Stassen et al. Environmental Health 2013, 12:46 http://www.ehjournal.net/content/12/1/46 RESEARCH Open Access Sensitizing events as trigger for discursive renewal and institutional change in Flanders’ environmental health approach, 1970s-1990s Kristien R Stassen1*, Roel Smolders2 and Pieter Leroy3 Abstract Background: Sensitizing events may trigger and stimulate discursive renewal. From a discursive institutional perspective, changing discourses are the driving force behind the institutional dynamics of policy domains. Theoretically informed by discursive institutionalism, this article assesses the impact of a series of four sensitizing events that triggered serious environmental health concerns in Flanders between the 1970s till the 1990s, and led onto the gradual institutionalization of a Flemish environmental health arrangement. Methods: The Policy Arrangement Approach is used as the analytical framework to structure the empirical results of the historical analysis based on document analysis and in-depth interviews. Results: Until the 1990s, environmental health was characterized as an ad hoc policy field in Flanders, where agenda setting was based on sensitizing events – also referred to as incident-driven. Each of these events contributed to a gradual rethinking of the epistemological discourses about environmental health risks and uncertainties. These new discourses were the driving forces behind institutional dynamics as they gradually resulted in an increased need for: 1) long-term, policy-oriented, interdisciplinary environmental health research; 2) policy coordination and integration between the environmental and public health policy fields; and 3) new forms of science-policy interactions based on mutual learning. These changes are desirable in order to detect environmental health problems as fast as possible, to react immediately and communicate appropriately. Conclusions: The series of four events that triggered serious environmental health concerns in Flanders provided the opportunity to rethink and re-organize the current affairs concerning environmental health and gradually resulted into the institutionalization of a Flemish environmental health arrangement. Keywords: Discursive institutionalism, Environmental health incidents, Policy arrangement approach Background environmental health discourse at the European level. Possible adverse health impacts of the deteriorating en- The main discourses relate to policy integration, stake- vironmental quality have been an issue since the early holder involvement, and children as a prioritized target days of environmental concern, as indicated in the Dec- group. As already concluded in our previous paper [1], laration of the United Nations Conference on the Hu- these novel discourses have greatly affected the European man Environment in 1972. In the late 1980s, the issue environmental health policy arrangement in terms of the regained attention by the Environment and Health establishment of new organizations, agreements, charters, Process for Europe, initiated by the World Health financial resources, and legislation. Yet, the implementa- Organization Europe (WHO-Europe). Its five-yearly tion of European discourses and agreements unfolded European Conferences on Environment and Health have rather slowly in Belgium, partly due to its internal com- played an important role in the agenda setting of the plexity. The Belgian State is characterized by a federal state composed of three Regions and three Communities * Correspondence: [email protected] 1HUB – Hogeschool-Universiteit Brussel, Centre for Corporate Sustainability, which have the authorities on environment and health Warmoesberg 26, Brussels 1000, Belgium prevention policies respectively. The previous study Full list of author information is available at the end of the article © 2013 Stassen et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Stassen et al. Environmental Health 2013, 12:46 Page 2 of 11 http://www.ehjournal.net/content/12/1/46 observed that local events that triggered serious environ- measures, practices, budgets, responsibilities, competen- mental health concerns seem to have induced institutional cies, and rules. change in Flanders, the northern region of Belgium. We Compared with the other theoretical perspectives within analyze their role in full detail in this paper, well aware of social sciences to study institutions - i.e., Rational Choice the role of international and European developments and Institutionalism, Historical Institutionalism, and Socio- of similar events in other countries and regions. logical Institutionalism [2] - discursive institutionalism The main objective of this contribution is to assess the im- emphasizes: 1) the important role of discourses in influen- pact of this series of four domestic events between the cing actors’ preferences, interests and behaviour [7]; and 1970s till the 1990s on the institutionalization of the Flemish 2) the role of these discourses in assuring institutional sta- environmental health arrangement, both scientifically and bility, while simultaneously triggering and legitimizing in- politically. Theoretically informed by discursive institutional- stitutional change [2]. Discursive institutionalism tends to ism, this article assumes that this series of events had grad- pay more attention to (a) the cognitive frames of agencies uallyshiftedtheenvironmental health discourses of rather than to their material interests; to (b) a more dy- politicians, scientists, and the population in general. These namic, agent-centred approach rather than to static and shifting discourses, in turn, triggered the institutional re- path-dependent patterns; and to (c) the dynamics of valu- newal of the scientific knowledge-production process as well ation and norm setting rather than with static ones [8,9]. as the environmental health policy arrangement, by inducing Related to the case study of Flanders, a discursive in- and introducing novel organizational facilities, new meth- stitutional perspective is taken into account. Our hy- odological tools, policy programmes, budgets, rules, etc. [2]. pothesis is that environmental health events can indeed This article structures as follows: the first section further induce discursive renewal, which in turn, can explain positions sensitizing events as a trigger to discursive changes in the institutionalization of the Flemish envir- renewal, and the impact of changing discourses on in- onmental health arrangement. stitutional dynamics. We briefly position discursive insti- tutionalism (DI) within recent policy analysis literature as Analytical framework: policy arrangement approach our paper fits the DI perspective. The second section de- In order to understand why discourses gain dominance picts the Policy Arrangement Approach (PAA) as an ap- while other understandings are discredited and to study propriate analytical framework to empirically analyze and the impact of these discourses on institutional dynamics, understand discursive shifts and institutional dynamics. the Policy Arrangement Approach (PAA) is identified as The third section accounts for our methodological an appropriate analytical framework. The PAA is devel- approach. The subsequent section then empirically eluci- oped to empirically analyze change and stability within dates the historical analysis of the aforementioned events policy arrangements [5] and tested in a series of research and their respective impacts on the environmental health endeavours in the environmental domain. discourse and the consequent institutional dynamics. The A policy arrangement is defined by Leroy and Arts [10] article concludes with a discussion of the main findings as: “The temporary stabilization of the content and and some suggestions for further research. organization of a particular policy domain at a certain pol- icy level.” These processes of temporary stabilizations are often referred to as “ongoing processes of institutiona- Theoretical background: sensitizing events and discursive lization” [11]. While studying institutional change (or the institutionalism lack thereof), the PAA distinguishes four interwoven di- As illustrated by Wiering and Arts [3], events that provoke mensions of any arrangement: (a) the actors and their coa- serious societal and political concerns (in their case: a litions involved in the policy domain, (b) the allocated near-flooding disaster in the Netherlands) can cause insti- resources and the differences in power that result from tutional renewal and shape the ideas and plans for future their distribution, (c) the formal and informal rules of the decision-making and risk management. Discourses are de- game, and (d) discourses. As such, the PAA aims to focus fined by Hajer and Versteeg [4] as, “an ensemble of ideas, on intentions, motives, discourses, beliefs of actors, formal concepts and categories through which meaning is given and informal regulatory roles and organizational struc- to social and physical phenomena.” Through interaction, tures, but also takes into account long-term processes that agencies exchange discourses, merge into discursive coali- characterize contemporary society. Each of these four di- tions or split-up into discursive oppositions, depending on mensions