There are existing indicator sets such as ENHIS, ECHIM and ECHI which are available within the European Union to facilitate national assessment of the health status of a population. This enables policy makers to quickly compare the performance of their country to another with very little effort. However, it is known that while some policies and interventions may have a positive outcome nationally it is often necessary to have policies and interventions targeted at sub-population where a number of similarities may exist such as access to hospitals, living in close proximity to industrial processes etc.
Given this, this consortium (of partners) felt there was a need to develop a harmonised environmental health information system of sub-national indicators to complement the national indicators set. The project will also aim to develop methods of collecting data for indicators which are considered relevant but for which comparable data does not exist or is ad hoc throughout Europe.

The ECHI (European Community Health Indicators) project was carried out in the framework of the Community Public Health Programme 2003-2008. In this project indicators were selected based on comprehensiveness, meeting user needs, being innovative, using earlier work and in particular those of the Health Monitoring and the Public Health Programmes. This resulted in the production of a list of indicators for the public health field arranged according to a conceptual view on health and health determinants.

ECHIM (European Community Health Indicators Monitoring) was also carried out within the framework of the Programme of Community Action in the Field of Public Health 2003-2008 and continued the work of ECHI. The project sought to develop health indicators and health monitoring in the European Union and all EU Member
States.

ENHIS was developed due to the realization that there was the need for good quality and reliable information on the environment, population health and their linkages to identify and prioritize issues, develop and evaluate policies and actions in order to reduce the burden of disease via control of hazardous environmental exposures and their effects. Accordingly, WHO ECEH-Bonn designed a programme on Environment and Health Information Systems, to establish a harmonised and evidence-based information system to support public health and environmental policies in Europe. As a result of this programme, ENHIS developed a methodology for a core set of twenty-six indicators to monitor and report the health status of a country in relation to environmental risk factors. This set of indicators aims to reflect and communicate the status of environment and health issues at a national level throughout Europe.
ENHIS was based on the DPSEEA (Drivers, Pressures, State, Exposure, Effect and Actions) model which allows for the mapping of a wide spectrum of environmental health issues. Hence the indicators included in the core set were Drivers, Pressures, State, Exposure, Effect or Actions which conformed to agreed selection criteria.