Like the DPSEEA framework, an MEME approach could be applied to monitor and measure the impacts of environmental change on human health (Table 1).
However, in practice, MEME has difficulty in distinguishing between the state of the environment and pressure on it.
It does not separate proximal (exposure) from distal(pressure and state) causes, which nonetheless would beparticularly useful for designing and applying interventionsfurther up the causal chain [8,30].