Health impact assessment and health equity in sub-Saharan Africa: A scoping review

BackgroundNatural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa.MethodologyWe conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community.ResultsOut of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators.ConclusionsWe found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals.     

How does stakeholder involvement affect environmental impact assessment?

Environmental impact assessment (EIA) processes are grounded on the assumption that producing information about environmental impacts will yield better environmental decisions. Despite the ubiquity of EIA as a policy tool, there is scant evidence of its environmental, social, or economic impacts. Focusing on Environmental Impact Statements (EIS) prepared for water and energy-related projects under the US National Environmental Policy Act, this analysis addresses two questions: (1) What is the balance of environmental impacts associated with infrastructure decisions?; and (2) How does the content of stakeholder feedback received during the review phase differ from draft EIS content, and does this correspond to any changes in the final EIS? We demonstrate the use of automated text mining approaches to identify the distribution of impacts, measure the content of public comments, and observe whether values reflected in comments are associated with a shift in emphases between the draft and final EIS. EISs are shown to convey evenly distributed focus across multiple impact areas. However, we observe no substantive change in focal emphasis between draft and final issuances. This calls into question assumptions about the role that public participation plays in bringing new information to light or changing the course of action.     

Integrated assessment of potential health impact of global environmental change: Prospects and limitations

Estimating the future health impact of global environmental change requires scientific methods that extend beyond conventional health risk assessment in relation to existing exposures. The dynamic and non‐linear nature of these changes in large complex biophysical systems, the interactions between them, and the reference to future scenarios all contribute uncertainty. Potential health impacts can be estimated from historical analogues, by mathematical modelling, or by reasonable foresight (especially in relation to social and economic disruptions). Integrated assessment methods draw upon all these techniques. In particular, integrated mathematical modelling techniques are evolving, as scientists (and policy‐makers) come to terms with this complex scenario‐based impact assessment task.     

Rethinking human health impact assessment

Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. An empirical study of 42 environmental impact statements found that more than half contained no mention of health impacts. In the others, health impacts were analyzed narrowly, if at all, using risk assessment to quantify the carcinogenic potential of a single substance over a single generation. This analytic focus overlooks other significant morbidity and mortality risks, cumulative and intergenerational effects, and broader determinants of health. This article investigates these problems and provides recommendations to improve human health impact assessment, using strategic environmental assessment, qualitative health data, health outcomes in addition to cancer, and a precautionary approach to risk.     

Determining Vulnerability Importance in Environmental Impact Assessment: The case of Colombia

The concept of vulnerability has been used to describe the susceptibility of physical, biotic, and social systems to harm or hazard. In this sense, it is a tool that reduces the uncertainties of Environmental Impact Assessment (EIA) since it does not depend exclusively on the value assessments of the evaluator, but rather is based on the environmental state indicators of the site where the projects or activities are being carried out. The concept of vulnerability thus reduces the possibility that evaluators will subjectively interpret results, and be influenced by outside interests and pressures during projects. However, up until now, EIA has been hindered by a lack of effective methods. This research study analyzes the concept of vulnerability, defines Vulnerability Importance and proposes its inclusion in qualitative EIA methodology. The method used to quantify Vulnerability Importance is based on a set of environmental factors and indicators that provide a comprehensive overview of the environmental state. The results obtained in Colombia highlight the usefulness and objectivity of this method since there is a direct relation between this value and the environmental state of the departments analyzed.     

Approaches to systematic assessment of environmental exposures posed at hazardous waste sites in the developing world: the Toxic Sites Identification Program

In the developing world, environmental chemical exposures due to hazardous waste sites are poorly documented. We describe the approach taken by the Blacksmith Institute's Toxic Sites Identification Program in documenting environmental chemical exposures due to hazardous waste sites globally, identifying sites of concern and quantifying pathways, populations, and severity of exposure. A network of local environmental investigators was identified and trained to conduct hazardous waste site investigations and assessments. To date, 2,095 contaminated sites have been identified within 47 countries having an estimated population at risk of 71,500,000. Trained researchers and investigators have visited 1,400 of those sites. Heavy metals are the leading primary exposures, with water supply and ambient air being the primary routes of exposure. Even though chemical production has occurred largely in the developed world to date, many hazardous waste sites in the developing world pose significant hazards to the health of large portions of the population. Further research is needed to quantify potential health and economic consequences and identify cost-effective approaches to remediation.     

Application of data envelopment analysis in environmental impact assessment of a coal washing plant: A new sustainable approach

The main problem of traditional methods of environmental impact assessment (EIA) is that in most of the existing algorithms and methods, such as Leopold, Folchi and RIAM, the main attention is to the destructive effects of the proposed plan, and the advantages of the industrial project are less noticeable. This has led to a permanent challenge between environmental organizations and industrial stakeholders. Data envelopment analysis (DEA) is a new approach of assessing the industrial units. Besides, it considers the positive economic and social impacts of the project and provides a comprehensive assessment of the industrial unit. With this approach, the environmental impacts of an industrial unit have been considered as “inputs” and its positive economic and social impacts considered as the “outputs” of the DEA models. Therefore, the problem of impact assessment changes into a DEA model. In the present study, the Alborz Sharghi Coal washing plant in northern Iran has been considered as a case study for implementing the DEA-EIA approach, and 19 plant activities and 11 environmental components have been used to evaluate the environmental effects of the plant. To solve the EIA problem, two commonly used DEA approaches, called CRS (constant returns to scale) and VRS (variable returns to scale), have been used. The DEA results identified the critical environmental components of the plant that should be considered seriously. Also, drawing the “potential improvement” diagram in the DEA method is an effective tool for determining the high risk activities of the factory and applying them in development plans. Besides, using the VRS model with maximize-output approach showed that some of the plant activities had the most differences with optimal mode and these components should be considered in future development plans. Finally, it can be concluded that, assessing the environmental impacts of the mineral industries with VRS maximize-output approach, is closer to the concept of sustainable development and cost-benefit analysis.     

Environmental economic impact assessment in China: Problems and prospects

The use of economic valuation methods to assess environmental impacts of projects and policies has grown considerably in recent years. However, environmental valuation appears to have developed independently of regulations and practice of environmental impact assessment (EIA), despite its potential benefits to the EIA process. Environmental valuation may be useful in judging significance of impacts, determining mitigation level, comparing alternatives and generally enabling a more objective analysis of tradeoffs. In China, laws and regulations require the use of environmental valuation in EIA, but current practice lags far behind. This paper assesses the problems and prospects of introducing environmental valuation into the EIA process in China. We conduct four case studies of environmental economic impact assessment (EEIA), three of which are based on environmental impact statements of construction projects (a power plant, a wastewater treatment plant and a road construction project) and one for a regional pollution problem (wastewater irrigation). The paper demonstrates the potential usefulness of environmental valuation but also discusses several challenges to the introduction and wider use of EEIA, many of which are likely to be of relevance far beyond the Chinese context. The paper closes with suggesting some initial core elements of an EEIA guideline.     

Environmental impact assessment (EIA): an overlooked instrument for sustainable development in Pakistan

Environmental impact assessment (EIA) is a policy tool used for evaluating a project proposal from physical and socioeconomic environmental perspectives. Its aim is to reduce the impact of development on environment, hence, ensuring environmental sustainability. It is mandatory to submit an Environmental Impact Statement before starting a mega project as required by Environmental Protection Act of 1997 and Environmental Policy of Pakistan. Public consultation plays a key role in an EIA system, identifying the likely aspects and impacts of a development activity. This aspect has been ignored in effective enactment of environmental legislation in Pakistan. Sufficient legislative instruments are there to support EIA system in the country but the agencies responsible for the enforcement of environmental regulations have failed to do so. The current research gives an insight into the actual status of EIA system in Pakistan along with the feedback of EIA specialists and university teachers of the concerned departments. A new index has been devised on the basis of questionnaire response to work out the overall performance of EIA system in Pakistan or any other country. The weaknesses and deficiencies of each EIA stage have been worked out for Pakistan and elaborated with the help of the controversial Zero point Interchange Project in the capital city of Pakistan.     

Coping with uncertainty in environmental impact assessments: Open techniques

Uncertainty is virtually unavoidable in environmental impact assessments (EIAs). From the literature related to treating and managing uncertainty, we have identified specific techniques for coping with uncertainty in EIAs. Here, we have focused on basic steps in the decision-making process that take place within an EIA setting. More specifically, we have identified uncertainties involved in each decision-making step and discussed the extent to which these can be treated and managed in the context of an activity or project that may have environmental impacts. To further demonstrate the relevance of the techniques identified, we have examined the extent to which the EIA guidelines currently used in Colombia consider and provide guidance on managing the uncertainty involved in these assessments. Some points that should be considered in order to provide greater robustness in impact assessments in Colombia have been identified. These include the management of stakeholder values, the systematic generation of project options, and their associated impacts as well as the associated management actions, and the evaluation of uncertainties and assumptions. We believe that the relevant and specific techniques reported here can be a reference for future evaluations of other EIA guidelines in different countries.     

Consideration of climate change on environmental impact assessment in Spain

Most of the projects subject to environmental impact assessment (EIA) are closely related to climate change, as they contribute to or are affected by it. The growing certainty about climate change and its impacts makes its consideration an essential part of the EIA process, as well as in strategic environmental assessment (SEA).This paper examines how climate change (CC) has been taken into account in EIA in Spain through the analysis of 1713 environmental records of decision (RODs) of projects submitted for EIA. In 2013 Spain approved one of the most advanced laws in terms of CC consideration in environmental assessment, although it had not yet accumulated extensive practice on the issue. This contrasts with the situation of countries like Canada or the USA, which have a significant body of experience without specific legal requirements.Only 14% of the RODs analysed included references to CC, and in more than half of the cases it was a mere citation. Thermal power plants, which are subject to specific GHG regulations, show the highest consideration, while transport infrastructures, which are important contributors to CC, show a very low consideration. Almost all the references are related to their contribution to CC, while consideration of the effects of CC is minimal.The increasingly common incorporation of CC into SEA, should not imply its exclusion from EIA, because both processes have different aims and uses. Including the obligation to consider CC in the EIA regulations is highly desirable, but probably not enough without other measures, such as practical guidance, training and motivational programmes for practitioners and evaluators. But even these actions cannot ensure effective and adequate assessments of CC. Probably more resources should be spent on creating greater awareness in all the agents involved in EIA.     

Methodology for environmental assessment of proposed activity using risk analysis

This study applies a process of detailed assessment to summarize the potential impact of a proposed construction or other activity on the environment before implementation of an investment plan. The aim of the study was to develop a general methodology for analysis and evaluation of environmental issues connected with planned activities and proposed projects (especially buildings and engineering constructions, required implementation of environmental impact assessment process) using a risk analysis method, thus enabling the best option among the proposed activities to be chosen. The methodology was developed for conditions in Slovakia but could be arranged for any other country considering national conditions, requirements, standards and legislative. Application of the developed methodology in environmental impact assessment could create preconditions for more effective implementation of the EIA process. This paper provides a framework for the risk analysis component of the scoping phase within the EIA process. The process outlined in this paper will assist with determination of an estimation of risks to environmental and health of proposed activities.     

A critique of the performance of EIA within the offshore oil and gas sector

The oil and gas sector is a key driver of the offshore economy. Yet, it is also associated with a number of unwanted environmental impacts which potentially threaten the long term economic and environmental viability of marine ecosystems. Environmental Impact Assessment (EIA) can potentially make a significant contribution to the identification and management of adverse impacts through the promotion of evidence based decision making. However, the extent to which EIA has been embraced by key stakeholders is poorly understood. On this basis, this paper provides an initial evaluation of EIA performance within the oil and gas sector. The methodology adopted for the paper consisted of the structured review of 35 Environmental Statements (ESs) along with interviews with regulators, operators, consultants and advisory bodies. The findings reveal a mixed picture of EIA performance with a significant number of ESs falling short of satisfactory quality and a tendency for the process to be driven by compliance rather than best practice.     

A review of EIAs on trade policy in China: Exploring the way for economic policy EIAs

During the discussion on the “Environmental Protection Law Amendment (draft)” in 2011, it was decided to drop the proposed clauses related to environmental impact assessments (EIAs) on policy, which means that there remained no provisions for policy EIAs, and China's strategic environmental assessment system stayed limited to the planning level. However, considering that economic policy making is causing significant direct and indirect environmental problems and that almost every aspect of governmental policy has an economic aspect, EIAs on economic policies are of the utmost urgency. The purpose of this study is to review the EIA work that has been carried out on trade policy in China through four case studies, and illustrate how trade policy EIAs can be helpful in achieving better environmental outcomes in the area of trade. Through the trade policy EIA case studies we try to argue for the feasibility of conducting EIAs on economic policies in China. We also discuss the implications of the case studies from the point of view of how to proceed with EIAs on economic policy and how to promote their practice.     

How does environmental pollution erode political trust in China? A multilevel analysis

The impacts of environmental pollution extend beyond the issue of health. Using Chinese survey and administrative data, this study sheds new light on the political costs of environmental pollution. We show that citizens' trust in government officials declines significantly with higher levels of measured pollution, perceptions of increased pollution, and a greater degree of willingness to support environmental protection. Political trust is particularly low when measured as well as perceived pollution are severe. However, the effect of greater willingness to support environmental protection on the erosion of political trust is independent of measured pollution. Our findings suggest that there is a tipping point at which legitimacy acquired primarily through economic achievements could be undermined by environmental degradation, which is a byproduct of economic achievements. It is imperative for the Chinese government to achieve a balance between fast-paced growth and environmental sustainability, to pay attention to the potential political consequences of environmental issues, and to permit more public dialogues and deliberations on the topic of environmental governance.     

Four conceptual issues to consider in integrating social and environmental factors in risk and impact assessments

In the last twenty years, both the increase in academic production and the expansion of professional involvement in Environmental Impact Assessment (EIA) and Social Impact Assessment (SIA) have evidenced growing scientific and business interest in risk and impact analysis. However, this growth has not brought with it parallel progress in addressing the main shortcomings of EIA/SIA, i.e. insufficient integration of environmental and social factors into development project analyses and, in cases where the social aspects are considered, technical-methodological failings in their analysis and assessment. It is clear that these weaknesses carry with them substantial threats to the sustainability (social, environmental and economic) of projects which impact on the environment, and consequently to the local contexts where they are carried out and to the delicate balance of the global ecosystem. This paper argues that, in a sociological context of complexity and dynamism, four conceptual elements should underpin approaches to socio-environmental risk and impact assessment in development projects: a theoretical base in actor–network theory; an ethical grounding in values which are internationally recognized (though not always fulfilled in practice); a (new) epistemological-scientific base; and a methodological foundation in social participation.     

A comparative evaluation of the environmental impact assessment legislation of South Africa and Zambia

This study evaluates the Environmental Impact Assessment (EIA) legislation of South Africa and Zambia against the modified criteria developed by Wood (1995) to determine the extent to which they follow “good practices” and incorporate emerging environmental issues into EIA. We modified the criteria of Wood due to new environmental issues that have emerged since their formulation. Some of these issues are in line with the Sustainable Development Goals (SDGs). National Environmental Acts and EIA Regulations for the two countries were reviewed to evaluate the current legislation. We also used telephone interviews to gather additional information that was not in the documents. As a fundamental component of the EIA system, the legislation needs to be clear, concise and inclusive of all the major environmental issues that affect the performance of the EIA system. Literature reveals that the performance of the Zambian EIA system is generally low compared with that of some African countries such as South Africa and Ghana; especially in terms of the quality of EIA reports and substantive environmental protection. Therefore, we hypothesised that the Zambian legislation does not follow the good practice hence the low EIA system performance. Results, however, showed that the two countries are almost on a par in terms of meeting the criteria used in this study. Hence there is more to be done to improve the quality of both countries' EIA legislation. Nevertheless, compared with the previous evaluations by Wood (1999) and Harrison (2005), the results show that there is considerable improvement in the quality of the South African EIA legislation following a series of amendments.     

The effectiveness of the mitigation hierarchy in environmental impact studies on marine ecosystems: A case study in France

While the development of maritime economic activity is increasingly encouraged, the consideration of its impacts constitutes a real challenge. The limitations of the implementation of the mitigation hierarchy have been widely discussed in scientific literature, yet data on marine biodiversity offset practices remains scarce. In this study, we investigated the use of Environmental Impact Assessments (EIAs) as suitable instruments to achieve the No Net Loss objective. Drawing on a French approach developed for the initial assessment of the European Marine Strategy Framework Directive, we examined the pressures and impacts related to various marine development projects and the effectiveness of the mitigation hierarchy in limiting these. An analysis of 55 recent French environmental impact studies showed that only 7% of the proposed measures had the aim of offsetting predicted degradation of sites of remarkable biodiversity. This can be partly explained by the lack of a clear definition of ‘significant impact’, which varies greatly depending on what is impacted, in turn allowing socio-economic activities to benefit more easily from offset. Furthermore, offsetting does not always constitute the final step of the mitigation hierarchy, highlighting the need to reinforce avoidance and reduction steps. Although we acknowledge the role of EIA in mitigating the negative impacts of development projects, synergies with other European marine environmental policies such as the Marine Strategy Framework Directive (MSFD) and the Maritime Spatial Planning directive (MSP) should be developed in order to improve current practices.