Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA.     

Can health feasibly be considered as part of the planning process in Scotland?

The planning system is significant because of its capacity to determine the quality of the built environment as well as the health, well-being and quality of life of the individuals and communities therein. Development planning is especially important because of the long-term impact of the decisions. This paper was developed in response to increasing recognition amongst HIA practitioners in Scotland of the importance of planning for health. It focuses on the relationship between the planning system in Scotland, specifically the Development Planning element of it, and population health and considers how the health impact assessment (HIA) approach can facilitate and support joint working with planners. In particular, consideration is given to the potential impact of the introduction of Strategic Environmental Assessment (SEA) on the linkages between health, HIA and planning.     

RETRACTED ARTICLE: Environmental Impact Assessment of Industrial Structure Change in a Rural Region of China

As the embodiment of human activities, the change of regional industrial structure is an essential driving factor of global environmental change. Consequently, the research on the change of regional industrial structure and associated effects on the environment is one of the key issues of researches on sustainable development, human–environment relationship, and regional response to global environment change. However, compared to the flourish of researches on environmental impact assessment of industrial departments, few studies have been conducted to assess the environmental impact of regional industrial structure. In this study, based on a synthetic analysis of environmental disturbances of different industrial departments, the environmental impact coefficient of industrial department associated with the index of environmental impact of industrial structure was constructed, so as to make a quantitative assessment of environmental impact of the change of regional industrial structure. And the results of the case study in Lijiang City, a rural region of China, have showed that there are two obvious changes of industrial structure in the study area from 1992 to 2003, associated with a continuous decreasing of the index of environmental impact of industrial structure, which indicated a positive environmental effects of the change of regional industrial structure.     

Evaluating the impact of HIA on urban reconstruction decision-making. Who manages whose risks?

Practitioners and academic researchers increasingly look to evaluation of health impact assessment (HIA) to improve its practice, its efficiency and its legitimacy. Evaluation is also used to account to policy-makers, who express doubts that the benefits of HIA justify its costs. Until recently evaluation of HIA focused on instrument design and procedures but now the focus needs to shift to analysis of the interaction of HIA and decision-making. Multiple case studies have been applied to identify the conditions in which HIA produces the desired benefits. These studies used analytical concepts derived from the literature on evaluation, knowledge utilization, science of sociology and knowledge management.This paper describes a case study in which the strategic motives of the decision-makers affected the impact of an HIA. This HIA comprised of a quantitative environmental model ‘City & Environment’ that was used to assess environmental health impacts of an urban reconstruction plan in a Dutch city. The evaluation of the HIA shows that the decision to follow the recommendations of the HIA was part of a damage control strategy. The more HIA goals deviate from the policy problem and the less HIA is embedded in institutional procedures, then the more HIA impact will be subject to strategic decision-making behaviour. Appropriate cognitive and social strategies are needed to avoid ‘negative learning’ in those the HIA seeks to influence.     

Incorporating natural capital into economy-wide impact analysis: a case study from Alberta

Traditionally, decision-makers have relied on economic impactestimates derived from conventional economy-wide models. Conventional models lack the environmental linkages necessary for examining environmental stewardship and economic sustainability, and in particular the ability to assess the impact of policies on natural capital. This study investigatesenvironmentally extended economic impact estimation on a regionalscale using a case study region in the province of Alberta knownas the Foothills Model Forest (FMF). Conventional economic impactmodels are environmentally extended in pursuit of enhancingpolicy analysis and local decision-making. It is found that theflexibility of the computable general equilibrium (CGE) modelingapproach offers potential for environmental extension, with a solid grounding in economic theory. The CGE approach may be the tool of the future for more complete integrated environment andeconomic impact assessment.     

Health impact assessment research and practice: A place for paradigm positioning?

In this article, we provide a critical review of the place of paradigm in health impact assessment (HIA) research and practice. We contend that most HIA practitioners have given insufficient attention to paradigm positioning when developing and applying HIA methodologies and that some concerns about current HIA practice can be attributed to this. We review HIA literature to assess the extent and nature of attention given to paradigm positioning and these related concerns. We then respond to our critique by exploring the implications, opportunities and challenges of adopting a critical realist paradigm, which we believe has the potential to help HIA practitioners to develop HIA methodology in a way that addresses these issues.     

Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys

The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed.     

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.     

Development of a New Approach to Cumulative Effects Assessment: A Northern River Ecosystem Example

If sustainable development of Canadian waters is to be achieved, a realistic and manageable framework is required for assessing cumulative effects. The objective of this paper is to describe an approach for aquatic cumulative effects assessment that was developed under the Northern Rivers Ecosystem Initiative. The approach is based on a review of existing monitoring practices in Canada and the presence of existing thresholds for aquatic ecosystem health assessments. It suggests that a sustainable framework is possible for cumulative effects assessment of Canadian waters that would result in integration of national indicators of aquatic health, integration of national initiatives (e.g., water quality index, environmental effects monitoring), and provide an avenue where long-term monitoring programs could be integrated with baseline and follow-up monitoring conducted under the environmental assessment process.     

论环境经济损益分析的方法

就建设项目环境影响评价中要进行的环境经济损益分析的目的、评价内容、评价方法等作系统介绍,以探讨国内在这方面的逐步规范化。     

垃圾焚烧厂的环境影响评价

垃圾焚烧厂是一类对环境有重大影响的建设项目 ,因此在建设焚烧厂之前 ,必须进行环境影响评价。文章在借鉴国外相关资料的基础上 ,结合国内的实际情况 ,探讨了垃圾焚烧厂环境影响评价的主要步骤和主要内容     

公众参与在环境影响评价中的应用

简述了环境影响评价中公众参与的定义、目的、意义，简要回顾了国内外环境管理及环境影响评价中公众参与的发生发展过程及其现状，浅析了公众参与在环境影响评价中的应用以及存在的问题，并提出了改进的建议。     

环境质量评价中关键因子识别的方法研究

应用投影寻踪聚类方法分析环境影响指标的数据资料 ,不但可以根据数据内在特性确定各评价指标的相对权重 ,避免权重人为给定的任意性 ,而且还可以通过逐次筛选找出影响环境质量的关键因子。本文将该方法成功地应用于南京市秦淮河水环境评价中 ,筛选出了影响秦淮河水质的关键因子 ,可供秦淮河水环境监测和治理作参考。另一方面 ,该方法还可以推广应用于其它类似问题的综合分析研究中。     

Assessing health consequences in an environmental impact assessment: The case of Amsterdam Airport Schiphol

In this article a comprehensive approach for the evaluation of possible health effects in an environmental impact assessment (EIA) is described, illustrated with the example of Amsterdam Airport Schiphol. Unlike many EIAs, we estimated quantitatively the impact of aircraft-related pollution in terms of the number of affected people for aircraft noise annoyance, odour annoyance and hypertension. In addition, an analysis of health registry data on cardiovascular and respiratory diseases and a short survey on annoyance and risk perception were carried out. The scope of a health impact assessment depends on the situation, available knowledge and data, concern in the population about the impact and the number of people concerned. It is important to pay attention to the perception of risks and concerns from all parties involved. Moreover, the results demonstrate that far more people outside the area for which standards apply were affected than inside.     

完善环境影响评价公众参与的初步研究

环境影响评价制度是我国的一项基本环境保护法律制度,是环境管理体系的重要组成部分,完善公众参与体系有利于解决当前环境影响评价中公众参与存在的问题。在总结国内外公众参与发展进程的基础上,对完善公众参与体系进行了初步研究,提出了完善公众参与体系的内涵要点,提高公众参与体系研究力度,建立公众参与学相关内容。     

HIA, the next step: Defining models and roles

If HIA is to be an effective instrument for optimising health interests in the policy making process it has to recognise the different contests in which policy is made and the relevance of both technical rationality and political rationality. Policy making may adopt a rational perspective in which there is a systematic and orderly progression from problem formulation to solution or a network perspective in which there are multiple interdependencies, extensive negotiation and compromise, and the steps from problem to formulation are not followed sequentially or in any particular order. Policy problems may be simple with clear causal pathways and responsibilities or complex with unclear causal pathways and disputed responsibilities. Network analysis is required to show which stakeholders are involved, their support for health issues and the degree of consensus.From this analysis three models of HIA emerge. The first is the phases model which is fitted to simple problems and a rational perspective of policymaking. This model involves following structured steps. The second model is the rounds (Echternach) model that is fitted to complex problems and a network perspective of policymaking. This model is dynamic and concentrates on network solutions taking these steps in no particular order. The final model is the “garbage can” model fitted to contexts which combine simple and complex problems. In this model HIA functions as a problem solver and signpost keeping all possible solutions and stakeholders in play and allowing solutions to emerge over time. HIA models should be the beginning rather than the conclusion of discussion the worlds of HIA and policymaking.     

An Integrated Approach for Impact Assessment of Water Harvesting Techniques in Dry Areas: The Case of Oued Oum Zessar Watershed (Tunisia)

In the arid regions of Tunisia, considerable investments are being made to maintain the old water harvesting techniques and introduce new ones to capture the scarce amount of rainwater (100 mm to 230 mm annually) for agricultural and domestic purposes. However, no detailed assessment of the multiple effects and the costs and benefits of these techniques have been made so far. This paper summarizes the results of an in depth investigation of the multiple impacts (runoff mobilization, ground water recharge, agro-socio-economic impacts) of the water harvesting works undertaken in the watershed of oued Oum Zessar (southeastern Tunisia). The importance of interdisciplinary and integrated approaches was revealed through this detailed impact assessment and economic evaluation. In fact, the profitability of the water harvesting works depends largely on the criteria chosen. However, further refinements are needed to better include all possible impacts (positive and negative) that occur as a result of the installation of the water harvesting structures.     

Assessing cumulative impacts within state environmental review frameworks in the United States

Cumulative impact assessment (CIA) is the process of systematically assessing a proposed action's cumulative environmental effects in the context of past, present, and future actions, regardless of who undertakes such actions. Previous studies have examined CIA efforts at the federal level but little is known about how states assess the cumulative impacts of nonfederal projects. By examining state environmental review statutes, administrative rules, agency-prepared materials, and a national survey of the administrators of state environmental review programs, this study identifies the legal and administrative frameworks for CIA. It examines current CIA practice, discusses the relationship between CIA policy and its implementation, and explores the opportunities for improvement. The results of the study show that twenty-nine state environmental review programs across twenty-six states required the assessment of cumulative environmental impacts. More than half of these programs have adopted specific procedures for implementing their policies. Some programs assessed cumulative impacts using a standard review document, and others have created their own documentations incorporated into applications for state permits or funding. The majority of programs have adopted various scales, baselines, significance criteria, and coordination practices in their CIA processes. Mixed methods were generally used for data collection and analysis; qualitative methods were more prevalent than quantitative methods. The results also suggest that a program with comprehensive and consistent environmental review policies and procedures does not always imply extensive CIA requirements and practices. Finally, this study discusses the potential for improving existing CIA processes and promoting CIA efforts in states without established environmental review programs.     

A Landscape Ecology Assessment of the Tensas River Basin

A group of landscape ecological indicators were applied to biophysical data masked to the Tensas River Basin. The indicators were used to identify and prioritize sources of nutrients in a Mississippi/Atchafalaya River System sub-basin. Remotely sensed data were used for change detection assessment. With these methods, we were able to look at land use practices over the past twenty years in the Tensas River Basin of Louisiana. A simple land use classification was applied to multispectral scanner (MSS) data from 1972 and 1991. The landscape analysis methods described in this paper will show how to use these methods to assess the impact of human land use practices that are being implemented to improve environmental quality. Landscape assessment methods can be used as a simple, timely, cost effective approach for monitoring, targeting, and modeling ecosystem health in watersheds. Although this study was conducted in the southeast, the methods described in this paper may be applicable to western landscapes.