Cartier Yuri, Benmarhnia Tarik, Brousselle Astrid
Ecole des Hautes Etudes en Santé Publique (Sorbonne Paris Cité), Rennes, France.; Canada Research Chair in Evaluation and Health System Improvement, Canada.
Ecole des Hautes Etudes en Santé Publique (Sorbonne Paris Cité), Rennes, France.; Canada Research Chair in Evaluation and Health System Improvement, Canada; Département de santé communautaire, Université de Montréal, Montréal, Québec, Canada.
Eval Program Plann. 2015 Dec;53:1-9. doi: 10.1016/j.evalprogplan.2015.07.004. Epub 2015 Jul 9.
Urban outdoor air pollution (AP) is a major public health concern but the mechanisms by which interventions impact health and social inequities are rarely assessed. Health and equity impacts of policies and interventions are questioned, but managers and policy agents in various institutional contexts have very few practical tools to help them better orient interventions in sectors other than the health sector. Our objective was to create such a tool to facilitate the assessment of health impacts of urban outdoor AP interventions by non-public health experts.
An iterative process of reviewing the academic literature, brainstorming, and consultation with experts was used to identify the chain of effects of urban outdoor AP and the major modifying factors. To test its applicability, the tool was applied to two interventions, the London Low Emission Zone and the Montréal BIXI public bicycle-sharing program.
We identify the chain of effects, six categories of modifying factors: those controlling the source of emissions, the quantity of emissions, concentrations of emitted pollutants, their spatial distribution, personal exposure, and individual vulnerability. Modifiable and non-modifiable factors are also identified. Results are presented in the text but also graphically, as we wanted it to be a practical tool, from pollution sources to emission, exposure, and finally, health effects.
The tool represents a practical first step to assessing AP-related interventions for health and equity impacts. Understanding how different factors affect health and equity through air pollution can provide insight to city policymakers pursuing Health in All Policies.
城市室外空气污染是一个主要的公共卫生问题，但很少评估干预措施对健康和社会不平等的影响机制。政策和干预措施对健康和公平的影响受到质疑，但在各种机构背景下的管理人员和政策制定者几乎没有实用工具来帮助他们更好地指导除卫生部门以外其他部门的干预措施。我们的目标是创建这样一种工具，以方便非公共卫生专家评估城市室外空气污染干预措施对健康的影响。
采用反复查阅学术文献、头脑风暴以及与专家协商的过程，以确定城市室外空气污染的影响链和主要调节因素。为测试其适用性，该工具应用于两项干预措施，即伦敦低排放区和蒙特利尔BIXI公共自行车共享计划。
我们确定了影响链、六类调节因素：控制排放源的因素、排放量、排放污染物的浓度、其空间分布、个人暴露以及个体易感性。还确定了可改变和不可改变的因素。结果以文字形式呈现，也以图表形式呈现，因为我们希望它成为一个实用工具，从污染源到排放、暴露，最终到健康影响。
该工具是评估空气污染相关干预措施对健康和公平影响的实际第一步。了解不同因素如何通过空气污染影响健康和公平，可为追求“健康融入所有政策”的城市政策制定者提供见解。
