Health Impact Assessment: An overview of practice worldwide


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Presentation for the Society for Risk Assessment World Congress on Friday 20 July 2012.

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Health Impact Assessment: An overview of practice worldwide

  1. 1. Health Impact Assessment An Overview of Practice Worldwide Centre for Primary Health Care and Equity Ben Harris-Roxas Consultant, Harris-Roxas Health Conjoint Lecturer, University of New South Wales, SydneyHealth Section Co-Chair, International Association for Impact Assessment
  2. 2. History• The evolution of HIA can be viewed as a little different from EIA • EIA has been strongly focused on major project assessment in many jurisdictions • In recent decades it has expanded to encompass other strategic assessment processes such as strategic environmental assessment (SEA)Harris-Roxas B, Viliani F, Bond A, Cave B, Divall M, Furu P, Harris P, Soeberg M, Wernham A,Winkler M. Health Impact Assessment: The state of the art, Impact Assessment and ProjectAppraisal, 30(1): 43-52. doi:10.1080/14615517.2012.666035
  3. 3. History• HIA can be seen as originating from three separate areas of activity • Environmental health • Social view of health • Health equity • Each bring with them their own disciplinary beliefs, values, support base and baggage • The role of health risk assessmentHarris-Roxas B, Harris E (2011) Differing Forms, Differing Purposes: A Typology of HealthImpact Assessment, Environmental Impact Assessment Review, 31(4):396-403.doi:10.1016/j.eiar.2010.03.003
  4. 4. HIA Health Equity Social View of Health Environmental Health Regulatory Environmental Impact Assessment Environmental Disasters1950s 1960s 1970s 1980s 1990s 2000s1956 Clean Air Act (UK) 1962 Silent Spring 1972 Lake Pedder Dam 1980 The Black Report 1990 Concepts & 2004 Equity Focused HIA controversy (UK) Principles of Equity Framework (Australia) in Health (Australia)1959 Minamata Bay 1969 Santa Barbara 1980 International (Japan) Channel (USA) 1990 Environmental 1972 The Indian Wildlife Association for 2005 Health included in Protection Act (UK) (Protection) Act Impact Assessment IFC Performance 1969 US National formed Environmental Standards 1992 Asian Development 1974 Lalonde Report Policy Act (USA) Bank HIA (Canada) 1984 Bhopal (India) 2005 Guide to HIA in the Guidelines Oil and Gas Sector 1969 Cuyahoga River 1974 Environmental 1986 Ottawa Charter Fire (USA) 1994 Framework for Protection (Impact 2007 1st Asia-Pacific HIA Environmental and of Proposals) Act 1986 Chernobyl Conference Health IA (Australia) (Ukraine) (Australia) (Australia) 1978 Seveso (Italy) 2007 HIA’s use included 1989 Exxon Valdez Oil 1997 Jakarta in Thailand’s Spill (USA) Declaration 1978 Love Canal (USA) Constitution 1998 Independent 1978 WHO Seminar on 2008 WHO Commission Inquiry into Environmental on the Social Inequalities in Health Impact Determinants of Health (UK) Assessment Health: Closing the (Greece) Gap in a 1998 Merseyside Generation Guidelines for HIASource: Harris-Roxas B, Harris E. Differing forms, 1978 Declaration of 2009 Montara Westdiffering purposes: A typology of health impact Alma Ata 1998 The Solid Facts Atlas Oil Spillassessment, Environmental Impact Assessment (Australia)Review, 31(4): 396-403. 1979 Three Mile Islanddoi:10.1016/j.eiar.2010.03.003 (USA) 1999 Gothenburg 2010Marmot Review Consensus Paper on HIA
  5. 5. International Perspectives• There are currently several approaches to legislating and institutionalising HIA’s use: • Requiring health be considered as party of EIAs or broader impact assessment (many countries’ EIA legislation; IFC Performance Standards; Equator Principles; EIA legislation in other regions) • Requiring stand-alone HIAs on a type/category of proposals (Thai National Health Act; Lao PDR; Tasmania, Australia) • Giving health authorities the right to conduct HIAs where they deem it necessary or appropriate (Victoria, Australia) • Legislating the right for communities to request HIAs be conducted or to be involved in them (Thai Constitution) • Regulations or policies that support HIA’s use but do not require it (many local governments and authorities in Europe; New South Wales, Australia; New Zealand)
  6. 6. International Perspectives• Capacity has been a critical factor in determining the extent to which these legislative mechanisms have been actually implemented• The broader Health in All Policies agenda has helped to promote HIA’s use
  7. 7. Opportunities and Threats• The opportunities and threats to HIA and its use are often the same• Better integration of health and HIA into other assessment processes • At the moment health is often limited to health risk assessment that are conducted as stand-alone assessments within larger assessment processes • There’s scope for better integrated assessment of health benefits
  8. 8. Where to next?• We’ve actually come a long way as a field in relatively short time• In 1995 Birley and Peralta wrote that: “At present HIA is a blunt tool with the rudiments of an accepted methodology”• This is no longer the case. There is greater consensus about the procedural elements of HIA (e.g. screening, scoping, etc) and when it is most useful. There is also better evidence about its effectiveness.Briley M, Peralta G (1995) Health Impact Assessment of Development Projects inEnvironmental and Social Impact Assessment (Eds Vanclay F and Bronstein D), Wiley:Chichester, p 153-170.
  9. 9. Where to next?• Potential activity: • Industry-specific HIA guidance, eg mining, wind power, etc (some already exists) • Better professional development for advanced practice • Improved methods for economic appraisal of health impacts
  10. 10. Acknowledgements• Enviros for organising this session• The International Association for Impact Assessment’s Health Section for their help and ideas• The University of New South Wales Centre for Primary Health Care and Equity for their ongoing collaboration
  11. 11. These slides are available @ben_hr or @hiablog