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

Objectives: theoretically inspired by multi-level governance and discursive institutionalism, this paper assesses what impact environmental health as a new discourse at the European policy level has on national public health governance and vice versa and what mechanisms trigger or hinder these effects. Study design: this paper compares dynamics in public health policy arrangements in Flanders (Belgium) and the United Kingdom, nations both influenced by international and European environmental health discourses. Methods: the Policy Arrangement Approach is used as a common framework to structure the results of the textual analysis. Results: the production of very different approaches to environmental health governance has occurred in Belgium/Flanders and the UK. In the Belgium/Flanders case a top-down approach is dominant whereas in the UK has developed a more inward facing approach to policy development on environmental health. Conclusion: the cases of the UK and Belgium show that although both countries are part of the EU and are therefore responding to the same general charters and governance initiatives, the uploading and downloading of environmental health policies is directly impacted by the activities of various national institutions, regional environmental health realities, and the interplay between formal and informal national and international institutions.