[Health and living conditions: reflections around an attempt for a multiple and sectoral approach].
There is consensus amongst community members, local practitioners and policy and decision makers on the need for an inter-sectoral approach to health, environment and living conditions. The author analyses the processes of linking various sectors involved in six health and environment projects developed at the local or regional level in Brussels-Capital. The question of inter-sectoral collaboration is addressed differently at the regional and local levels. This question is also dealt with according to the underpinning conceptual framework of a given project. Three conceptual frameworks were identified, each reflecting the processes of knowledge development or action from the sector having initiated the project. Each framework is characterised by a clear demarcation between the fields of health and habitation and a particular linking between these two fields and other aspects of life. The sector initiating the project imposes its own model, logic and expertise, which then leads to difficulties in ensuring active participation of the other sectors implicated. The linkage of vertical or specialised approaches and broad, general ones is too often solely reduced to the integration of specialised aspects into all purpose actions. The analysis of the different projects demonstrates the lack of awareness by specialists, in this case being environmental, of the composition and complexity of the interaction between multiple aspects of life when trying to link with other sectors. Finally, the viable preservation and continuation of overarching, universal approaches are impeded by the lack of recognition and absence of funding for interventions which aim at affecting multiple aspects of life.
De Spiegelaere
Myriam
M
Observatoire de la Santé et du Social de Bruxelles, Ecole de Santé Publique, Université Libre de Bruxelles, Belgique. mdespieg@ulb.ac.be
D001530:Belgium; D004782:Environmental Health; D006801:Humans; D007373:Interinstitutional Relations; D011050:Policy Making; D017149:Private Sector; D016730:Program Development; D011634:Public Health; D017150:Public Sector