Abstract

Avoiding or minimizing potential environmental impact is the driving idea behind protecting a population’s health via Environmental Impact Assessments (EIAs) and Strategic Environmental Assessments (SEAs). However, both are often carried out without any systematic approach. This paper describes the findings of a review of HIA, EIA and SEA experiences carried out by the authors, who act as institutional competent subjects at the national and regional levels in Italy. The analysis of how health is tackled in EIA and SEA procedures could support the definition of a protocol for the integration of HIA with EIA and SEA. Although EIA and SEA approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO. HIA is still poorly integrated into the decision-making process, screening and monitoring phases are only occasionally implemented, and operational details are not well-defined. The collaborative approach of institutions involved in environment and health is a core element in a systematic advancement toward supporting effective decisions and effective protection of the environment and health. At the Italian national level, the definition of guidelines and tools for HIA, also in relation with EIA and SEA, is of great interest.

Highlights

  • There has been substantial interest worldwide in promoting the inclusion of healthcare within policy in order to achieve Health in All Policies (HiAP) goals, since its first acknowledgment in Europe in2006 [1]

  • Environmental Impact Assessments (EIAs) and Strategic Environmental Assessment (SEA) approaches include the aim of protecting health, significant technical and methodological gaps are present when assessing health systematically, and their basic principles regarding assessment are unsatisfactory for promoting and addressing healthcare concepts stated by the WHO

  • The evolution of the Health Impact Assessment (HIA) applications in Italy have led to inclusion of a socio-economic “holistic” model of health, contributing to clarification of the importance of risk factors acting on the wide determinants of health, in different non-health sectors, in a full-chain model of impact [38].In the specific context of the mandatory evaluation of projects, plans and programs via EIA and SEA procedures, an explicit definition of what the sustainability means for the assessment of human health should be included among the terms of reference in the health report/chapter

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Summary

Introduction

There has been substantial interest worldwide in promoting the inclusion of healthcare within policy in order to achieve Health in All Policies (HiAP) goals, since its first acknowledgment in Europe in2006 [1]. Since the early evolution of HIA, the practice was developed to provide a flexible tool adaptable to different contexts, sectors, and resource availability [7], while lack of knowledge is a limiting factor in HIA implementation [8,9]. This is why capacity-building in HIA has been addressed by different levels of government organizations in the public health sector, environmental sector, and other sectors involved in the process [10,11,12,13].

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