Scoping population health equity in impact assessments: A realist synthesis-informed review of key literature 2010–2019

While extractive industries in Canada provide many benefits like employment, income, and education, they can also pose disproportionate physical and socio-cultural risks to population health equity for Indigenous populations. The Government of Canada established a new federal framework to review extractive industry and large infrastructure developments in 2019, with impact assessment of project proposals incorporating a 180-day planning phase and mandated consideration of positive and negative impacts on health, social, economic, and environmental factors. To support implementation of best practices and principles for prioritizing population health equity during the planning phase, a realist synthesis was completed on 185 peer-reviewed and grey literature sources from 2010 to 2019, ten years leading up to passage of the new legislation. Evidence was mapped to five key leverage points in the planning phase, namely—the preparations conducted prior to the planning phase; opportunities for involvement by public health authorities; guidance for participatory processes involving Indigenous communities; evidence-based identification of issues and concerns; and development of plans and guidance to support subsequent phases of impact assessment.