The DPSEEA framework was developed on behalf of the World Health Organisation, initially as a basis for developing enviromental health indicators.  It adapted the DPSIR framework primarily by recognising the links from state of the environment through exposures to health effects; responses were relabelled as actions.  It also extended the concept of driving forces backwards to represent the role of more remote, contectual factors such as social and economic development.

The framework thus sees health impacts as originating in these driving forces (D), which lead to pressures on the environment (P) in the form of production, consumption, waste generation etc, and their consequent releases into the environment.  These contribute to changes in the state of the environment (S) - for example as environmental pollution or increased risks of natural hazards.  Exposures (E1) occur when humans come into contact with these hazards, leading to potential health effects (E2).  Policy and other actions (A) are taken to control adverse health effects.  These may be targetted at different points in the causal chain.  Later interventions (aimed at reducing exposures or mitigating the health impacts) may appear to be more directly effective and sometimes cheaper, because they can be targetted more directly at specific population groups and health outcomes.  Preventive measures, in contrast, tend to involve somewhat blunter tools - but with the major advantage that they can control the problems at source, and often offer a wide range of other environmental and social benefits.