Türkiye’nin Çevre Mevzuatına Tüm Politikalarda Sağlık Merceğinden Bir Bakış

Öz

Tüm Politikalarda Sağlık (TPS) devlet politikalarında, geniş kapsamlı şehir projelerinde ve yasal düzenlemelerde halk sağlığı ve eşitliğini çekirdeğe yerleştirmeyi hedef alan bir yaklaşımdır. Bu yaklaşım uluslararası düzeyde birçok ülke tarafından kullanılmaktadır. Ülkemizde çevresel konuların sürdürülebilir bir biçimde yönetilmesini düzenleyen “çevre mevzuatı” ise halk sağlığının korunması için kritik bir öneme sahiptir. Bu sebeple bu çalışmada çevre mevzuatı TPS çerçevesinden incelenerek, halk sağlığı ve eşitlik açısından güçlü ve geliştirilebilir taraflarının tespit edilmesi amaçlanmıştır. Sistematik derleme metodu olarak çevre bilimlerinde kullanımı yaygın görülen PSALSAR (protokol, araştırma, değer biçme, sentez, analiz ve rapor etme) yöntemi kullanılmıştır. Bu kapsamda TPS dokümanları (hakemli makaleler, raporlar, rehberler ve kitaplar) ve çevre mevzuatına bağlı yönetmelikler taranmıştır. Araştırma sonuçlarına göre çevre mevzuatı; halk sağlığını korumayı çekirdeğine yerleştirebilmiş, çevresel konularda çok sektörlü ortaklığı teşvik eden bir mevzuattır. Ayrıca mevzuat, Türkiye’de çevresel adaleti güçlendirebilecek ve çevresel adalet konularında halk da dâhil tüm paydaşları bilinçlendirebilecek bir potansiyele sahiptir. Çalışmanın sonunda bu potansiyelden yola çıkılarak çevresel adaleti güçlendirebilecek öneriler sunulmuştur.

Anahtar Kelimeler

• Tüm politikalarda sağlık
• çevre mevzuatı
• halk sağlığı
• çevresel adalet

An Overview of Turkey's Environmental Legislation from the Health in All Policies Lens

Öz

Health in All Policies (HiAP) is an approach that aims to put public health and equity at the core in government policies, large-scale city projects and legal regulations. This approach is used by many countries at international level. "Environmental legislation", which regulates the sustainable management of environmental issues in Turkey, is crucial for the protection of public health. For this reason, in this study, it is aimed to determine the strong and developable sides of the environmental legislation in terms of public health and equality by examining the environmental legislation from the HiAP perspective. As a systematic review method, PSALSAR (protocol, search, appraisal, synthesis, analysis and report) method, which is widely used in environmental sciences, was used. In this context, HiAP documents (peer-reviewed journal articles, reports and guides) and regulations related to environmental legislation were reviewed. According to the review results, environmental legislation in Turkey puts the protection of public health at its core and promotes multi-sectoral partnership in environmental issues. İn addition, the legislation has a potential which can strengthen environmental justice in Turkey and raise awareness about environmental justice to all stakeholders including the public. At the end of this study, suggestions that can strengthen environmental justice are presented based on this potential.

Anahtar Kelimeler

• Health in all policies
• environmental legislation
• public health
• environmental justice

Kaynakça

1. [1] World Health Organization. (2015). Health in all policies: training manual. World Health Organization. Retrieved from http://apps.who.int/iris/bitstream/handle/10665/151788/9789241507981_eng.pdf
2. [2] Stahl, T., Wismar, M., Ollila, E., Lahtinen, E., & Leppo, K. (2006). Health in all policies, prospects and potentials. Finland: Ministry of Social Affairs and Health. Health Department.
3. [3] Baum, F., Delany-Crowe, T., MacDougall, C., Lawless, A., van Eyk, H., & Williams, C. (2017). Ideas, actors and institutions: lessons from South Australian Health in All Policies on what encourages other sectors’ involvement. BMC Public Health, 17(1), 811. doi:10.1186/s12889-017-4821-7
4. [4] Brown, E. G. Jr., Kelly B. P., Dougherty M., & Ajise K. (2015). Caltrans strategic management plan 2015 – 2020. California Department of Transportation. Retrieved from http://www.dot.ca.gov/perf/library/pdf/Caltrans_Strategic_Mgmt_Plan_033015.pdf
5. [5] National Association of County & City Health Officials (2017) HiAP, experiences from local governments. Retrieved from https://www.naccho.org/uploads/downloadable-resources/NACCHO-HiAP-Report_Experiences-from-Local-Health-Departments-Feb-2017.pdf
6. [6] Wismar, M., & Ernst, K. (2010). Health in all policies in Europe. Implementing health in all policies: Adelaide. Retrieved from https://www.who.int/sdhconference/resources/implementinghiapadel-sahealth-100622.pdf#page=33
7. [7] Wernham, A., & Teutsch, S. M. (2015). Health in all policies for big cities. Journal of Public Health Management and Practice, 21(Suppl 1), S56.
8. [8] Dora, C., Pfeiffer, M., & Racioppi, F. (2013). Lessons from environment and health for HiAP. Health in All Policies, 255.

9. [9] Prüss-Üstün, A., Wolf, J., Corvalán, C., Bos, R., & Neira, M. (2016). Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. World Health Organization.
10. [10] Leppo, K., Ollila, E., Pena, S., Wismar, M., & Cook, S. (2013). Health in all policies-seizing opportunities, implementing policies. Retrieved from https://www.euro.who.int/__data/assets/pdf_file/0007/188809/Health-in-All-Policies-final.pdf
11. [11] Mengist, W., Soromessa, T., & Legese, G. (2020/1). Method for conducting systematic literature review and meta-analysis for environmental science research. MethodsX, 7, 100777.
12. [12] Kocak, T. K. (2019). Investigating Air Pollution and Equity Impacts of a Proposed Transportation Improvement Program for Tampa.
13. [13] Mengist, W., Soromessa, T., & Legese, G. (2020/2). Ecosystem services research in mountainous regions: A systematic literature review on current knowledge and research gaps. Science of The Total Environment, 702, 134581.
14. [14] Grant, M. J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91-108.
15. [15] World Health Organization. (1978). International Conference on Primary Health Care, Alma-Ata, USSR. Retrieved from https://www.who.int/publications/almaata_declaration_en.pdf
16. [16] Rudolph, L., Caplan, J., Ben-Moshe, K., & Dillon, L. (2013). Health in all policies: a guide for state and local governments. Washington (DC): American Public Health Association. Retrieved from http://www.phi.org/resources/?resource=HiAPguide
17. [17] Ollila, E. (2011). Health in all policies: from rhetoric to action. Scandinavian Journal of Public Health, 39(6_suppl), 11-18. doi:10.1177/1403494810379895
18. [18] Government of South Australia’s Department of Health. (2010). The South Australian approach to health in all polices: background and practical guide. Retrieved from https://www.sahealth.sa.gov.au/wps/wcm/connect/cb6fa18043aece9fb510fded1a914d95/HiAPBackgroundPracticalGuide-v2.pdf? MOD=AJPERES&CACHEID=ROOTWORKSPACE-cb6fa18043aece9fb510fded1a914d95-mwNc22C
19. [19] World Health Organization. (2014). Health in all policies (HiAP) framework for country action. Geneva: WHO. Retrieved from https://www.who.int/cardiovascular_diseases/140120HPRHiAPFramework.pdf
20. [20] Lawless, A., Williams, C., Hurley, C., Wildgoose, D., Sawford, A., & Kickbusch, I. (2012). Health in All Policies: evaluating the South Australian approach to intersectoral action for health. Canadian Journal of Public Health, 103(1), S15-S19. doi:10.1007/BF03404454
21. [21] Dahlgren, G., & Whitehead, M. (1991). Policies and strategies to promote social equity in health. Stockholm: Institute for future studies. Retrieved from https://core.ac.uk/download/pdf/6472456.pdf
22. [22] Baum, F., & Laris, P. (2010). Improving health equity: action on social determinants of health through Health in All Policies. Implementing Health in All Policies: Adelaide, 25-38. Retrieved from https://www.semanticscholar.org/paper/Health-in-all-policies.-Puska/5741290816613fa25d30e62a7f1f9bc24a140601?p2df#page=19
23. [23] Kickbusch, I., & Buckett, K. (2010). Implementing health in all policies: Adelaide 2010 (pp. 11-24). Adelaide: Health in All Policies Unit, SA Department of Health. Retrieved from http://158.232.12.119/sdhconference/resources/implementinghiapadel-sahealth-100622.pdf
24. [24] Marshall, J. D. (2008). Environmental inequality: air pollution exposures in California's South Coast Air Basin. Atmospheric Environment, 42(21), 5499-5503. doi:10.1016/j.atmosenv.2008.02.005
25. [25] Freiler, A., Muntaner, C., Shankardass, K., Mah, C. L., Molnar, A., Renahy, E., & O'campo, P. (2013). Glossary for the implementation of Health in All Policies (HiAP). J Epidemiol Community Health, 67(12), 1068-1072. doi:10.1136/jech-2013-202731
26. [26] Molnar, A., Renahy, E., O’Campo, P., Muntaner, C., Freiler, A., & Shankardass, K. (2016). Using win-win strategies to implement health in all policies: a cross-case analysis. PloS one, 11(2), e0147003.
27. [27] Barr, V., Pedersen, S., Pennock, M., & Rootman, I. (2008). Health equity through intersectoral action: an analysis of 18 country case studies. Public Health Agency of Canada and World Health Organization. Retrieved from https://www.who.int/social_determinants/resources/health_equity_isa_2008_en.pdf
28. [28] Howard, R., & Gunther, S. (2012). Health in All Policies: An EU literature review 2006–2011 and interview with key stakeholders. Equity Action. Retrieved from http://www.chrodis.eu/wp-content/uploads/2015/04/HiAP-Final-Report.pdf
29. [29] Fox, A. M., Balarajan, Y., Cheng, C., & Reich, M. R. (2014). Measuring political commitment and opportunities to advance food and nutrition security: piloting a rapid assessment tool. Health policy and Planning, 30(5), 566-578. doi:10.1093/heapol/czu035
30. [30] Kotchian, S. (1997). Perspectives on the place of environmental health and protection in public health and public health agencies. Annual review of public health, 18(1), 245-259.
31. [31] Bezirtzoglou, C., Dekas, K., & Charvalos, E. (2011). Climate changes, environment and infection: facts, scenarios and growing awareness from the public health community within Europe. Anaerobe, 17(6), 337-340.
32. [32] Çevresel Etki Değerlendirmesi, İzin ve Denetim Genel Müdürlüğü. (n.d.). Çevre Etki Değerlendirmesi Rapor Yazım Rehberi. Retrieved November 25, 2020, from https://webdosya.csb.gov.tr/db/ced/editordosya/REVIZE_CED_RAPORU_YAZIM_REHBERI.pdf
33. [33] Kara, H. (2011). Eko-Etiket. Sürdürülebilir Üretim ve Tüketim Yayınları–III, Ankara.
34. [34] Aydın, G. Ş. (2019). Eko-Etiketleme ve Türkiye Çevre Etiketi. Harran Üniversitesi Mühendislik Dergisi, 4(1), 40-47.
35. [35] Baum, F., Delany-Crowe, T., MacDougall, C., Lawless, A., van Eyk, H., & Williams, C. (2017). Ideas, actors and institutions: lessons from South Australian Health in All Policies on what encourages other sectors’ involvement. BMC Public Health, 17(1), 811. doi:10.1186/s12889-017-4821-7
36. [36] Delany, T., Harris, P., Williams, C., Harris, E., Baum, F., Lawless, A., ... & Kickbusch, I. (2014). Health impact assessment in New South Wales & Health in all policies in south Australia: Differences, similarities and connections. BMC public health, 14(1), 699. doi:10.1186/1471-2458-14-699
37. [37] Association of State and Territorial Health Officials (ASTHO), 2013.Health in all Policies strategies to Promote innovative leadership. Retrieved from http://www.astho.org/Programs/Prevention/Implementing-the-National-Prevention-Strategy/HiAP-Toolkit/
38. [38] Melkas, T. (2013). Health in all policies as a priority in Finnish health policy: a case study on national health policy development. Scandinavian Journal of Public Health, 41(11_suppl), 3-28. doi:10.1177/1403494812472296
39. [39] Kocak, T., Menon, N., Gurram, S., Bertini, R. L., & Stuart, A. L. (2020). Air pollution and equity impacts of the proposed Tampa Bay Next program from a Health in all Policies perspective.
40. [40] Chakraborty, J., Maantay, J. A., & Brender, J. D. (2011). Disproportionate proximity to environmental health hazards: methods, models, and measurement. American Journal of Public Health, 101(S1), S27-S36.
41. [41] Voinov, A., Seppelt, R., Reis, S., Nabel, J. E., & Shokravi, S. (2014). Values in socio-environmental modelling: persuasion for action or excuse for inaction. Environmental Modelling & Software, 53, 207-212.
42. [42] Koçak, T. K., & Ebrahimi, F. Uydulardan Elde Edilebilen Aerosol Optik Derinlik Verilerini Kullanarak Zemin Seviyesi İnce Partikül Konsantrasyonlarını Tahmin Etmek İçin Doğrusal Olmayan Bir Model Geliştirilmesi. Ulusal Çevre Bilimleri Araştırma Dergisi, 3(3), 119-127.
43. [43] Gurram, S., Stuart, A. L., & Pinjari, A. R. (2015). Impacts of travel activity and urbanicity on exposures to ambient oxides of nitrogen and on exposure disparities. Air Quality, Atmosphere & Health, 8(1), 97-114.
44. [44] Argent, R. M., Perraud, J. M., Rahman, J. M., Grayson, R. B., & Podger, G. M. (2009). A new approach to water quality modelling and environmental decision support systems. Environmental Modelling & Software, 24(7), 809-818.
45. [45] Harner, J., Warner, K., Pierce, J., & Huber, T. (2002). Urban environmental justice indices. The Professional Geographer, 54(3), 318-331.
46. [46] Lakes, T., Brückner, M., & Krämer, A. (2014). Development of an environmental justice index to determine socio-economic disparities of noise pollution and green space in residential areas in Berlin. Journal of Environmental Planning and Management, 57(4), 538-556.
47. [47] Wheeler, B. W. (2004). Health-related environmental indices and environmental equity in England and Wales. Environment and Planning A, 36(5), 803-822.
48. [48] Stuart, A. L., & Zeager, M. (2011). An inequality study of ambient nitrogen dioxide and traffic levels near elementary schools in the Tampa area. Journal of environmental management, 92(8), 1923-1930.
49. [49] Lee, M. E., & Seo, I. W. (2010). 2D finite element pollutant transport model for accidental mass release in rivers. KSCE Journal of Civil Engineering, 14(1), 77-86.
50. [50] Montella, R., Di Luccio, D., Troiano, P., Riccio, A., Brizius, A., & Foster, I. (2016, November). WaComM: A parallel Water quality Community Model for pollutant transport and dispersion operational predictions. In 2016 12th International Conference on Signal-Image Technology & Internet-Based Systems (SITIS) (pp. 717-724). IEEE.
51. [51] Yu, H., & Stuart, A. L. (2013). Spatiotemporal distributions of ambient oxides of nitrogen, with implications for exposure inequality and urban design. Journal of the Air & Waste Management Association, 63(8), 943-955.
52. [52] Gulliver, J., & Briggs, D. (2011). STEMS-Air: A simple GIS-based air pollution dispersion model for city-wide exposure assessment. Science of the total environment, 409(12), 2419-2429.
53. [53] Stuart, A. L., Mudhasakul, S., & Sriwatanapongse, W. (2009). The social distribution of neighborhood-scale air pollution and monitoring protection. Journal of the Air & Waste Management Association, 59(5), 591-602.
54. [54] Stuart, A. L., Aksoy, A., Zhang, F., & Nielsen-Gammon, J. W. (2007). Ensemble-based data assimilation and targeted observation of a chemical tracer in a sea breeze model. Atmospheric Environment, 41(14), 3082-3094.
55. [55] Zhang, F., Bei, N., Nielsen‐Gammon, J. W., Li, G., Zhang, R., Stuart, A., & Aksoy, A. (2007). Impacts of meteorological uncertainties on ozone pollution predictability estimated through meteorological and photochemical ensemble forecasts. Journal of Geophysical Research: Atmospheres, 112(D4).
56. [56] Coşkun, B., Ak, D., & Yıldırım, Ç. P. (2018). Mevzuatta son dönemlerde meydana gelen gelişmeler bağlamında çevresel açıdan korunan alan yönetiminin değerlendirilmesi. Aksaray Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 10(4), 29-44.