Effectiveness Of Health Impact Assessment Research Articles

Health impact assessment in two planning projects in England: reflections on normative effectiveness

BackgroundThis article reports on research commissioned by (what was at the time) Public Health England (PHE). The objective is to reflect on the normative effectiveness of Health Impact Assessment (HIA) applied to two planning projects; (a) the new town at Cranbrook, Devon (HIA prepared in 2007), and (b) the regeneration of the Marsh farm area in Luton (HIA prepared in 2009). In this context, the focus is on the contribution of HIA to actions that are intended to lead to good or improved health and wellbeing.MethodsNormative HIA effectiveness criteria derived from a literature review were used to guide the analysis. The two included HIA cases were previously identified as good practice examples with regards to procedure and report quality. Semi-structured interviews with public health, planning and other actors originally involved in the HIAs were conducted in 2021. This was followed up by web-searches for evidence on actual developments in 2023.ResultsInterviews indicated that normative effectiveness initially appeared to be high, but that the longer-term effects of the financial crash of 2008 reduced this. Delays in initially anticipated timelines and HIA actors moving elsewhere or retiring meant that HIAs were not followed-up and connections between developments and the HIAs were no longer made. However, web-based searches conducted in 2023 found that key HIA suggestions were eventually implemented, albeit with delay. There is also evidence for improved IMD (index of multiple deprivation) rankings in the Marsh farm regeneration case.ConclusionA mismatch is observed with regards to HIA exercises appearing to be largely ‘forgotten’ after over a decade of their publication, but recommendations still being implemented, possibly as a result of ‘institutional memory’. Making monitoring and follow-up of HIA binding rather than advisory would allow for direct linkages to be made.

Use and effectiveness of health impact assessment in the energy and natural resources sector in the United States, 2007 – 2016

ABSTRACTDecisions made in the energy and natural resources sector can affect public health. This report reviews the characteristics and assesses the effectiveness of health impact assessments (HIAs) conducted in this sector. A total of 30 HIAs conducted in 14 states in the United States were identified using a targeted literature search. Five HIAs illustrative of the different source and sub-sector categories, and with identifiable impacts on decision-making processes were selected for review. An existing conceptual framework (Wismar) was used to assess the effectiveness of the five selected HIAs on decision-making related to non-renewable energy, renewable energy, mining, and energy conservation. The 30 HIAs were performed for a variety of projects and assessed health impacts ranging from metabolic disorders to community livability. Eight of the 30 reports were incorporated into environmental impact assessments. All five selected HIAs were generally effective and raised awareness of the health effects of the projects being assessed; four were directly effective and led to changes in final project decisions. Their variable effectiveness may be related to the extent of community engagement and consideration of equity issues, differences in the details and quality of monitoring and evaluation plans devised as part of the HIA process, and whether the outcomes of monitoring and evaluation are reported.

The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005–2009

BackgroundHealth Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs.MethodsWe used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics.ResultsWe found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement.ConclusionsThis study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions.

The impact and effectiveness of health impact assessment: A conceptual framework

The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project and (iii) an in-depth study of seven completed HIAs. The framework emphasises context, process and impacts as key domains in understanding and evaluating the effectiveness of an HIA. This new framework builds upon the existing approaches to evaluating HIA and extends them to reflect the broad range of factors that comprise and influence the effectiveness of HIAs. It may be of use in evaluating completed HIAs and in planning HIAs that are yet to be undertaken.

Health impact assessment in Europe--current dilemmas and challenges

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 …

European Public Health News * Health Impact Assessment--A Challenge for Eupha's Capacity Building? * Message from the WHO Regional Director for Europe: Addressing Health Inequities * EU action in health: providing added value * Amsterdam 2010: 3rd European Public Health Conference--update * EUSPR--Preventing substance misuse in young people: emerging evidence for psycho-social developmental interventions

We are pleased to provide you with interesting news from the key players in European public health. Our president’s column discusses a role for EUPHA in Health Impact Assessment; Dr Jakab from WHO/EURO informs on the proposal on a European Public Health policy to tackle health inequities and Mr Fahy from DG Sanco describes the added value of the EU in public health. The paper on the 3rd joint European Public Health Conference update shows that all these points will be addressed in Amsterdam in November. Finally, the European Society for Prevention Research presents the theme of preventing substance misuse in young people. # Health Impact Assessment—A Challenge for Eupha’s Capacity Building? {#article-title-2} Health Impact Assessment (HIA) was invented as a means of assessing the health impacts of policies, plans and projects in diverse economic sectors using quantitative, qualitative and participatory techniques. According to WHO, HIA is a practical approach used to judge the potential health effects of a policy, programme or project on a population, particularly on vulnerable or disadvantaged groups. Recommendations are produced for decision-makers and stakeholders, with the aim of maximizing the proposal’s positive health effects and minimizing its negative health effects. HIA can be a valuable tool for helping to develop policy and assisting decision-makers. HIA has come a long way and evolution in the past two decades since one of its earliest applications to construction projects in developing countries, originating from the environmental impact assessment.1 A number of European countries already have considerable experience with applying HIA at various levels, although it has focused more at project than policy level. 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 countries. None of the countries have strengthened and developed all the …

Review Article: Health impact assessment developments in Sweden

The contextual prerequisites in a country are crucial to the implementation and effectiveness of health impact assessment (HIA). This article aims to show how the Swedish government has been working to create supportive contextual prerequisites for HIA. These prerequisites are described based on the following factors: stewardship, including public health policy, party politics and legal preconditions; organization, including resources and funding; and delivery, which is dependent on the public health culture. The aim has also been to draw conclusions about facilitators of and obstacles to HIA implementation. The article is based on a review of relevant literature. Since 2000, the Swedish government has taken a number of initiatives to increase the application of public health and HIA. National agencies and all of Sweden's county administrative boards have received government assignments with the National Institute of Public Health in a supportive role. Some facilitators of HIA implementation are: utilizing existing impact assessment knowledge; connecting HIA with the concept of a sustainable social development; and awareness of the time needed to adopt complex information. Obstacles detected are: the lack of a mandatory law for HIA; a lack of funding; and an occasional lack of public health skills. The final conclusion is that the public health policy adopted by the Swedish Riksdag, with its overarching aim of equality in health and its 11 domains of objectives, has had a crucial effect as a framework for HIA in Sweden.

Process and impact evaluation of the Greater Christchurch Urban Development Strategy Health Impact Assessment

Backgrounddespite health impact assessment (HIA) being increasingly widely used internationally, fundamental questions about its impact on decision-making, implementation and practices remain. In 2005 a collaboration between public health and local government authorities performed an HIA on the Christchurch Urban Development Strategy Options paper in New Zealand. The findings of this were incorporated into the Greater Christchurch Urban Development Strategy;Methodsusing multiple qualitative methodologies including key informant interviews, focus groups and questionnaires, this study performs process and impact evaluations of the Christchurch HIA including evaluation of costs and resource use;Resultsthe evaluation found that the HIA had demonstrable direct impacts on planning and implementation of the final Urban Development Strategy as well as indirect impacts on understandings and ways of working within and between organisations. It also points out future directions and ways of working in this successful collaboration between public health and local government authorities. It summarises the modest resource use and discusses the important role HIA can play in urban planning with intersectoral collaboration and enhanced relationships as both catalysts and outcomes of the HIA process;Conclusionas one of the few evaluations of HIA that have been published to date, this paper makes a substantial contribution to the literature on the impact, utility and effectiveness of HIA.

Exploring Health Impact Assessment in Europe

Background: Health impact assessment (HIA) prospectively judges the potential health impacts of pending decisions and feeds the assessment back into the decision making process. HIA is considered as a key tool for intersectoral collaboration. This article presents selected results of a mapping exercise on HIA in Europe. The mapping exercise is complemented by the presentation of a conceptual framework on the effectiveness of HIA and illustrative examples. Method: Two methodologies are employed in this article: First, the use of HIA across Europe is based on a survey conducted by 21 teams in 19 countries. A semi standardized questionnaire was employed, using a wide variety of sources. Second, for the discussion on the effectiveness of HIA, a conceptual framework using four types of effectiveness was employed. Results: HIA is a common practice only in a handful of European countries. In most of Europe, HIA is at an early developmental stage. The mapping exercise, however, provides evidence that HIA can work across all sectors and at all political level, although there is currently a focus on the local level. HIA is conducted in different countries by different sets of actors and organizations, reflecting the existing setup. The evidence on the effectiveness of HIA is still inconclusive. However, single case studies and upcoming evidence suggests that HIA has the capacity to inform and influence the decision making process. Conclusions: HIA can work and deliver. The variations in context across European countries have resulted in different forms of implementation and different dynamics of developing HIA.

Health Impact Assessment in a Swedish context: The Route 73 case study

Background: Health issues are being allocated increasingly higher priority on the political agenda in Sweden, due to initiatives taken by both the Parliament (the Riksdag) and the Government over the last few years. The Riksdag has recently adopted a bill for public health. Methods: The case study was performed in accordance with the framework for the project “The effectiveness of Health Impact Assessment”, which includes a common questionnaire and a model for evaluating effectiveness. During the study, six interviewees representing different actors and stakeholders in the decision-making process were contacted. The analysis of effectiveness of the HIA on Route 73 is based on the “partial HIA”, i.e. the HIA that is incorporated into the EIA, but the case study also illustrates the benefits of performing a complementary HIA in accordance with the new guidelines in Sweden. Results: The case study on Route 73 shows that the partial HIA had general health effectiveness and general or direct community effectiveness. With respect to equity effectiveness, the answers varied. If the complementary HIA had been used as a basis instead of the partial HIA, it would have highlighted equity aspects much more since the complementary HIA focuses on priority groups and gender throughout the assessment and makes them an important part of the assessment. Conclusions: There is a growing awareness of public health in Sweden today due to the policies adopted by the Riksdag and the Government. Public health objectives, the pinpointing of prioritised groups, health determinants and indicators constitute a good framework for conducting HIA in accordance with the new public health policy and represent its prime facilitators.

Track D10: Workshop: The effectiveness of health impact assessment

Track D10: Workshop: The effectiveness of health impact assessment