This report describes the progress made by WHO European Member States in improving their health and environment situations over the last 20 years. The assessment focuses on the aspects of health related to clean water and air, chemical safety, noise and safety at work, and environments supporting safe mobility and physical activity. These issues arise from the four regional priority goals of the Children's Environment and Health Action Plan for Europe (CEHAPE), agreed at the Fourth Ministerial Conference on Environment and Health in 2004. Information collected by the European Environment and Health Information System forms the basis for the analysis. The report also presents the aspects of national policies on environment and health that are related to public governance and healthy public policy. It summarizes the implementation, impact and challenges of CEHAPE in countries, using the information collected through a web-based survey conducted in November 2009.