Is health recognized in the EU's policy process? An analysis of the European Commission's impact assessments

BACKGROUND: The European Commission has an Impact Assessment (IA) procedure that aims to inform decision-makers of the all important impacts that decisions may have. This article studies how health is considered in the IA procedure and how it is reflected in the reports: what aspects, whose and simply in what context health is mentioned in the IA reports. METHODS: Half of the Commissions IAs from 2006 were studied. The analysis was text based and informed by content analysis. In total, 48 reports by 17 DGs were analysed. RESULTS: Five DGs (29%) and 10 reports (21%) made no reference to human health, public health or health systems. Five DGs were clearly considering health impacts more often than others; DG EMPL, SANCO, AGRI, ELARG and ENV. Health systems/services were most often and human health next most common referred to (39% and 29% of all, respectively). Health impacts were usually referred to in the sections on the definition of problems and the analysis of impacts. Seldom were they reported on in the sections on policy options, comparing options, or in the monitoring and evaluation sections. CONCLUSION: The results partly support concerns about the potential neglect of health impacts. The results also suggest that health is not considered an important factor when discussing alternative policy choices, and neither does it seem to be an important objective. There is a clear need for further exploration on ways in which health could be more appropriately considered when impacts of other policies are considered by the various DGs.