Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment—An International Virtual Scoping Survey and Expert Interviews
Abstract
:1. Introduction
2. Materials and Methods
2.1. Survey Design and Dissemination
2.2. Semi-Structured Interviews
3. Results
3.1. Study Participants
3.2. Raising Awareness and Promoting an Understanding of the Key Concepts of HIAs
3.3. Why Are PHIs Important in the Use and Promotion of HIAs?
I think because they’re normally government led, they have a bit of, they have the, again, it’s that credibility and the endorsement and the recognition amongst other government agencies. (Interviewee I)
Otherwise, it’s just another metric that, you know, lots of consultancies and people, you know, have vary, variations that you could describe as HIA, or different frameworks that just, you know, decision making frameworks that they’ve made up, you know, they’ve kind of developed themselves. There’s nothing wrong with that, but we want everybody to be doing the same thing. (Interviewee I)
3.4. Current Use of HIAs in National and Regional PHIs
This differs across the organisation…. We are more likely to undertake Health Inequalities Impact Assessments on our own programmes of work, and to support HIAs undertaken by others. But ….has done a range of HIAs on things like housing and planning. Our environmental health team have done them on air quality and I think maybe alternative heat sources. (Interviewee C)
3.5. Perceived Barriers to the Use and Promotion of HIAs
You know, a lot of, additional learning through conferences, seminars, e-learning, the different kind of routes that people have for the existing workforce, and then I suppose for the workforce coming through, it’s about embedding that more strongly into Public Health Training and things like Masters in Public Health and epidemiology. (Interviewee C)
There is great interest in this work, we have strong group, but it would help to have further training and more time available to do the work. Other tasks are not going away. (Interviewee D)
Despite theoretical institutional interest on HIA, the lack of resources, leadership and clear political support are just some of the very difficult barriers lived by organizations to undertake a real institutionalization of HIA. (Interviewee E)
It shouldn’t be the most important. But at the end of the day, it’s it is important, isn’t it, but where, where is the money coming from? (Interviewee G)
…there is always the problem, I suppose not a problem, well I don’t see it as a problem, but what some people would see is HIA, the only pushback we’ve ever received on it is the fact that, oh my…, it’s just another process and thing to do. (Interviewee I)
Then we don’t have legal support, a legal-law, a law that says that you need to do this. But I think in sometimes it’s not only the law, it’s the perception of it, because we have this EU directive, which say that we need-there’s a, a description of health in the, in the impact-health impact-not health-environment impact assessment. (Interviewee E)
3.6. Perceived Benefits to PHIs
HIA is seen very much as it’s become more popular as pre, you know, as it’s supposed to do, pre-empting problems that come down the line, and I think there’s an attempt to have a more holistic approach to dealing with health inequalities, in particular. (Interviewee I)
…HIAs… are very useful into bringing, so again, whether we call it health in all policies …or a cross sector sort of engagement is where of course, we try to influence the wider determinants of health, it is a very helpful because on one hand, they show the different sectors, what is their impact on health, but also they show with the, with the social value as to why, what is what Public Health is doing, which can actually has a value to their own areas of responsibility. (Interviewee G)
Also, the thing about using, you know, like, if you use HIA as a tool to look at, like a built environment intervention or something like that, then, yeah, it provides a way for the Institutes to get that into part of the decision-making process, and, yeah, I think that’s probably one of the key aspects of it. (Interviewee A)
3.7. What Could Be Done to Improve the Situation and the Awareness and Enable the Use of HIAs in NPHIs?
3.7.1. Improving Awareness of HIAs as a Methodology
And if you’ve got someone good from public health, who knows how to communicate the benefits to people, you can actually have really good conversations that help people in other sectors to understand why they have a role to play in health improvement and why they… What they can do, I suppose, so, you know, people don’t generally….don’t generally want to harm health. (Interviewee C)
So they, they always look for, kind of lots of evidence to deliver something, case studies. But the, the major thing I’ve always found is that if it’s something that’s been transferred from a similar jurisdiction and it has worked well there, that, that really gives them a lot of confidence in, in pursuing it. (Interviewee I)
I think the Welsh example of having legislative mandate and also a lead agency is an excellent example of how to strengthen HIA across all the dimensions. (Interviewee A)
3.7.2. Improving Awareness of HIA Outputs
3.8. What Support Would Public Health Officers in Phis Need in Practice to Promote and Use HIAs?
And at the top, yes, we’ve got buy-in, I would say, and this period (COVID-19) has really cemented that buy-in in terms to the concept because of the work that’s gone on and they’ve seen the value in it. (Interviewee B)
It’s been very helpful the work that Wales has done on everything. We really- we know we have a place to look for… But we- And with this COVID-19, we have really been looking into the work … done for that and are… adapting, you know, to [inaudible-0:27:18.3] following the steps… (Interviewee D)
Case studies, always invaluable. I mean, you know, what we’ve learned from x’s work in Wales has been really, really helpful to us, you know, and that really is what you need. You know, you need somebody who’s gone down the path before you. We’re modelling completely on what Wales’ team has done. (Interviewee I)
But… I don’t think we have to make the case anymore…. What we have to do is really, truly embed it into people’s practice. (Interviewee C)
3.9. COVID-19 Pandemic
‘it was difficult for it (HIA) to get traction. I think it’s beginning, I think the time is right now for it to get traction because people are beginning, post-pandemic, particularly to understand more about social determinants of health, about how, you know, personal responsibility is not the only issue’. (Interviewee I)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Green, L.; Ashton, K.; Parry-Williams, L.; Dyakova, M.; Clemens, T.; Bellis, M.A. Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment—An International Virtual Scoping Survey and Expert Interviews. Int. J. Environ. Res. Public Health 2022, 19, 13367. https://doi.org/10.3390/ijerph192013367
Green L, Ashton K, Parry-Williams L, Dyakova M, Clemens T, Bellis MA. Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment—An International Virtual Scoping Survey and Expert Interviews. International Journal of Environmental Research and Public Health. 2022; 19(20):13367. https://doi.org/10.3390/ijerph192013367
Chicago/Turabian StyleGreen, Liz, Kathryn Ashton, Lee Parry-Williams, Mariana Dyakova, Timo Clemens, and Mark A. Bellis. 2022. "Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment—An International Virtual Scoping Survey and Expert Interviews" International Journal of Environmental Research and Public Health 19, no. 20: 13367. https://doi.org/10.3390/ijerph192013367