Health impact assessment in Europe--current dilemmas and challenges

Abstract

Health impact assessment (HIA) is promoted by the World Health Organization (WHO) as a means of ensuring that decision makers from a wide variety of sectors are sufficiently aware of the health consequences of their policies. Although concerns have been raised about whether HIA, largely developed to assess local health impacts, can be adapted to national and international levels, more fundamental questions about the use of impact assessment (IA) within policymaking have received only limited consideration by the public health community.1 A number of European countries have already considerable experience with applying HIA at various levels, although they focus more on projects, programmes and plans than on impacts of policies. In 2004, the European Observatory on Health Systems and Policies launched a 3-year multi-country project on the effectiveness of HIA. The results showed that HIA implementation and institutionalization are incomplete in all concerned …