Sensitizing events as trigger for discursive renewal and institutional change in Flanders’ environmental health approach, 1970s-1990s

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.