Environmental Health Indicators for the Metropolitan Region of Sao Paulo, Brazil

Advances in development and implementation of policies for environmental protection and health promotion have guided the construction of systems of indicators for management processes. The WHO has proposed a model of environmental health analysis framework known as DPSEEA matix (DrivingForce/Pressure/State/Exposure/Effect/Action). The Brazilian government, through the Ministry of Health (MS) have applied this model annually for its 27 states. This paper aims at an approximation of this experience to the Metropolitan Region of Sao Paulo (RMSP) and its municipalities. The 48 indicators selected by MS, organized into six categories of analysis were found, using data available in public databases online, on the following criteria: relevance, validity, reliability, population coverage, sensitivity, methodological transparency, access, frequency; disaggregated data on population and territory; and comparability of time series. Among indicators consulted, only 28 have been satisfactorily incorporated into the matrix of RMSP, and 8/8 the size of Driving Force, 2/5 of the pressure scale; 8/13 the size situation, 4/5 the size of exposure, 6/8 the size effects, and 0/9 dimension action. In conclusion, despite the large amount of indicators available in the databases consulted, we found limitations in all criteria examined. We highlight the fragility of the environmental indicators. Besides, the need for improvement in the production of environmental information highlights the inadequacy of public policies that do not consider the metropolis as an interdependent system.