Impact of environmental discourses on public health policy arrangements: a comparative study in the UK and Flanders, (Belgium).

OBJECTIVES Theoretically inspired by discursive institutionalism and multi-level governance, this paper assesses the extent to which 'environmental health' has emerged as a new discourse at European level, the effects it has had on national public health governance in two European countries, and what mechanisms have triggered or hindered these effects. STUDY DESIGN Comparison of the dynamics in public health policy arrangements in Flanders (Belgium) and the UK, nations influenced by both international and European environmental health discourses. METHODS The Policy Arrangement Approach was the analytical framework used to structure the results of this textual analysis. RESULTS Despite their shared focus on environmental health, Belgium and the UK display quite different approaches to environmental health governance. While Belgium works on environmental health in a predominantly top-down approach, the UK has developed a more inward-facing approach to environmental health policies. CONCLUSION The cases of the UK and Belgium show that, although these countries respond similarly to internationally agreed charters and both are members of the European Union, national differences in environmental health policies persist, mainly due to pre-existing national policy arrangements and the activities of national institutions. This leads to a divergent interplay between national and international institutions.