Health impact assessment (HIA) is defined as "a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population." ( ECHP 1999 , p. 4)
Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". According to Akarowhe (2018), the working definition of population health is expressed thus; population health is an art, process, science and a product of enhancing the health condition of a specific number of people within a given geographical area - population health as an art, simply means that it is geared towards equal health care delivery to an anticipated group of people in a particular geographical location; as a science, it implies that it adopt scientific approach of preventive, therapeutic, and diagnostic service in proffering medical treatment to the health problem of people; as a product, it means that population health is directed toward overall health performance of people through health satisfaction within the said geographical area; and as a process it entails effective and efficient running of a health management/population health management system to cater for the health needs of the people. It is an approach to health that aims to improve the health of an entire human population. This concept does not refer to animal or plant populations. It has been described as consisting of three components. These are "health outcomes, patterns of health determinants, and policies and interventions". A priority considered important in achieving the aim of Population Health is to reduce health inequities or disparities among different population groups due to, among other factors, the social determinants of health, SDOH. The SDOH include all the factors that the different populations are born into, grow up and function with throughout their lifetimes which potentially have a measurable impact on the health of human populations. The Population Health concept represents a change in the focus from the individual-level, characteristic of most mainstream medicine. It also seeks to complement the classic efforts of public health agencies by addressing a broader range of factors shown to impact the health of different populations. The World Health Organization's Commission on Social Determinants of Health, reported in 2008, that the SDOH factors were responsible for the bulk of diseases and injuries and these were the major causes of health inequities in all countries. In the US, SDOH were estimated to account for 70% of avoidable mortality.
HIA is intended to produce a set of evidence-based recommendations to inform decision-making ( Taylor & Quigley 2002 , p. 2). HIA seeks to maximise the positive health impacts and minimise the negative health impacts of proposed policies, programs or projects.
Evidence, broadly construed, is anything presented in support of an assertion. This support may be strong or weak. The strongest type of evidence is that which provides direct proof of the truth of an assertion. At the other extreme is evidence that is merely consistent with an assertion but does not rule out other, contradictory assertions, as in circumstantial evidence.
In psychology, decision-making is regarded as the cognitive process resulting in the selection of a belief or a course of action among several alternative possibilities. Decision-making is the process of identifying and choosing alternatives based on the values, preferences and beliefs of the decision-maker. Every decision-making process produces a final choice, which may or may not prompt action.
Health is a state of physical, mental and social well-being in which disease and infirmity are absent.
The procedures of HIA are similar to those used in other forms of impact assessment, such as environmental impact assessment or social impact assessment. HIA is usually described as following the steps listed, though many practitioners break these into sub-steps or label them differently:
Policy Impact Assessments (IAs) are formal, evidence-based procedures that assess the economic, social, and environmental effects of public policy. They have been incorporated into policy making in the OECD countries and the European Commission.
Environmental assessment (EA) is the assessment of the environmental consequences of a plan, policy, program, or actual projects prior to the decision to move forward with the proposed action. In this context, the term "environmental impact assessment" (EIA) is usually used when applied to actual projects by individuals or companies and the term "strategic environmental assessment" (SEA) applies to policies, plans and programmes most often proposed by organs of state. Environmental assessments may be governed by rules of administrative procedure regarding public participation and documentation of decision making, and may be subject to judicial review.
Social impact assessment (SIA) is a methodology to review the social effects of infrastructure projects and other development interventions. Although SIA is usually applied to planned interventions, the same techniques can be used to evaluate the social impact of unplanned events, for example disasters, demographic change and epidemics.
The main objective of HIA is to apply existing knowledge and evidence about health impacts, to specific social and community contexts, to develop evidence-based recommendations that inform decision-making in order to protect and improve community health and wellbeing. Because of financial and time constraints, HIAs do not generally involve new research or the generation of original scientific knowledge. However, the findings of HIAs, especially where these have been monitored and evaluated over time, can be used to inform other HIAs in contexts that are similar. An HIA's recommendations may focus on both design and operational aspects of a proposal.
Community health is a major field of study within the medical and clinical sciences which focuses on the maintenance, protection, and improvement of the health status of population groups and communities. It is a distinct field of study that may be taught within a separate school of public health or environmental health. The WHO defines community health as:
environmental, social, and economic resources to sustain emotional and physical well being among people in ways that advance their aspirations and satisfy their needs in their unique environment.
A design is a plan or specification for the construction of an object or system or for the implementation of an activity or process, or the result of that plan or specification in the form of a prototype, product or process. The verb to design expresses the process of developing a design. In some cases, the direct construction of an object without an explicit prior plan may also be considered to be a design activity. A design usually has to satisfy certain goals and constraints, may take into account aesthetic, functional, economic, or socio-political considerations, and is expected to interact with a certain environment. Major examples of designs include architectural blueprints, engineering drawings, business processes, circuit diagrams, and sewing patterns.
HIA has also been identified as a mechanism by which potential health inequalities can be identified and redressed prior to the implementation of proposed policy, program or project ( Acheson 1998 ).
A number of manuals and guidelines for HIA's use have been developed (see further reading).
The proposition that policies, programs and projects have the potential to change the determinants of health underpins HIA's use. Changes to health determinants then leads to changes in health outcomes or the health status of individuals and communities. The determinants of health are largely environmental and social, so that there are many overlaps with environmental impact assessment and social impact assessment.
Three forms of HIA exist:
It has been suggested that HIAs can be prospective (done before a proposal is implemented), concurrent (done while the proposal is being implemented) or retrospective (done after a proposal has been implemented) ( Taylor, Gorman & Quigley 2003 , p. 1). This remains controversial, however, with a number of HIA practitioners suggesting that concurrent HIA is better regarded as a monitoring activity and that retrospective HIA is more akin to evaluation with a health focus, rather than being assessment per se ( Kemm 2003 , p. 387). Prospective HIA is preferred as it allows the maximum practical opportunity to influence decision-making and subsequent health impacts.
HIA practitioners can be found in the private and public sectors, but are relatively few in number. There are no universally accepted competency frameworks or certification processes. It is suggested that a lead practitioner should have extensive education and training in a health related field, experience of participating in HIAs, and have attended an HIA training course. It has been suggested and widely accepted that merely having a medical or health degree should not be regarded as an indication of competency.
The International Association for Impact Assessment has an active health section.
A HIA People Directory can be found on the HIA GATEWAY.
HIA is currently being used or developed around the world, most notably in Europe, North America, Australia, New Zealand, Africa and Thailand.
The new safeguard policies and standards of the International Finance Corporation (IFC), part of the World Bank, were established in 2006. These contain a requirement for health impact assessment in large projects. The standards have been accepted by most of the leading lending banks who are parties to the Equator Principles. Health impact assessments are becoming routine in many large development projects in both public and private sectors of developing countries. There is also a long history of health impact assessment in the water resource development sector - large dams and irrigation systems.
The 13th International HIA Conference was held in Geneva in 2013.
The 12th International HIA Conference was held in Québec City in 2012.
In social science, the term built environment, or built world, refers to the human-made environment that provide the setting for human activity, ranging in scale from buildings to parks. It has been defined as "the human-made space in which people live, work, and recreate on a day-to-day basis."
Cost–benefit analysis (CBA), sometimes called benefit costs analysis (BCA), is a systematic approach to estimating the strengths and weaknesses of alternatives used to determine options which provide the best approach to achieving benefits while preserving savings. A CBA may be used to compare completed or potential courses of actions, or to estimate the value against the cost of a decision, project, or policy. It is commonly used in commercial transactions, business or policy decisions, and project investments.
Environmental protection is the practice of protecting the natural environment by individuals, organisations and governments. Its objectives are to conserve natural resources and the existing natural environment and, where possible, to repair damage and reverse trends.
The Department for Work and Pensions (DWP) is the largest government department in the United Kingdom, and is responsible for welfare and pension policy.
The California Environmental Quality Act (CEQA) is a California statute passed in 1970, shortly after the United States federal government passed the National Environmental Policy Act (NEPA), to institute a statewide policy of environmental protection. CEQA does not directly regulate land uses, but instead requires state and local agencies within California to follow a protocol of analysis and public disclosure of environmental impacts of proposed projects and, in a departure from NEPA, adopt all feasible measures to mitigate those impacts. CEQA makes environmental protection a mandatory part of every California state and local (public) agency's decision making process. It has also become the basis for numerous lawsuits concerning public and private projects.
Environmental justice emerged as a concept in the United States in the early 1980s. The term has two distinct uses with the more common usage describing a social movement that focuses on the fair distribution of environmental benefits and burdens. The other use is an interdisciplinary body of social science literature that includes theories of the environment and justice, environmental laws and their implementations, environmental policy and planning and governance for development and sustainability, and political ecology.
Health promotion is, as stated in the 1986 World Health Organization (WHO) Ottawa Charter for Health Promotion, "the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being".
Environmental indicators are simple measures that tell us what is happening in the environment. Since the environment is very complex, indicators provide a more practical and economical way to track the state of the environment than if we attempted to record every possible variable in the environment. For example, concentrations of ozone depleting substances (ODS) in the atmosphere, tracked over time, is a good indicator with respect to the environmental issue of stratospheric ozone depletion..
Procurement is the process of finding, acquiring, buying goods, services or works from an external source, often via a tendering or competitive bidding process. The process is used to ensure the buyer receives goods, services or works the best possible price, when aspects such as quality, quantity, time, and location are compared. Procurement is considered sustainable when organizations broadens this framework by meeting their needs for goods, services, works, and utilities in a way that achieves value for money and promotes positive outcomes not only for the organization itself but for the economy, environment, and society. This framework is also known as the triple bottom line.
The Healthy Development Measurement Tool (HDMT), developed by the San Francisco Department of Public Health, provides an approach for evaluating land-use planning and urban development with regards to the achievement of human health needs. The HDMT provides a set of baseline data on community health metrics for San Francisco and development targets to assess the extent to which urban development projects and plans can improve community health. The HDMT also provides a range of policy and design strategies that can advance health conditions and resources via the development process.
The Conservation Effects Assessment Project (CEAP) was established in 2002 to quantify the environmental impact of the United States Department of Agriculture's (USDA) conservation program. The project focuses on how watersheds are affected. CEAP monitored 14 benchmark watershed sites. The CEAP's vision is to enhance "natural resources and healthier ecosystems through improved conservation effectiveness and better management of agricultural landscapes. The goal is "to improve efficacy of conservations practices and programs by quantifying conservation effects and providing the science and education base needed to enrich conservation planning, implementation, management decisions, and policy."
Because of the ongoing controversy on the implications of nanotechnology, there is significant debate concerning whether nanotechnology or nanotechnology-based products merit special government regulation. This mainly relates to when to assess new substances prior to their release into the market, community and environment.
The environmental impact of paper is significant, which has led to changes in industry and behaviour at both business and personal levels. With the use of modern technology such as the printing press and the highly mechanized harvesting of wood, disposable paper became a relatively cheap commodity, which led to a high level of consumption and waste. The rise in global environmental issues such as air and water pollution, climate change, overflowing landfills and clearcutting have all lead to increased government regulations. There is now a trend towards sustainability in the pulp and paper industry as it moves to reduce clear cutting, water use, greenhouse gas emissions, fossil fuel consumption and clean up its impacts on local water supplies and air pollution.
The environmental impact of the energy industry is diverse. Energy has been harnessed by human beings for millennia. Initially it was with the use of fire for light, heat, cooking and for safety, and its use can be traced back at least 1.9 million years. In recent years there has been a trend towards the increased commercialization of various renewable energy sources.
An equality impact assessment (EqIA) is a process designed to ensure that a policy, project or scheme does not discriminate against any disadvantaged or vulnerable people.
The FACE risk profile is a commercial mental health assessment tool that is part of a collection of tools produced by Imosphere.
Health in All Policies (HiAP) was a term first used in Europe during the Finnish presidency of the European Union (EU), in 2006, with the aim of collaborating across sectors to achieve common goals. It is a strategy to include health considerations in policy making across different sectors that influence health, such as transportation, agriculture, land use, housing, public safety, and education. It reaffirms public health's essential role in addressing policy and structural factors affecting health, as articulated by the Ten Essential Public Health Services, and it has been promoted as an opportunity for the public health sector to engage a broader array of partners.
The Celtic Array was a proposed UK round 3 offshore wind farm in the Irish Sea south east of the Isle of Man.
Vietnam joined the World Bank Group (WBG) on 21 September 1956. Before the mid-1980s, Vietnam was one of the world's least developed countries. A series of economic and political reforms launched in 1986, known as Đổi Mới, caused Vietnam to experience rapid economic growth and development, becoming a lower middle-income country. The World Bank (WB) has maintained a development partnership with Vietnam since 1993. As of 25 March 2019, it has committed a total of US$24 billion in loans, credits, and grants to Vietnam through 165 operations and projects, 44 of which are active as of 2019 and comprise US$9 billion. With an estimated extreme poverty rate below 3% and a GDP growth rate of 7.1% in 2018, Vietnam's economy continues to show fundamental strength and is supported by robust domestic demand and export-oriented manufacturing.
This page uses Harvard referencing. References are sorted alphabetically by author surname.
|dead-url=(help). Includes several chapters on HIA.
|dead-url=(help); Italic or bold markup not allowed in:
|dead-url=(help); Italic or bold markup not allowed in:
This page uses Harvard referencing. Further reading categories are sorted alphabetically; citations are sorted by year (newest to oldest), then alphabetically by author surname within years. If citations are included in the references section they are not listed in the further reading section.
This page uses Harvard referencing. External links are sorted alphabetically.