Integrating environmental health in health guidelines: the French experience

Article type
Authors
Blanchard-Musset S1, Gabach P1, Hard R1, Laot S1, Trellu S1, Valois P1
1Haute Autorité De Santé, Paris, France
Abstract
Context:
French National Authority for Health (HAS) is a key player in public health, through all its missions: access to healthcare products, public health recommendations, and quality of care.
Faced with the major challenges of environmental health, HAS integrated environmental issues into its strategic project and intends to pursue and fully commit to this dynamic.

Objective:
Analyze the actions already taken and define those to be followed in order to intensify a proactive approach in this area

Method:
A 28-member multidisciplinary and cross-functional working group (WG) was set up, with methodologists from all operational departments (Health Technology Assessment [HTA], Guidelines [GL], and Quality), librarians, data scientists, and members of general direction.
The WG performed a literature review, a retrospective analysis of the HAS working plan, interviews of experts, and meetings to develop a general roadmap of actions to be implemented.

Results:
The number of HAS projects related to environmental health has increased over the last decade.
The roadmap focus on 4 objectives and 13 actions in 3 domains: HTA, GL, and Quality. The identified actions dedicated to improving the integration of environment health into the HAS GL, focusing on preventive actions and cure/care relevancy, were
• using environmental issues as criteria to increase GL projects in the work program;
• integrating environmental expertise at all levels of GL development;
• developing specific GL on practices to promote reflections on the impact of the environment on health and/or medico-social fields;
• systematically using a short and pragmatic questionnaire (4 questions) when launching new projects to assess the need to integrate environmental aspects into each GL project right from the scoping phase; and
• examining whether new and specific methods are required in this field.

Conclusion:
In its new roadmap, HAS identifies actions to be taken to improve the integration of environmental issues into subjects of prevention, appropriateness of care, and GL.
The continuation of the WG will enable to measure the achievement of its objectives.
This experience will be shared with GIN members to discuss how to better collaborate on integrating environmental health into the health GL.