Health Impact Assessment

by

Jason Corburn

• LAST REVIEWED: 13 January 2014
• LAST MODIFIED: 13 January 2014
• DOI: 10.1093/obo/9780199756797-0080

Introduction

Health impact assessment (HIA) is often defined as a combination of procedures, methods, and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program, or project on the health of a population and the distribution of those effects within a population. HIA is as much a process as it is a method of analysis. It aims for achieving transparent decision making, integrating multiple determinants of health, and assessing short- and long-term human health impacts to specific population groups and the general population health. HIA has emerged from a history of policy analysis and impact assessments, such as environmental and social impact assessment, and should be viewed as part of these literatures. Since the early 1990s, the practice of HIA has taken hold in Australia and Europe and more recently in North America and Asia. Local and national government agencies, as well as nongovernmental organizations, private consultants, and international organizations—such as the World Health Organization (WHO) and the International Finance Corporation (IFC)—have all produced guidance documents for conducting HIAs. While the practice is still emerging, case studies and evaluations of practice exist within the peer-reviewed literature. Some local and national governments have formally institutionalized HIA as a distinct practice into public health and other agencies, while other governments integrate HIA within existing health analyses and public decision-making analyses. HIA is also increasingly linked to and part of other emerging public health paradigms, including health in all policies, social determinants of health, and sustainability and health.

General Overviews

These articles and books make the case for why HIA is an important approach for analyzing policy and planning decisions and also outline how to conduct an HIA. Scott-Samuel 1996 makes the case for why HIA is an important analytic and political process for informed public policy. Kemm, et al. 2004 is the earliest and most comprehensive edited volume on HIA, documenting methods, frameworks, and case studies of practice focused in Europe. The Bulletin of the World Health Organization: The International Journal of Public Health is similar to Kemm, et al. 2004, offering a range of HIA methodologies and practice examples while also highlighting existing challenges facing the field. This WHO Bulletin special issue includes a global perspective of HIA, documenting practice in Europe, Australia, and Asia. Phoolcharoen, et al. 2003 describes the rise of HIA practice in Thailand from civil society activism to national legislation and offers the reader one important example of HIA practice in the global south. Finally, Harris-Roxas and Harris 2011 offers four different typologies of HIA that capture the different methods, participants, and applications of HIA around the world.

• Harris-Roxas, B., and E. Harris. 2011. Differing forms, differing purposes: A typology of health impact assessment. Environmental Impact Assessment Review 31.4: 396–403.

  DOI: 10.1016/j.eiar.2010.03.003

  This paper acknowledges that HIA is not one practice or technique and that there is not widespread agreement in public health on the different approaches, methods, or applications of HIA, and it offers a typology of four different forms of HIA that can be observed in current HIA practice: mandated, decision-support, advocacy, and community-led HIAs.

• Kemm, J., J. Parry, and S. Palmer, eds. 2004. Health impact assessment: Concepts, theory, techniques, and applications. Oxford: Oxford Univ. Press.

  DOI: 10.1093/acprof:oso/9780198526292.001.0001

  This book is the first to provide a comprehensive overview of core HIA concepts, theory, techniques, and applications. It draws on examples and thinking from many different disciplines and includes examples from the global north and south.

• Phoolcharoen, W., D. Sukkumnoed, and P. Kessomboon. 2003. Development of health impact assessment in Thailand: Recent experiences and challenges. Bulletin of the World Health Organization 81.6: 465–467.

  This article highlights the emergence and adoption of HIA in Thailand. Thailand is an important case of how a country in the global south has developed HIA practice and integrated it into national legislation called the National Health Act. The article includes examples of the use of HIA in Thailand to inform industrial and energy policies, agricultural and rural policy, urban and transport planning, water resource management, and international trade agreements.

• Scott-Samuel, A. 1996. Health impact assessment: An idea whose time has come. British Medical Journal 313.7051: 183–184.

  DOI: 10.1136/bmj.313.7051.183

  One of the first publications justifying the need for HIA and a brief description of its practice and role in promoting greater evidence-based decision making.

• Special issue: Health impact assessment. 2003. Bulletin of the World Health Organization. 81.6: 387–472.

  In this special issue of the WHO Bulletin, twenty articles on HIA cover a range of topics from the history of the practice to community involvement procedures. Examples of integrating broad health analyses into transport, land use, water resource, agriculture, food, pipeline development, and other policies in Europe, Asia, and Africa are discussed.