Health Care Evaluation: Health and environmental impact assessment

“Health Impact Assessment (HIA) is a combination of procedures, methods and tools by which a policy, programme or plan may be judged as to its potential effects on the health of the population and the distribution of those effects within the population” (1999, WHO consensus conference).

HIA assesses the potential health risks and benefits entailed in any proposal in a rigorous fashion. HIA is a decision making tool and is designed to take account of the wide range of potential effects that a proposal may have on a target population. It considers relevant evidence, takes into account opinions, analyses the potential health impacts of the proposal to enable informed decision making.

HIAs can be carried out prospectively, concurrently or retrospectively.
Prospective HIA is usually the most useful as health impacts can be considered before commitments made.

HIA can be use to inform:

• The design and development of a policy or strategy
• The commissioning of services
• Resource allocation
• Community participation and service user involvement
• Community development and planning
• Preparing funding bids

HIA involves 6 main steps:

1. economic issues- size of the project and the population affected; and the costs of the project and their distribution
2. outcome issues- nature of potential health impacts of the project; likely nature and extent of disruption caused to communities by the project; existence of potentially cumulative impacts
3. epidemiological issues- degree of certainty (risk) of health impacts; likely frequency (incidence/prevalence) of potential health impacts; likely severity of potential health impacts; size of any probable health service impacts; likely consistency of “expert” and “community” perceptions of probability, frequency and severity of impacts.

Environmental impact assessment

An (EIA) is an assessment of the possible impact of a programme or project on the natural environment. The assessment ensures that decision makers consider any possible environmental impacts prior to deciding whether to proceed with a project.

Environmental impact assessment enables environmental factors to be given due weight, along with economic or social factors. It helps to promote a sustainable pattern of physical development and land and property use in cities, towns and the countryside.

EIA uses the same structure as HIA- screening, scoping, appraisal, presenting results, decision-making and implementing, monitoring and evaluating, and similarly is multi-disciplinary in its participation.

Examples of EIAs include those undertaken in relation to proposals for building new dams, constructing new run ways or on a more local scale, a town by-pass.

European Union legislation on EIA of the effects of projects on the environment was introduced in 1985 and was amended in 1997. For some types of project EIA is a mandatory part of the planning process whereas for other projects, EIAs are only required if the particular project in question is judged likely to give rise to significant environmental effects.^[27]

References

[27] www.communities.gov.uk/documents/planningandbuilding/pdf/157989.pdf

© Rosalind Blackwood 2009