Assessment of complex environmental health problems: framing the structures and structuring the frameworks.

Many environmental risks are multi-faceted and their health consequences can be far-ranging in both time and space. It can be a challenging task to develop informed policies for such risks. Integrated environmental health impact assessment aims to support policy by assessing environmental health effects in ways that take into account the complexities and uncertainties involved. For such assessment to be successful, a clear and agreed conceptual framework is needed, which defines the issue under consideration and sets out the principles on which the assessment is based. Conceptual frameworks facilitate involvement of stakeholders, support harmonized discussions, help to make assumptions explicit, and provide a framework for data analysis and interpretation. Various conceptual frameworks have been developed for different purposes, but as yet no clear taxonomy exists. We propose a three-level taxonomy of conceptual frameworks for use in environmental health impact assessment. At the first level of the taxonomy, structural frameworks show the wide context of the issues at hand. At the second level, relational frameworks describe how the assessment variables are causally related. At the third level, this causal structure is translated into an operational model, which serves as a basis for analysis. The different types of frameworks are complementary and all play a role in the assessment process. The taxonomy is illustrated using a hypothetical assessment of urban brownfield development for residential uses. We suggest that a better understanding of types of conceptual frameworks and their potential roles in the different phases of assessment will contribute to more informed assessments and policies. Copyright 2010 Elsevier B.V. All rights reserved.