The table below explains the DPSEEA terms; it draws on the work of von Schirnding (2002).

The sources on this page can be found in References




Link to Structural Funds

Driving Force

A number of factors on the macro scale ultimately affect human health. For example:

  • the global, national and regional economy will indirectly impact on human health by affecting income levels and the distribution of income;
  • a changing climate will mean increased risk of severe weather events with short-, medium- and long-term effects on physical and mental health;  and
  • demographic change will directly and indirectly affect health and wellbeing through changes to the age structure of the population and the workforce.

These are the global, national and regional forces that provide the context (i.e. drive) for regional economic and social development and for policy actions, including Structural Fund programmes.


The various driving forces considered above – along with policy actions – will result in pressures on the social, economic and physical environment.

Pressures are generated by all sectors of economic activity, such as

  • transport
  • energy
  • agriculture
  • industry
  • tourism  

The pressures are manifest in changes to, for example, living conditions, quality of infrastructure and income poverty.

The pressures arise from economic sectors as well as people’s consumption and behaviours. Structural Fund programmes support investments in many of these areas, shaping, for example, the quality of transport and waste management infrastructure and the development of SMEs.


The state (quality) of the social, economic and physical environment is affected by the various pressures above. States can be adverse or they can be beneficial.

Some changes may be complex and widespread, for example global climate change and regional economic development, while others may be more localized: for example, contamination of a local water supply or training for workers in a community.

This is likely to be the level at which Structural Fund programmes begin to operate, i.e. making a concerted attempt to improve the state (quality) of the social, economic or physical environment.


Even where there are large effects on the state of the environment, people’s health and well-being will be affected only when they are actually exposed to a particular state, whether for good or for ill.

Many factors determine whether an individual will be exposed. For pollution in the environment, for example, levels vary from place to place and over time, and people’s activities and behavioural patterns may influence the extent to which they come into contact with the pollutants.

Likewise, in the case of economic downturn, not all sections of society are equally affected.

Structural Fund programmes can play a role in determining who is exposed to beneficial or adverse factors.


Once a person has been exposed to a hazard, health effects can vary in type, intensity and magnitude depending on the type of hazard, the level of exposure and other factors.

The ill-health effects of environmental exposures may be

  • acute, occurring relatively soon after exposure (from a single large dose due to an accident or a spill for example); or
  • chronic, occurring as a result of cumulative exposures over time.

A long time may elapse between the initial exposure and the appearance of the adverse health effect, for example exposure to asbestos and mesothelioma, or exposure to radiation and leukaemia.

Movements in the population at risk over time and the long incubation period make reconstruction of exposures problematic for chronic problems. Health effects are often easier to detect than chronic ones, which may be difficult to relate to specific hazards or sources.

This is the health effect of all the preceding stages.


What are the policy options to protect and improve health?

These are shown in the pages on the Approaches to Consider pages, which focus on the actions that can be taken using the Structural Funds.