Search Results (51)

This project report explores the use of a Health in All Policies (HiAP) approach by the Georgia Health Policy Center (GHPC) to integrate health perspectives into affordable housing policy and practice in Georgia. It focuses on five interconnected projects from over a decade-long collaboration to illustrate how the GHPC team started with a Health Impact Assessment (HIA) to seed cross-sector partnerships and then sustained them through subsequent collaborations. These projects included comprehensive-, intermediate-, and rapid-scale HIAs, as well as direct collaborations on housing development funding applications and a multidisciplinary research study on public housing renovations. This paper documents how HiAP tactics were applied across these projects to foster sustained collaboration and promote health equity. The insights offered highlight how the HiAP approach cultivated mindset shifts among public health practitioners, housing stakeholders, and policymakers, leading to a broader understanding of health and housing intersections. This synthesis contributes practical guidance for practitioners looking to advance the Vital Conditions for Health and Well-Being through housing policy initiatives. Full article

Health impact assessment (HIA) is a prospective approach that aims to identify the potential consequences of policies or projects on health in order to propose measures to make them healthier. Initiated in the late nineties, the approach emerged over ten years ago in France. However, the evaluation of HIA effectiveness remains seldomly practised and its theoretical background should be deepened. The aim of this article is to generate a discussion on how to evaluate HIA effectiveness and contribute to its methodological tooling, drawing on an evaluative experience of multiple French HIAs. Our work is based on an iterative approach between an analysis of the evaluation literature and a critical look at an HIA evaluation. We first carried out the evaluation of three HIAs in 2017–2018, combining a normative approach and qualitative research in order to explore each HIA as a phenomenon in its own context. Two years later, we conducted a self-assessing expertise on this evaluation, supported by an analysis of the literature in the field of public policy evaluation, in order to refine the theoretical framework for evaluating HIA effectiveness and ultimately to enhance professional practice by evaluators. This work led to the production of a logic model that identifies, through three dimensions (context, implementation and governance), the multiple pathways that HIA may take to bring about change. It also seeks to show the interdependence of these pathways towards change and helps identify the key drivers and mechanisms of HIA success. In this respect, it complements existing HIA evaluation models as it can serve both as a generic framework for evaluating HIA effectiveness and as an instrument for monitoring HIA implementation. Full article

The occurrence and spread of infectious diseases pose considerable challenges to public health. While the relationship between the built environment and the spread of infectious diseases is well-documented, there is a dearth of urban planning tools specifically designed for conducting Health Impact Assessments (HIAs) targeted at infectious diseases. To bridge this gap, this paper develops a comprehensive framework of an HIA for Urban Planning and Epidemic (HIA4UPE), formulated by considering the progression of public health incidents and the distinct transmission patterns of infectious diseases. This framework is designed to provide a comprehensive assessment by including a health risk-overlay assessment, health resource-quality assessment, health resource-equality assessment, and health outcome-impact prediction, enabling a multidimensional evaluation of the potential impacts of current environmental conditions or planning proposals on the incidence of infectious diseases. Furthermore, this paper advances the application of spatial analysis and computation, comprehensive assessment methodologies, and predictive analytics to conduct specific assessments. The theoretical framework and analytical tools presented in this paper contribute to the academic discourse and offer practical utility in urban planning and policymaking on epidemic prevention and control. Full article

Environmental impact assessment (EIA) performance has remained of interest, and over the past ten years, the evaluation technique has evolved. Thailand implemented an EIA with a health impact assessment (HIA) as an environmental health impact assessment (EHIA), which necessitated investigating and developing these instruments; however, its implementation performance has been questioned. The main goal of this study is to comparatively assess how well EIAs and EHIAs are performed in projects in an area in Thailand. Six projects in various sectors that were implemented in Eastern Thailand were studied. The 162 residents (nine local authorities and 153 villagers) closest to the project completed a survey and evaluated the performance according to three aspects (i.e., substantive, procedural, and transactive), using a rating scale and evaluation checklists. The results were presented as a percentage of the total scores and interpreted according to the five scales. The overall performance reached a satisfactory level, albeit not significantly different between cases; however, it was pointed out that the shortcomings of EHIAs and EIAs, particularly their dependability, lack of public involvement, and the need for more transparency, could be addressed through the establishment of an open access database, which would help to simplify the assessment of all stages of EIAs and EHIAs. Full article

Health Impact Assessment (HIA), an inherently trans-disciplinary approach, is used to help evaluate and improve projects or programmes in sectors such as transportation, where new infrastructure is likely to have effects on health. This article describes the screening, scoping, appraisal, and recommendation steps of an HIA on a new 24 km highway around the conurbation of Strasbourg, France. Methods included a literature review and quantitative estimates of the health effects of air pollution and noise. Although planned, interviews and focus groups proved impossible due to political and administrative difficulties. In replacement, answers to a related public inquiry were submitted to a secondary, thematic analysis. The new infrastructure is likely to create or help maintain some jobs in the short term and might accelerate certain journeys, but it does not seem able to improve local mobility and air quality issues. It crystallises the dissatisfaction of a part of the local population and raises the question of the transparency of the design and validation processes of major infrastructure projects. Despite an unfavourable political context, the HIA approach described in this article was able to overcome methodological difficulties and obstacles thanks to creative research methods and trans-disciplinarity to finally yield relevant information and suggestions for urban health promotion. Full article

Diisocyanates are a group of chemicals widely used in different industrial applications. The critical health effects related to diisocyanate exposure are isocyanate sensitisation, occupational asthma and bronchial hyperresponsiveness (BHR). Industrial air measurements and human biomonitoring (HBM) samples were gathered in specific occupational sectors to examine MDI, TDI, HDI and IPDI and the respective metabolites from Finnish screening studies. HBM data can give a more accurate picture of diisocyanate exposure, especially if workers have been exposed dermally or used respiratory protection. The HBM data were used for conducting a health impact assessment (HIA) in specific Finnish occupational sectors. For this purpose, exposure reconstruction was performed on the basis of HBM measurements of TDI and MDI exposures using a PBPK model, and a correlation equation was made for HDI exposure. Subsequently, the exposure estimates were compared to a previously published dose–response curve for excess BHR risk. The results showed that the mean and median diisocyanate exposure levels and HBM concentrations were low for all diisocyanates. In HIA, the excess risk of BHR from MDI exposure over a working life period was highest in the construction and motor and vehicle industries and repair sectors, resulting in estimated excess risks of BHR of 2.0% and 2.6%, and 113 and 244 extra BHR cases in Finland, respectively. Occupational exposure to diisocyanates must be monitored because a clear threshold for DI sensitisation cannot be established. Full article

The Health Impact Assessment (hereinafter referred to as HIA) is an effective method for predicting potential health impacts from decisions. Little is known about the implementation of the HIA in the Republic of Kazakhstan (further, RK). In addition, the Russian language literature has not yet been reviewed in terms of HIA-related knowledge. By conducting a literature review of enabling factors, including Russian language literature, on the implementation of the HIA and studying governance systems in RK, we aim to suggest an implementation process to implement the HIA in RK. After careful analysis of the governance system, we suggest set up of a HIA support unit under the National Scientific Center for Health Development and discuss the possible benefits. The proposed center should guide the implementation of the HIA in RK. Full article

Public health institutes have an important role in promoting and protecting the health and well-being of populations. A key focus of such institutes are the wider determinants of health, embracing the need to advocate for ‘Health in All Policies’ (HiAP). A valuable tool to support this is the health impact assessment. This study aims to support public health institutes to advocate more successfully for the use of health impact assessments and HiAP in order to promote and protect health, well-being and equity. During July 2021, a quantitative online survey was undertaken across international networks with 17 valid responses received. Semi-structured interviews were also administered with nine expert representatives and analysed thematically. In total, 64.7% (n = 11) of survey respondents were aware of health impact assessments and 47.1% (n = 8) currently conducted health impact assessments. It was noted that there are differing approaches to HIAs, with a need for a clear set of standards. Barriers to use included lack of knowledge, training and resources. Overall, 64.7% (n = 11) of survey respondents would like to do more to develop knowledge and capacity around health impact assessments. The results from this study can serve as a platform to help build knowledge, networks and expertise, to help support a ‘Health in All Policies’ approach and address inequalities which exist in all societies. Full article

Based on the broader concept of health proposed by the Pan-American Health Organization/World Health Organization (PAHO/ WHO), 2018, and the absence in the literature of indices that translate the causal relationship between sanitation and health, a methodology for assessing the health impact of a water and sanitation programmes, known as a Health Impact Assessment (HIA), was developed, specifically in the Brazilian context, and focused on a school in the northeast of the country. Through exploratory and descriptive evidence, and using documentary research as a method, a retrospective survey was carried out from 2000 to 2022 using documents proposing evaluation methodologies. A single document was found to fit the research objective, which was used to develop the proposed HIA methodology. Development of the methodology consisted of two stages: definition of the health dimensions and selection of the indicators making up each dimension. The HIA methodology was then applied to a school in northeast Brazil to test its use, before a water-efficient management intervention was going to be used. The overall score of 46% indicated that there was room for improvement, which the new management approach could facilitate. This methodology is therefore proposed to be an instrument for the evaluation of public water and sanitation policies, thus assisting managers in the decision-making process and in guiding sanitation programs and plans. Full article

Physical activity has a variety of health benefits for young people. The World Health Organization (WHO) recommends that children and adolescents aged 5–17 years should be physically active for at least 60 min a day. This Health Impact Assessment (HIA) examined the potential impact of a daily physical activity unit in Austrian schools, with a focus on children and adolescents up to eighth grade. The HIA methodology systematically followed several stages: screening and scoping, appraisal, and formulation of recommendations. A literature review, an online survey (n = 712), focus group discussions (n = 4), and appraisal workshops (n = 2) have been carried out. The analyzed results indicate a primarily positive impact on the individual health of children and adolescents, on social and community-related networks, on living and working conditions, and on the system level. Recommendations for the implementation include ensuring equal opportunities and support for disadvantaged children and schools. Furthermore, the comprehensible selection of pilot regions and the nationwide resource planning should be considered. Additional important factors include the education and further training of pedagogical staff and coaches, and the availability of sufficient infrastructure. In the long term, the fixed integration of five additional teaching units of physical activity per week, and an increased focus on the elementary/nursery school sector were identified as significant. Full article

Health impact assessment (HIA) has been regarded as an important means and tool for urban planning to promote public health and further promote the integration of health concept. This paper aimed to help scientifically to understand the current situation of urban HIA research, analyze its discipline co-occurrence, publication characteristics, partnership, influence, keyword co-occurrence, co-citation, and structural variation. Based on the ISI Web database, this paper used a bibliometric method to analyze 2215 articles related to urban HIA published from 2012 to 2021. We found that the main research directions in the field were Environmental Sciences and Public Environmental Occupational Health; China contributed most articles, the Tehran University of Medical Sciences was the most influential institution, Science of the Total Environment was the most influential journal, Yousefi M was the most influential author. The main hotspots include health risk assessment, source appointment, contamination, exposure, particulate matter, heavy metals and urban soils in 2012–2021; road dust, source apposition, polycyclic aromatic hydrocarbons, air pollution, urban topsoil and the north China plain were always hot research topics in 2012–2021, drinking water and water quality became research topics of great concern in 2017–2021. There were 25 articles with strong transformation potential during 2020–2021, but most papers carried out research on the health risk assessment of toxic elements in soil and dust. Finally, we also discussed the limitations of this paper and the direction of bibliometric analysis of urban HIA in the future. Full article

Vehicular traffic is one of the major sources of air pollution in European cities. This work aims to understand which characteristics of the urban environment could influence mobility-related air pollution, quantify the health impacts of exposure to traffic-derived PM_2.5 and NO₂ concentrations, and assess the potential health benefits expected from traffic interventions. The health benefits modeled are intended to provide a set of comparable data to support decision-makers and encourage informed decision-making to design healthier cities. Targeting a large geographical coverage, 12 European cities from 9 countries were comparatively assessed in terms of mean daily traffic volume/area, the number of public transport stops/area, and the percentage of green and outdoor leisure areas, among other urban indicators. This was implemented using an open-source data mining tool, which was seen as a useful engine to identify potential strategies to improve air quality. The comparison of urban indicators in the selected cities evidenced two trends: (a) cities with the most heterogeneous distribution of public transport stops, as an indicator of poor accessibility, are also those with the lowest proportion of km dedicated to cycleways and footways, highlighting the need in these cities for more sustainable mobility management; and (b) the percentage of green and outdoor leisure areas may influence the share of journeys by bicycle, pointing out that promoting the perception of green routes is relevant to enhance the potential of active transport modes. Socioeconomic factors can be key determinants of the urban indicators and would need further consideration. For the health impact assessment (HIA), two baseline scenarios were evaluated and compared. One is based on mean annual traffic contributions to PM_2.5 concentrations in each target city (ranging between 1.9 and 13 µg/m³), obtained from the literature, and the second is grounded on mean annual NO₂ concentrations at all available traffic and urban background stations within each city (17.2–83.5 µg/m³), obtained from the European Environment Agency database. The intervention scenarios modeled were designed based on traffic mitigation strategies in the literature, and set to ranges of 6–50% in traffic-derived PM_2.5 concentrations and of 4–12.5% in NO₂ concentrations. These scenarios could result in only a 1.7% (0.6–4%) reduction in premature mortality due to exposure to traffic-derived PM_2.5, and 1.0% (0.4–2%) due to exposure to NO₂, as the mean for all the cities. This suggests that more ambitious pollution abatement strategies should be targeted. Full article

Following alerts about the diminishing role of health risk assessment (HRA) in informing public health decisions, this study examines specific HRA topics with the aim of identifying possible solutions for addressing this compelling situation. The study administered a survey among different groups of stakeholders involved in HRA or decision-making, or both. The responses show various understandings of HRA in the decision-making context—including confusion with the health impact assessment (HIA)—and confirm recurring foundational issues within the risk analysis field that contribute to the growth of inconsistency in the HRA praxis. This inconsistency lowers the effectiveness of HRA to perform its primary purpose of informing public health decisions. Opportunities for improving this situation come at the beginning of the assessment process, where greater attention should be given to defining the assessment and decision-making contexts. Both must reflect the concerns and expectations of the stakeholders regarding the needs and purpose of an HRA on one side, and the methodological and procedural topics relevant for the decision case at hand on the other. The HRA process should end with a decision follow-up step with targeted auditing and the participation of stakeholders to measure its success. Full article

Health effects related to exposure to air pollution such as ozone (O₃) have been documented. The World Health Organization has recommended the use of the Sum of O₃ Means Over 35 ppb (SOMO35) to perform Health Impact Assessments (HIA) for long-term exposure to O₃. We estimated the avoidable mortality associated with long-term exposure to tropospheric O₃ in 14 cities in Mexico using information for 2015. The economic valuation of avoidable deaths related to SOMO35 exposure was performed using the willingness to pay (WTP) and human capital (HC) approaches. We estimated that 627 deaths (95% uncertainty interval (UI): 227–1051) from respiratory diseases associated with the exposure to O₃ would have been avoided in people over 30 years in the study area, which confirms the public health impacts of ambient air pollution. The avoidable deaths account for almost 1400 million USD under the WTP approach, whilst the HC method yielded a lost productivity estimate of 29.7 million USD due to premature deaths. Our findings represent the first evidence of the health impacts of O₃ exposure in Mexico, using SOMO35 metrics. Full article

Background: Health impact assessment (HIA) is a tool used to assess the potential health impacts of proposed projects, programs, and policies. The extent of the use of HIAs conducted on health sector proposals, and what they focus on, is currently largely undocumented. This paper reviews HIAs conducted on health sector proposals, their characteristics and describes the settings in which they were conducted. Methods: A systematic review was conducted, including peer-reviewed journals and grey literature utilizing keywords, synonyms, and subject headings relevant to HIA and the health sector. Eligibility criteria were independently applied to the identified works and data appraisal conducted using the Critical Appraisal Skills Programme qualitative checklist tool. Results: 19 HIAs were identified and included in the review, including 13 rapid, three intermediate, and two comprehensive HIAs. The HIAs use was evident across a range of health service contexts, though all but one had been conducted in developed countries. Conclusion: The use of HIAs in the health sector is limited. There were various benefits attributed to the HIAs analysed including and not limited to the allocation of resources, reducing inequalities, and identification of possible negative consequences of a project. There is an opportunity to improve the use and reporting of HIAs across health settings internationally to enhance the consideration of broader determinants of health, influence decision making, and use of evidence in health sector planning for the future. Full article