Healthy lives are the ambition.
Exposure is the first test.
The five-year question: what health burden was likely prevented through the changes we helped deliver, and how strong is the evidence?
People covered by implemented protections
Children covered by protections
Attributable PM₂.₅ change
Intervention areas monitored
Municipalities implementing action
Policy changes supported
Disease burden avoided
Healthy life years protected
Funding deployed
Health impact per euro
A defensible North Star
Long-term ambition: healthy life years protected. Our proposed technical expression is modelled disability-adjusted life years (DALYs) averted through attributable, sustained exposure reductions, with an explicit counterfactual and uncertainty range.
This is not yet a validated organisational metric. It should be a secondary, modelled impact measure until methods and data are sufficient. The early primary outcome is the adjusted change in relevant exposure, reported with population coverage, duration and distribution.
Why not lead with a health total now?
A small pilot cannot normally observe the diseases that did not occur. DALY estimates depend on baseline disease rates, age, the exposure–response relationship, duration, latency and the counterfactual. A precise-looking total can hide large uncertainty.
QALYs and DALYs answer different evaluation questions and are not interchangeable. We would use QALYs only where a specific analysis warrants them. Neither will be described as a direct count of healthy years observed in participants.
How the ten indicators will be reported
Each indicator will have a definition, denominator, geography, time period, data source, quality assessment, update date and accountable owner. Outcome indicators will report a baseline and comparison; modelled estimates will state model version and sensitivity assumptions.
Counts of people covered describe the reach of a delivered measure. They will not be labelled “people healthier” without evidence. Overlapping areas and repeat participants must be deduplicated.
From concentration to health
- Estimate the intervention-related change against a plausible no-intervention scenario.
- Assess representativeness, population exposure and how long the change persists.
- Select externally reviewed, applicable exposure–response functions and baseline rates.
- Report modelled disease burden and DALYs with uncertainty and alternative assumptions.
- Distinguish the intervention’s estimated benefit from our contribution to making it happen.
What did it cost?
Report actual funding deployed, shared organisational costs and intervention costs separately. Health impact per euro should use a clearly stated perspective and time horizon. Any societal valuation will be supplementary, with valuation methods, discounting and sensitivity analysis disclosed.
We will avoid adding overlapping disease outcomes, pollutant effects or monetary valuations. An optimistic scenario will not be presented as a forecast.
At year five, the intended report will answer: what changed, who benefited, how persistent was it, what health burden was likely avoided, what did it cost, what failed and where should the approach go next?