Health in Impact Assessments – Opportunities not to be missed

Issue/problem Impact assessment is an approach to estimate and anticipate the consequences of plans and policies. It is a key resources for achieving foresight in societal decisions. As such, impact assessment can and does play a crucial role in governing the health implications of policies in all sectors of society. However, human health is often not covered adequately in impact assessments focusing, for example, on environmental impacts. Health Impact Assessment (HIA) has emerged as a response. Opinions about the merits of separate HIA differ. Clearly, the issue deserves a close look. Method/Description of the problem The WHO, IAIA, and EUPHA jointly reviewed principles and practice in impact assessment to address the following questions: How can impact assessments contribute to promoting and protecting human health? How can further integration of health support the various forms of impact assessments, and what experiences can be shared across the various IA types? What forms/levels of integration seem advisable? The review, being published as a book, considers five types of impact assessment of key relevance for health: Environmental Impact Assessment, Strategic Environmental Assessment, Social Impact Assessment, Sustainability Assessment, and Health Impact Assessment. Results There is underutilized potential; the contributions to protecting and promoting human health would benefit greatly from, e.g., consistent use of a clearer conceptualization of health; access to reliable health information, including on proximate as well as distant health determinants; involvement of health experts; and awareness by other impact assessors as well as decision makers on the interconnections of policies and projects with health. For bringing together health and impact assessments, several paths are discernible: better coverage of health within existing impact assessments other than HIA; further implementation of HIA; better use of integrated assessments; these options do not exclude each other. Lessons For a variety of reasons, HIA has had limited interaction with the overall impact assessment culture. Today, willingness to cooperate seems quite pronounced. However, the question of how best to bring together health and impact assessments, calls for continued attention. Key messages Prospective Impact Assessments, as established around the world, provide unique opportunities of “foresight” which should be used systematically for protecting and promoting human health. For bringing together health and impact assessments, several paths (including dedicated Health Impact Assessment) are discernible which should be seen as complementary rather than competing.