佳科学知识和理解之上，还必须考虑到利益相关方和受影响方（包括社区成员、商界人士和环境倡导者）的知识、价值观和偏好。本文考察了公众参与在美国基于风险的决策中逐渐扩大的作用，并追溯了其从一个被视为外部压力的边缘问题演变为21世纪风险评估 - 风险管理范式不可或缺的要素的过程。如今，以及在可预见的未来，公众参与和利益相关者参与都是美国新兴监管格局的内在特征，这种格局强调采用协作方法来实现对复杂且往往具有争议性的环境健康问题的合作性和成本效益高的解决方案。
