Governing the long-term: platforms and complex public health risks

Abstract Balancing short-term public health needs with long-term systemic change is challenging, especially for boundary-spanning issues like industrial pollution and health risks. Governance platforms, designed to sustain multiple collaborations, offer potential for producing agreement between actors and mediating temporal trade-offs. However, their role in addressing urgent public health issues while incorporating long-term perspectives into agreements remains underexplored. We used process tracing (PT) methods to identify mechanisms that explain the production of future-oriented agreements. This study focuses on a Dutch governance platform addressing health risks from industrial emissions. Data included 10 semi-structured interviews with 11 government and political actors, and 36 documents. Contextual and process-level data were analysed to trace events and governance dynamics. Three mechanisms explain how platform governance generates agreement: 1. Joint fact-finding facilitates evidence-driven processes to engage actors in independent research. This helped navigate interpretation, build support for results, and produce agreement on long-term health effects. 2. Crafting time horizons enables actors to embed short-term health priorities while developing long-term visions. This mechanism produced process agreement about the reduction of health risks. 3. Aggregation scaled decision-making across local, regional and national levels. Although this exposed tensions between localised demands and systemic objectives, iterative interactions aligned policy preferences across diverse actors. Governance platforms are intermediaries for fostering agreements and addressing complex policy challenges like industrial pollution. Yet, platforms are not standalone solutions, as their capacity can be constrained by wider institutional contexts. To achieve forward-looking policies, platforms must be coupled with other governance frameworks like legal mandates, earmarked budgets, and regulation.