A framework for integrated environmental health impact assessment of systemic risks

Traditional methods of risk assessment have provided good service in support of policy, mainly in relation to standard setting and regulation of hazardous chemicals or practices. In recent years, however, it has become apparent that many of the risks facing society are systemic in nature – complex risks, set within wider social, economic and environmental contexts. Reflecting this, policy-making too has become more wide-ranging in scope, more collaborative and more precautionary in approach. In order to inform such policies, more integrated methods of assessment are needed. Based on work undertaken in two large EU-funded projects (INTARESE and HEIMTSA), this paper reviews the range of approaches to assessment now in used, proposes a framework for integrated environmental health impact assessment (both as a basis for bringing together and choosing between different methods of assessment, and extending these to more complex problems), and discusses some of the challenges involved in conducting integrated assessments to support policy

Intervals of confidence: Uncertain accounts of global hunger

Global health policy experts tend to organize hunger through scales of ‘the individual’, ‘the community’ and ‘the global’. This organization configures hunger as a discrete, measurable object to be scaled up or down with mathematical certainty. This article offers a counter to this approach, using ethnographic cases to illustrate how the calculated referent of ‘hunger’ does not hold stable. In the highlands of Guatemala, where obesity has become a matter of concern, many people treated hunger as a sensation connected to family and history. For doctors working in the region, hunger was determined through body mass indices and global risk statistics. For global health experts it was different still, operating as an indicator derived from agricultural and population data. I draw these different, yet connected, versions of hunger together to explore dilemmas of scaling an object that is not solid but is made and unmade variously. This allows me to illustrate that global hunger is not a summation of hunger in the world, but its own version of hunger. I further suggest that ‘multi-object ethnography’, which allows for the persistence of uncertainty, can help to develop policy responses to hunger(s) that will, in some cases, be more appropriate and effective than scale-based evaluation