Implementation Of Health Impact Assessment Research Articles

Equity focused health impact assessment: social determinants of health

Addressing health disparities during planning and delivery of services in health care requires an understanding of the health requirements of the disadvantaged population as well as key barriers to equitable quality care. To gain knowledge in social determinant of health it is important to have effective planning tools. Over the past two decades there has been continuous use of health impact assessment (HIA) to assess the health impacts of proposals, programs, policies, projects and even plans. The major problem affecting the implementation of HIA is the identification of the health issues in a policy since it depends on the judgment and the interpretation of the policy aspects by policy makers. The equity focused HIA has an opportunity to make important contributions to policy making processes. The main purpose of EFHIA (Equity Focused Health Impact Assessment) is to ensure that policies, plans, and programs being developed or proposed have observed health equity in order to promote social health.

Implementation of Health Impact Assessment in the Czech Republic: a case study of bottom-up approach

Implementation of Health Impact Assessment in the Czech Republic: a case study of bottom-up approach

Implementation of health impact assessment in Danish municipal context.

Implementation of Health Impact Assessment (HIA) in Danish municipalities has been analyzed using the Roger's Diffusion of Innovation Theory. Municipalities were chosen from among those who presented their health policies on websites according to the status of inclusion of HIA into health policy. Qualitative interviews were conducted in 6 municipalities (3 with HIA inducted in their health policy and 3 without it) gathering information on knowledge and attitudes to HIA, barriers to its implementation, social system and communication channels used or expected to be used for implementation of HIA. No significant differences were found among analyzed municipalities by status of HIA inclusion into health policy. Among barriers; a lack of tools with general validity, a lack of intersectoral working culture, balance between centralized versus participatory way of working and organizational structure of a municipality, and a lack of capacities were enlisted as most relevant. The last one is a crucial factor of an internal social system of a municipality. With regards to communication channels, reporting and presentation skills of implementers and doers are of key importance. Systematic and sustainable capacity building is needed to achieve high level implementation of HIA in Danish municipalities. Development of validated tools, most importantly screening tools with focus on priorities of national public health policy would enhance implementation on municipal level.

The value of mainstreaming human rights into health impact assessment.

Health impact assessment (HIA) is increasingly being used to predict the health and social impacts of domestic and global laws, policies and programs. In a comprehensive review of HIA practice in 2012, the authors indicated that, given the diverse range of HIA practice, there is an immediate need to reconsider the governing values and standards for HIA implementation [1]. This article responds to this call for governing values and standards for HIA. It proposes that international human rights standards be integrated into HIA to provide a universal value system backed up by international and domestic laws and mechanisms of accountability. The idea of mainstreaming human rights into HIA is illustrated with the example of impact assessments that have been carried out to predict the potential effects of intellectual property rights in international trade agreements on the availability and affordability of medicines. The article concludes by recommending international human rights standards as a legal and ethical framework for HIA that will enhance the universal values of nondiscrimination, participation, transparency and accountability and bring legitimacy and coherence to HIA practice as well.

Putting Health Impact Assessment into practice through the lenses of diffusion of innovations theory: a review

This paper looks into the applicability of diffusion of innovation (DoI) theory and the implementation of a Health Impact Assessment (HIA) approach, focusing mainly on the resource extraction sector in low- and middle-income countries (LMICs). The paper begins with a review of DoI theory and discusses how HIA adoption in a LMIC context might be understood from the perspective of DoI theory. It then asks whether knowledge translation theories and approaches might be relevant to DoI, and if so, how. Based on the findings of the literature review and practical applications of DoI theory in HIA implementation, this paper is concluded by arguing that DoI is useful as an overarching theoretical framework to plan and implement adoption strategies and activities, to identify potential challenges.

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 …

Health Impact Assessment in Mongolia

Many developing countries have limited capacity to adequately assess and manage health impacts associated with environmental change. In Mongolia, methodologies to introduce health impact assessment (HIA) as part of the environmental impact assessment (EIA) process have been investigated, and a mechanism to incorporate HIA into the current EIA process is proposed. Some challenges to the implementation of HIA are discussed. The country is now in a position to incorporate HIA as part of the approvals process for development projects. Given the recent growth in population, industrial development, and urbanization together with the interest from international mining companies in the resources of the country, it is important for Mongolia to have such tools in place in order to take advantage of economic growth while improving health and well-being outcomes for the population.

Health Impact Assessment in a Network of European Cities

The methodology of health impact assessment (HIA) was introduced as one of four core themes for Phase IV (2003-2008) of the World Health Organization European Healthy Cities Network (WHO-EHCN). Four objectives for HIA were set at the beginning of the phase. We report on the results of the evaluation of introducing and implementing this methodology in cities from countries across Europe with widely differing economies and sociopolitical contexts. Two main sources of data were used: a general questionnaire designed for the Phase IV evaluation and the annual reporting template for 2007-2008. Sources of bias included the proportion of non-responders and the requirement to communicate in English. Main barriers to the introduction and implementation of HIA were a lack of skill, knowledge and experience of HIA, the newness of the concept, the lack of a legal basis for implementation and a lack of political support. Main facilitating factors were political support, training in HIA, collaboration with an academic/public health institution or local health agency, a pre-existing culture of intersectoral working, a supportive national policy context, access to WHO materials about or expertise in HIA and membership of the WHO-EHCN, HIA Sub-Network or a National Network. The majority of respondents did not feel that they had had the resources, knowledge or experience to achieve all of the objectives set for HIA in Phase IV. The cities that appear to have been most successful at introducing and implementing HIA had pre-existing experience of HIA, came from a country with a history of applying HIA, were HIA Sub-Network members or had made a commitment to implementing HIA during successive years of Phase IV. Although HIA was recognised as an important component of Healthy Cities' work, the experience in the WHO-EHCN underscores the need for political buy-in, capacity building and adequate resourcing for the introduction and implementation of HIA to be successful.

Health impact assessment of industrial development projects: a spatio-temporal visualization

Development and implementation of large-scale industrial projects in complex eco-epidemiological settings typically require combined environmental, social and health impact assessments. We present a generic, spatio-temporal health impact assessment (HIA) visualization, which can be readily adapted to specific projects and key stakeholders, including poorly literate communities that might be affected by consequences of a project. We illustrate how the occurrence of a variety of complex events can be utilized for stakeholder communication, awareness creation, interactive learning as well as formulating HIA research and implementation questions. Methodological features are highlighted in the context of an iron ore development in a rural part of Africa.

La institucionalización de la evaluación del impacto en la salud en Quebec: ¿un modelo factible en España?

Objectives In Canada, the province of Quebec has institutionalized Health Impact Assessment (HIA) by including it in its Public Health Act (PHA). In Spain, the Ministry of Health, Social Policy and Equality is in the process of reforming its PHA, and plans to include HIA in this legislation. This study reviews the factors that have led to the effective implementation of HIA in Quebec and discusses the possible applications of the Quebec model in the Spanish context. Methods Information was gathered through interviews conducted in various public health institutions in Quebec. The Quebec model was compared to the Spanish situation, to identify potential needs associated with the practice of HIA in Spain. Results In Quebec, public health institutions have developed a strategy for effective implementation of HIA. This strategy is based on several measures: creation of a network of ministerial representatives, development of an internal procedure at the Ministry of Health and Social Services to respond to requests, preparation of methodological guidelines, establishment of a research program, strengthening of knowledge transfer mechanisms, and establishment of communication and participation tools. Conclusions HIA legislation does not guarantee its successful implementation. The institutionalization of HIA requires establishing a well-designed structure, as well as the allocation of adequate resources. The Quebec experience offers one model of HIA implementation that could be adapted to our country, taking into account elements of Spanish idiosyncrasies.

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 …

The need for health impact assessment in China: Potential benefits for public health and steps forward

Health impact assessment (HIA) is a useful tool to predict and estimate the potential health impact associated with programs, projects, and policies by comprehensively identifying relevant health determinants and their consequences. China is undergoing massive and rapid socio-economic changes leading to environment and population health challenges such as a large increase in non-communicable diseases, the emergence and re-emergence of infectious diseases, new health risks associated with environmental pollutants and escalating health inequality. These health issues are affected by multiple determinants which can be influenced by planned policies, programs, and projects. This paper discusses the needs for health impact assessment in China in order to minimize the negative health consequences from projects, programs and policies associated with rapid social and economic development. It first describes the scope of China's current impact assessment system and points out its inadequacy in meeting the requirements of population health protection and promotion. It then analyses the potential use of HIA and why China needs to develop and apply HIA as a tool to identify potential health impacts of proposed programs, projects and policies so as to influence decision-making early in the planning process. Thus, the paper recommends the development of HIA as a useful tool in China to enhance decision-making for the protection and promotion of population health. For this to happen, the paper outlines steps necessary for the establishment and successful implementation of HIA in China: beginning with the establishment of a HIA framework, followed by workforce capacity building, methodology design, and intersectoral collaboration and stakeholder engagement.

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.

Building health impact assessment capacity as a lever for healthy public policy in urban planning

Building capacity to improve health through applying health impact assessment (HIA) increases the range of people, organisations and communities who are able to address health problems and, in particular, the problems that arise out of social inequity and social exclusion. To achieve this, a range of strategies is required across the areas of organisational development, workforce development, resource allocation, leadership and partnerships. A conceptual framework to guide understanding of capacity building evolved during a three-year capacity building project that supported the implementation of HIA. This is also applicable to the broader agenda of healthy public policy.

Assessing the Implementation of Health Impact Assessment for Drinking-water Pollution in European Countries

P-562 Introduction: Health risks from exposure to drinking-water pollution (DWP) may be considerable, particularly in children. Measures to reduce the impact of water on children's health were proposed at the Fourth Ministerial Conference on Environment and Health in Budapest, Hungary. Furthermore, one of the Regional Priority Goals of the Children's Environment and Health Action Plan for Europe is to ensure water quality and adequate sanitation. In this context, the project “Implementing Environment and Health Information System in Europe” (ENHIS) analysed the feasibility of using the Health Impact Assessment (HIA) methodology for DWP in a set of European countries, focussing mainly on children. Methods: A literature review based on international water expert advice was carried out to identify relevant DW pollutants, to select appropriate health outcomes and to obtain the most robust and pertinent Exposure-Response functions (ERFs) from the available epidemiological studies. Biological pollution, turbidity and chemical pollution (arsenic, lead, disinfection by-products, nitrates, pesticides and copper) were studied. The findings were compiled and discussed with international water experts to decide on the feasibility of implementing HIA for each pollutant. Results: The relationship between the selected pollutants in DW and health effects is not documented well enough to conduct a HIA. For biological pollution, there is a lack of available ERFs for each potential pathogen, due to the impossibility of finding the DWP origin of the infections observed on numerous occasions. In addition, the pathogens are not routinely monitored in DW and there is no quantitative relationship between positive results of faecal indicators and occurrence of pathogens in DW. In case of turbidity, any general quantification between this parameter values and health risks is unfeasible. As regards chemical pollution, epidemiological studies reported quantitative associations for arsenic, disinfection by-products, lead and pesticides, but not for nitrates and copper. However, findings were controversial in many aspects especially when considering chronic exposure. Discussion and Conclusions: The lack of specific ERFs hinders the development of HIA of DWP on European population and more epidemiological research is needed to provide them. Other approaches, such as Health Risk Assessment and/or Environmental Burden of Disease, can be used to quantify the adverse human health effects due to DWP for public health purposes. All ENHIS project partners. The ENHIS programme is supported by the European Commission DG SANCO (Grant: SPC 2003112). Elena Boldo was supported by a grant from the Regional Ministry of Education, Madrid, Regional Governement, Spain (Orden 7580/2003).

Health impact assessment needs in south-east Asian countries.

A situation analysis was undertaken to assess impediments to health impact assessment (HIA) in the South-East Asia Region of WHO (SEARO). The countries of the region were assessed on the policy framework and procedures for HIA, existing infrastructure required to support HIA, the capacity for undertaking HIA, and the potential for intersectoral collaboration. The findings show that environmental impact assessment (EIA) is being used implicitly as a substitute for HIA, which is not explicitly or routinely conducted in virtually all countries of the Region. Therefore, policy, infrastructure, capacity, and intersectoral collaboration need strengthening for the routine implementation of HIA.