14 Jan 2010
The Northern Ireland Executive opened a public consultation on its draft Sustainable Development Strategy in October 2009. You can also access a later IPH submission from October 2010 connected to ‘Everyone’s Involved’ here.
The full IPH summary can be accessed below:
Submission from the Institute of Public Health in Ireland on the Sustainable Development Strategy (Northern Ireland)
Submitted to the Office of the First Minister and Deputy First Minister
The Institute of Public Health in Ireland
The Institute of Public Health in Ireland (IPH) aims to improve health on the island of Ireland by working to combat health inequalities and influence public policies in favour of health. IPH promotes cooperation between Northern Ireland and the Republic of Ireland in public health research, training and policy advice. Its key focus is on efforts to improve health equity.
The work of IPH (www.publichealth.ie) includes health impact assessment, building and sharing evidence for public health development, developing Ireland and Northern Ireland’s population health observatory (INISPHO www.inispho.org ), and providing public health policy advice in areas such as health inequalities, obesity, fuel poverty and food poverty.
Health is influenced by a wide range of social determinants, including economic, environmental, social and biological factors. IPH has a key interest and significant experience in raising awareness and developing work to influence these wider social and environmental determinants in ways which improve health.
Sustainable development and public health are inextricably linked, in ways which are described in section 3. Sustainable development is essentially at the heart of healthy communities and individuals as well as a healthy environment and sustainable economic development – all factors at the heart of public health.
IPH has been developing interest and expertise in building evidence and supporting action on linking sustainable development, health and equity. Recent relevant work includes, for example, reviews on the health impact of the built environment, and the health impact of transport; annual updates on fuel poverty; a report on an all island approach to health inequalities and social determinants.
IPH welcomes the opportunity to comment on the Office of the First Minister and Deputy First Minister (OFMDFM), Everyone’s Involved: Sustainable Development Strategy, and would be pleased to contribute to the next stages of development of the strategy and its implementation plan.
2 Key points
i) IPH welcomes the aim of the Sustainable Development Strategy to put in place economic, social and environmental measures to ensure a strong, healthy, just and equal society, and calls for a much stronger revised Strategy which provides clarity, direction and guidance.
IPH strongly supports the concept of a strategy as an overarching framework within which all Government policies should be developed. Central Government has a key leadership and coordinating role, and a strong strategy and coherent implementation plan could draw together the different elements and organisations which are needed to take action to achieve sustainability in Northern Ireland.
The Strategy should provide a framework for government policies and be delivered through the Programme for Government.
It should include high level targets with commitments to reduce
ecological footprint and reduce greenhouse gases, improve public health
and promote equity. The targets need to carry across from the
Sustainable Development Strategy to the Programme for Government and to
Public Service Agreements and Departmental Action Plans.
An Implementation Plan should be developed as a priority alongside the revision of the Strategy. The Implementation Plan should be cross-cutting and used to integrate the work of all sectors to ensure a coordinated approach to meeting sustainable development targets.
Mechanisms for accountability and monitoring should be set for all public bodies who should report on their progress on delivering the targets in the revised Strategy.
ii) IPH calls for a greater acknowledgement of the need for convergence between sustainable development and public health. These links need to be stated explicitly in a revised Strategy.
The Sustainable Development Strategy should be closely integrated with
efforts to improve health and reduce health inequalities, and closely
linked to Northern Ireland’s Investing for Health Strategy. The
co-benefits to health arising from action on sustainable development are
not widely appreciated. A greater awareness might encourage further
commitment and help to make best use of investment.
Sustainable development must include access to sustainable food, access to a sustainable transport system, healthy planning policies and built environments, and reduction in the harmful effects of climate change. Lack of action in these areas is highly likely to have a detrimental impact on health and health inequalities.
iii) IPH calls for a greater emphasis on equity as an underlying principle of sustainable development in Northern Ireland.
The Sustainable Development Strategy should emphasise the importance of balancing environmental, social and economic objectives.
Health is influenced by a variety of factors, including all those identified as important to sustainable development. Poor social, environmental and economic circumstances affect health throughout life. People further down the social ladder run at least twice the risk of illness and premature death as those near the top. There is an appalling health gap between rich and poor, and a clear social gradient whereby health generally improves with each step of the income ladder.
Inequalities in health are caused by the unequal distribution of political power, income, goods and services, and the consequent inequalities that affect the living conditions and health of people. This unequal distribution is in direct contradiction to the aims of the Sustainable Development Strategy. The Strategy should be used as a significant opportunity to challenge this injustice.
As more information becomes available on the likely health impacts of climate change it is clear that as well as efforts to control greenhouse gas emissions there is a need to adapt and manage the effects. There is a particular need to ensure that policies such as price mechanisms do not increase income inequality and worsen health inequalities.
iv) The revised Strategy should demonstrate clearly strong links with UK and EU and global priorities.
It is abundantly clear that the factors which make up the sustainable development agenda are often highly influenced by action outside Northern Ireland. It is in all our interests, now and in the future that Northern Ireland plays its part in national, international and global efforts to improve sustainability, health, and equity.
v) An innovative research and development strategy should form part of the Sustainable Development Strategy to ensure it is based on good science.
Building links between research, policy and practice needs to be built into all aspects of the Strategy’s development and implementation. Translational research should build on some of the models being developed by the UKCRC Centre for Excellence for Public Health (Northern Ireland).
Sustainable development and health are inextricably linked internationally and nationally.
Sustainable development has risen on the agenda since the Sustainable Development Strategy was first developed in Summer 2008 and the links between sustainable development and public health are increasingly being understood and highlighted.
The threat of climate change has generated a flood of policy documents outlining how climate change will harm human health and how successful strategies to mitigate the effects of the change will restrict that harm. But studies suggest that these mitigation strategies will have independent effects on health, many of which will be beneficial.
These co-benefits are not widely appreciated. Greater integration of sustainable development and public health will achieve synergies of impact and offset at least some of the costs of, for example, climate change mitigation.
Sustainable development presents an opportunity to improve health and reduce health inequalities in several areas including energy efficiency, transport, food production, the built environment, and reduction of poverty and inequality.
(1) Household energy
Fuel poverty is a significant risk to health especially for some vulnerable groups. Living in cold, damp homes present a number of health risks including cardiovascular disease, stroke and depression.
Recent attention has turned to more sustainable solutions to addressing fuel poverty such as better home insulation. Research shows that improvements in household energy efficiency have substantial net benefits for health, mainly through improved indoor temperature and better air quality/ventilation. Changes of modes of electricity generation would reduce not only carbon dioxide (CO2) emissions but also particulate air pollution and consequently mortality.
Current transportation methods are unsustainable and detrimental to health and wellbeing. Impacts on health include injuries and deaths from traffic accidents, respiratory and cardiovascular problems due to air pollution as well as obesity and obesity-related illnesses due to low levels of physical activity. Noise annoyance, traffic related stress, community severance and journeys not made due to unavailability of transport services can also contribute to poorer health. Taking a broader perspective, transport emissions are a major contributor to climate change, with subsequent health impacts.
Meeting greenhouse gas emissions targets will require less private motor vehicle use. A sustainable transport system which facilitates physical activity such as walking and cycling and supports a better public transport system will reduce reliance on private transport. The health benefits of more active forms of transport are numerous. Choosing active forms of travel will bring about some immediate health benefits for individuals primarily through increasing their levels of physical activity. Other impacts will be more dependent on changes made at population level. Pedestrians and cyclists are more vulnerable to negative health impacts such as injuries, air and noise pollution as long as the car remains the dominant mode of travel. However, in countries where there are high volumes of pedestrians and cyclists, risks to health decrease.
Moving towards more sustainable transport systems requires cooperation and coordination between regional and local development and transport planning. Consideration of impacts on health and health inequalities in such development can add further support to the need for policy and investment to improve levels of active travel.
As well as contributing to increasingly unsustainable methods of food production, the 20th Century change from largely plant-based diets to energy-dense diets high in fat and animal foods has played a key role in the upsurge of diet-related, preventable health problems. Health impacts of poor nutrition are substantial and include obesity, cancer, heart disease, stroke and depression. Poorer social groups are currently less likely to have access to a healthy diet.
The agricultural sector contributes 10-12 % of total greenhouse gas emissions worldwide. Deforestation and other changes in land use contribute an additional 6-17% of global emissions. Production of food from animal sources is the major contribution to emissions from the agricultural sector.
Global demand for animal-source foods is projected to increase substantially internationally over the next 30 years. Technological strategies within the food and agricultural sector, such as improved efficiency of livestock farming, increased carbon capture through management of land use, improved manure management, and decreased dependency of fossil-fuel inputs, are necessary but not sufficient to meet targets to reduce emissions. A combination of technological improvements and reduction in production of foods from animal sources could provide an efficient contribution to meet national and global targets to reduce emissions.
A sustainable food system that can supply safe, healthy food with positive social benefits and low environmental impacts is a key concern for public health and vital for increased health equity. Concomitant reduction in consumption of livestock products in high consumption populations could substantially improve public health, for example through reductions in heart disease.
(4) Reducing poverty and ensuring equity
Prosperity is best defined by people’s capability to flourish physically, psychologically and socially. A sustainable economy is not achievable through current economic growth, which appears to sustain inequality.
At its heart a sustainable development strategy is about equity. Less material consumption can help to reduce many of the social and economic variables that determine health and health inequalities. Overconsumption in food and energy use are key issues while at the same time equitable access to sustainable goods is essential. Sustainable development and a healthy environment is essentially at the centre of healthy communities and individuals.
The Executive’s cross-cutting public health strategy, Investing for Health, is based on an approach which acknowledges the importance of social, environmental, and economic influences on health and it is important that links are built between sustainable development, health and equity.
In summary, a strong Sustainable Development Strategy has huge potential benefits for public health and well-being. This will only be realised if there is a sense of urgency in the implementation of the strategy and if synergy is built with the public health agenda.
Response to Consultation Questions
1. Do you agree the draft Sustainable Development Strategy
presents itself as an enabling document which paves the way for the
creation of an Implementation Plan containing explicit plans and targets
in support of sustainable development?
If you do not agree, please explain why and what alternatives you would propose.
Sustainable development should provide the overarching framework for Government, and be closely aligned to the Programme for Government, with commitments which direct what should be included in the next three year programme period.
The draft Sustainable Development Strategy aims to be an enabling document for the creation of an Implementation Plan. It should provide clarity of purpose and clear principles. It needs to set high level targets which would motivate and encourage action, and measure progress.
The current draft is vague and the commitments are abstract. There is little focus on action. It has far too many confusing principles, commitments, objectives, and it lacks the detail and strength to be an enabling document. The chapter headings are repetitive, several relate to the need for sectors to work together. A shorter, crisper, more meaningful document would increase its utility.
2. Do you agree that the draft Sustainable Development Strategy will effectively link high level objectives to delivery of plans? If you do not agree, please explain why and what alternatives you would propose.
IPH call for stronger leadership to help develop a clearer and stronger Strategy as a framework for the implementation of an effective Implementation Plan.
Direction, guidance and advice need to be provided to all sectors to
enable them to fully understand the necessity of moving towards a
IPH supports the triple approach outlined by Northern Ireland Environmental Link (NIEL) and believes this approach is needed to achieve change. It includes:
Education and public awareness – of the need for action, the reasons for action and the actions required
Financial drivers – to support and encourage changes which make it financially advantageous to do so (tax breaks, grants, charges etc.)
Legislation and regulation – to support changes in the required direction through standards, enforcement (speed restrictions, waste management etc).
The lack of specific targets and vague commitments currently do not present the basis for effectively linking high level objectives to delivery of plans. High level targets are needed in the Strategy with operational targets in the Implementation Plan. Both need timescales within which to measure progress.
Implementation targets should be SMART (specific, measurable, achievable, realistic and timely).
The plan for delivery needs to identify who should be involved and how progress will be measured. Central Government needs to ensure accountability and the Duty for Sustainable Development can provide a mechanism to monitor progress. Performance reports should be required from all public bodies as a means of accountability to the Assembly.
3. Do you agree with the Principles, Priorities and Strategic Objectives identified within the draft Sustainable Development Strategy? If you do not agree, please explain why and what alternatives you would propose.
IPH supports the first set of principles contained in the Strategy.
In addition to these 6 principles the Strategy also contains 5 priority areas, 4 more principles, 24 strategic objectives, and 20 commitments.
IPH recommends that high level strategic targets are developed which set out the direction for the Implementation Plan. These should include commitments to improvement of health and equity, reduce ecological footprint, and reduce greenhouse gases. The Strategy needs to be closely aligned with sustainable development strategies in Ireland, the devolved administrations of the UK and the EU.
IPH urges greater explicit acknowledgment of the links between sustainable development and health, and recommends stressing the need to link the Strategy to the Investing for Health Strategy.
Most of the commitments and objectives are process or relationship focused and written in general terms and this needs to be rectified.
4. Do you agree the Commitments (Annex A) will be sufficient to make sure those inside and outside Government contribute to the Strategy? If you do not agree, please explain why and what alternatives you would propose.
The draft Strategy appears to be based on a series of 20 commitments which seem to sit above the strategic objectives. The commitments and the objectives are vague and general. The commitments are vague and non-action focused and if retained they need to be strengthened. Stronger language needs to be used eg “we will explore” or “we will seek ways” should be changed to “we will implement” or “we will put in place” etc.
IPH urges the strengthening of the current commitments, identification of the range of organisations and agencies which should be involved and what action they are required to take.
A stronger strategy with much stronger language is required to facilitate and engage other sectors to take appropriate action. Greater acknowledgement is needed of those inside and outside Government who should be contributing and an explicit statement is required that sustainable development should be central to all other strategies.
An accountability mechanism needs to be established. Progress against revised commitments needs to be monitored on a regular basis and the Assembly should be given legislative powers to ensure full compliance towards meeting targets.
IPH is concerned about the lack of greater recognition of the work of local Government and the community and voluntary sector. The Sustainable Development Strategy should be for everyone but the focus seems to be for Central Government. The role of Central Government is crucial but there also needs to be a clear commitment to engaging the roles and responsibilities of other sectors including the community and voluntary sector.
This needs to be addressed to ensure ‘Everyone is involved’.
5. Do you agree with the scope of the four broad Key Challenges for cross-sectoral engagement set out in Chapter 3? If you do not agree, please explain why and what alternatives you would propose.
The challenges seem to relate mainly to how Central Government works with others. Recognition of the value of a partnership approach will enhance engagement with other sectors. IPH suggests that the challenge section should be written to spell out the real challenges facing Northern Ireland. The current text is non-specific, repetitive and generally avoids the crucial issues of what needs to be done to give Northern Ireland a chance of creating a sustainable future.
Local Government has a central role to play in contributing to the Sustainable Development Strategy but their involvement has received little recognition. The Review of Public Administration presents an important opportunity for the delivery of sustainable development policies and goals at a local level. Community Planning and the Power of Wellbeing present an opportunity for integration and mainstreaming sustainable development practices.
6. Does the draft Sustainable Development Strategy provide you or your organisation with sufficient information to facilitate the shaping of your own sustainable development plans? If you do not agree, please explain why and what alternatives you would propose.
The Strategy does not provide sufficient information to facilitate the
shaping of organisational plans. Its vague approach, lack of
specificity, weak language and failure to spell out the crucial roles of
other sectors means lack of clarity on the level of commitment and
specific actions required of other sectors.
A much stronger alternative framework is required which provides leadership, direction and guidance to facilitate organisations to shape their development plans.
This alternative framework should include high level targets, stronger objectives and timescales. There should be an explicit recognition of the need for close links between sustainable development and public health and equity.
7. We will develop indicators of sustainability which will align with the Programme for Government and National and European indicators. To what else should we have regard in doing this?
Specific indicators have to be developed for Northern Ireland to ensure progress is achieved towards a more sustainable society. Indicators must cover a range of social, environmental and economic issues and these must connect with work on health and equity indicators.
This would help different sectors identify what they are required to do, and so that progress can be measured.
IPH suggest that Central Government take account of the need for a few overarching indicators and put in place a process similar to the Boston indicators project (www.bostonindicators.org). This would avoid the difficulty of having different sets of indicators stemming from different Government departments. The indicators should be broad enough to incorporate health and quality of life indicators rather than be indicators for the environment alone. Northern Ireland is lagging behind the UK and therefore indicators should be developed and implemented as a priority.
8. Do you agree that the draft Sustainable Development Strategy supports the delivery of the Executive’s strategic priorities, as expressed in the Programme for Government? If you do not agree, please explain why and what alternatives you would propose.
In its current form there does not appear to be significant divergence between the Strategy and the Executive’s strategic priorities.
However the current draft of the Strategy and its vague nature does not suggest any real commitment to sustainable development and little apparent leadership for many of the issues which need to be addressed.
9. Are there any others issues in the Strategy that you wish to comment on?
A sense of urgency needs to written into the Strategy to reduce the harm in areas where action has not been implemented.