Abstract
As taxation is one of the key public policy domains influencing population health, and as there is a legal, strategic, and programmatic basis for health impact assessment (HIA) in Finland, we analyzed all 235 government bills on tax legislation over the years 2007–2014 to see whether the health impacts of the tax bills had been assessed. We found that health impacts had been assessed for 13 bills, bills dealing with tobacco, alcohol, confectionery, and energy legislation and that four of these impact assessments included impacts on health inequalities between social classes. Based on our theoretical classification, the health impacts of 40 other tax bills should have been evaluated.
Highlights
Health impact assessment (HIA) is a tool for planning and decision making that helps to evaluate the impact of public policies on population health.[1]
Health impacts were not assessed in any of the bills related to income distribution, housing, employment, health insurance, social security, inheritance tax, and gift tax, even if tax proposals in each of these categories were present in the data
In this study, we found that health impacts had been assessed for 13 bills dealing with tobacco, alcohol, confectionery, and energy legislation and that based on our theoretical classification, the health impacts of 40 other tax bills should have been evaluated
Summary
Health impact assessment (HIA) is a tool for planning and decision making that helps to evaluate the impact of public policies on population health.[1] In Finland, there is a legal basis for HIA, found in the Finnish Constitution (731/1999) and complemented by clarifications in the Local Government Act (2015/410), the Health Protection Act (1994/763), the Public Health Act (66/1972), and the Health Care Act (1326/2010). Policy making in Finland is guided by the European Union (EU), where the legal basis for HIA can be found, especially in the Treaty on the Functioning of the EU (2012/C326/01) and in the Charter of Fundamental Rights of the EU (2012/C326/02). In addition to the legal basis, the Finnish HIA mandate is complemented by guidelines, strategies, and programmes. In Finland, it has been argued that the Ministry of Finance, and especially its tax department, has been resistant to assessing the impacts of the ministry’s decisions on health,[6] but there is no empirical
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