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Olyaeemanesh A, Takian A, Mostafavi H, Mobinizadeh M, Bakhtiari A, Yaftian F, Vosoogh-Moghaddam A, Mohamadi E. Health Equity Impact Assessment (HEIA) reporting tool: developing a checklist for policymakers. Int J Equity Health 2023; 22:241. [PMID: 37980523 PMCID: PMC10657117 DOI: 10.1186/s12939-023-02031-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/03/2023] [Indexed: 11/20/2023] Open
Abstract
INTRODUCTION Health Equity Impact Assessment (HEIA) is a decision support tool that shows users how a new program, policy, or innovation affects health equity in different population groups. Various HEIA reporting and dissemination tools are available, nevertheless, a practical standard tool to present the results of HEIA in an appropriate period to policymakers is lacking. This work reports the development of a tool (a checklist) for HEIA reporting at the decision-making level, aiming to promote the application of HEIA evidence for improving health equity. METHODS This is a mixed-method study that was carried out over four stages in 2022-2023: 1) identifying HEIA models, checklists, and reporting instruments; 2) development of the initial HEIA reporting checklist; 3) checklist validation; and 4) piloting the checklist. We also analyzed the Face, CVR, and CVI validity of the tool. RESULTS We developed the initial checklist through analysis of 53 included studies and the opinions of experts. The final checklist comprised five sections: policy introduction (eight subsections), managing the HEIA of policy (seven subsections), scope of the affected population (three subsections), HEIA results (seven subsections), and recommendations (three subsections). CONCLUSION Needs assessment, monitoring during implementation, health impact assessment, and other tools such as monitoring outcome reports, appraisals, and checklists are all methods for assessing health equity impact. Other equity-focused indicators, such as the equity lens and equity appraisal, may have slightly different goals than the HEIA. Similarly, the formats for presenting and publishing HEIA reports might vary, depending on the target population and the importance of the report.
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Affiliation(s)
- Alireza Olyaeemanesh
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Amirhossein Takian
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Health Management, Policy, and Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hakimeh Mostafavi
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Mohammadreza Mobinizadeh
- National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Ahad Bakhtiari
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Fateme Yaftian
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Abbass Vosoogh-Moghaddam
- Governance and Health Training and Research Department, National Institute for Health Research, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
- Secretariat for Health and Food Security, TehranUniversity of Medical Sciences (TUMS), Tehran, Iran
| | - Efat Mohamadi
- Health Equity Research Center (HERC), TehranUniversity of Medical Sciences (TUMS), Tehran, Iran.
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Kalel ZS, Gulis G, Aringazina AM. Implementation of Health Impact Assessment in the Healthcare System of the Republic of Kazakhstan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2335. [PMID: 36767699 PMCID: PMC9915209 DOI: 10.3390/ijerph20032335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/25/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The Health Impact Assessment (hereinafter referred to as HIA) is an effective method for predicting potential health impacts from decisions. Little is known about the implementation of the HIA in the Republic of Kazakhstan (further, RK). In addition, the Russian language literature has not yet been reviewed in terms of HIA-related knowledge. By conducting a literature review of enabling factors, including Russian language literature, on the implementation of the HIA and studying governance systems in RK, we aim to suggest an implementation process to implement the HIA in RK. After careful analysis of the governance system, we suggest set up of a HIA support unit under the National Scientific Center for Health Development and discuss the possible benefits. The proposed center should guide the implementation of the HIA in RK.
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Affiliation(s)
- Zhan S. Kalel
- Caspian International School of Medicine, Caspian University, 521 Seifullin Street, Almaty 050000, Kazakhstan
| | - Gabriel Gulis
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, Esbjerg 6700, Denmark
- Olomouc University Social Health Institute OUSHI, Palacky University Olomouc, Katerinska 653/17, 77900 Olomouc, Czech Republic
| | - Altyn M. Aringazina
- Caspian International School of Medicine, Caspian University, 521 Seifullin Street, Almaty 050000, Kazakhstan
- AlmaU School of Health Sciences, Almaty Management University, 227 Rozybakiev Street, 050060 Almaty, Kazakhstan
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Green L, Ashton K, Parry-Williams L, Dyakova M, Clemens T, Bellis MA. Facilitators, Barriers and Views on the Role of Public Health Institutes in Promoting and Using Health Impact Assessment-An International Virtual Scoping Survey and Expert Interviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13367. [PMID: 36293948 PMCID: PMC9602578 DOI: 10.3390/ijerph192013367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/06/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
Public health institutes have an important role in promoting and protecting the health and well-being of populations. A key focus of such institutes are the wider determinants of health, embracing the need to advocate for 'Health in All Policies' (HiAP). A valuable tool to support this is the health impact assessment. This study aims to support public health institutes to advocate more successfully for the use of health impact assessments and HiAP in order to promote and protect health, well-being and equity. During July 2021, a quantitative online survey was undertaken across international networks with 17 valid responses received. Semi-structured interviews were also administered with nine expert representatives and analysed thematically. In total, 64.7% (n = 11) of survey respondents were aware of health impact assessments and 47.1% (n = 8) currently conducted health impact assessments. It was noted that there are differing approaches to HIAs, with a need for a clear set of standards. Barriers to use included lack of knowledge, training and resources. Overall, 64.7% (n = 11) of survey respondents would like to do more to develop knowledge and capacity around health impact assessments. The results from this study can serve as a platform to help build knowledge, networks and expertise, to help support a 'Health in All Policies' approach and address inequalities which exist in all societies.
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Affiliation(s)
- Liz Green
- Policy and International Health, WHO Collaborating Centre on ‘Investment in Health and Well-Being’, Public Health Wales, Cardiff CF10 4BZ, UK
- Department of International Health, Care and Public Health Research Institute CAPHRI, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
| | - Kathryn Ashton
- Policy and International Health, WHO Collaborating Centre on ‘Investment in Health and Well-Being’, Public Health Wales, Cardiff CF10 4BZ, UK
- Department of International Health, Care and Public Health Research Institute CAPHRI, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
| | - Lee Parry-Williams
- Policy and International Health, WHO Collaborating Centre on ‘Investment in Health and Well-Being’, Public Health Wales, Cardiff CF10 4BZ, UK
| | - Mariana Dyakova
- Policy and International Health, WHO Collaborating Centre on ‘Investment in Health and Well-Being’, Public Health Wales, Cardiff CF10 4BZ, UK
| | - Timo Clemens
- Department of International Health, Care and Public Health Research Institute CAPHRI, Maastricht University, Duboisdomein 30, 6229 GT Maastricht, The Netherlands
| | - Mark A. Bellis
- Policy and International Health, WHO Collaborating Centre on ‘Investment in Health and Well-Being’, Public Health Wales, Cardiff CF10 4BZ, UK
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Yu B, Horton R, Munson B, Newkirk-Turner BL, Johnson VE, Khamis-Dakwar R, Muñoz ML, Hyter YD. Making Race Visible in the Speech, Language, and Hearing Sciences: A Critical Discourse Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:578-600. [PMID: 34731585 DOI: 10.1044/2021_ajslp-20-00384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The purpose of this critical discourse analytic study is to identify how two key professional standards documents in the Speech, Language and Hearing Sciences field-the Standards for Certification document and the Essential Functions rubric-contribute to the discursive construction of the ideal speech-language pathologist and audiologist, and to examine whether the experiences and needs of people of color are taken into consideration in these documents. METHOD Critical discourse analysis was used as both a conceptual and methodological lens for the systematic analysis of the targeted text. RESULTS The findings show that considerations of race and racism were almost entirely absent from both documents and thus reflected a discourse of race neutrality that is ideologically consistent with color-blind racism. The enactment of racially coded expectations within a construct of race-neutral discourse maintains racial inequities in the speech, language, and hearing sciences professions. CONCLUSIONS The findings highlight the need for the open acknowledgment of racism in our institutional policies and discourses and official and ongoing commitments to concrete and measurable antiracist actions to counteract systemic racism. Recommendations for and examples of antiracist measures are offered.
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Affiliation(s)
- Betty Yu
- Department of Speech, Language and Hearing Science, San Francisco State University, CA
| | - RaMonda Horton
- Department of Speech-Language Pathology, Midwestern University,Downers Grove, IL
| | - Benjamin Munson
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Twin Cities, Minneapolis
| | | | - Valerie E Johnson
- Department of Communication Sciences and Disorders, Emerson College, Boston, MA
| | - Reem Khamis-Dakwar
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY
| | - Maria L Muñoz
- Department of Communication Sciences and Disorders, University of Redlands, CA
| | - Yvette D Hyter
- Department of Speech, Language and Hearing Sciences, Western Michigan University, Kalamazoo
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Rivadeneyra-Sicilia A, Rivadeneyra-Sicilia A. L’efficacité de l’évaluation d’impact sur la santé : leçons tirées d’une expérience dans l’agglomération bordelaise. SANTE PUBLIQUE 2021; Vol. 33:37-46. [PMID: 34372638 DOI: 10.3917/spub.211.0037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This work presents the results of an impact evaluation applied to an HIA of an urban development project. The purpose of the evaluation was to assess the direct effects of the HIA procedure on the decision making by the implementation of the recommendations as well as its indirect effects in terms of stakeholders’ appropriation and use of the information produced throughout the process. METHODS 12 semi-structured interviews were conducted with HIA stakeholders including regional public health directors and professionals, local elected officials, and technical staff from the engaged local authorities. RESULTS Data collected confirmed HIA indirect impacts in terms of interviewees’ enhanced values and beliefs according to a holistic model of health, changes in professional practices through appropriation of the knowledge generated throughout the process and strengthening of intersectoral collaborations for health. More modest results were identified regarding HIA direct effects on decision making through the consideration of the proposed recommendations because of their redundancy with technical teams’ routine practices and their late timing. Nevertheless, interest in capitalizing on these recommendations for future municipal and metropolitan projects suggests deferred effects on decision making that should not be neglected. CONCLUSIONS This study provides new data on the effectiveness, to varying degrees, of one of the first HIAs conducted in the region of Nouvelle Aquitaine. Other evaluations should be promoted in France to demonstrate HIA value and to draw useful lessons to inform its further development and consolidation in the coming years.
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Were MC, Sinha C, Catalani C. A systematic approach to equity assessment for digital health interventions: case example of mobile personal health records. J Am Med Inform Assoc 2021; 26:884-890. [PMID: 31188438 DOI: 10.1093/jamia/ocz071] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/19/2019] [Accepted: 05/09/2019] [Indexed: 11/13/2022] Open
Abstract
Despite the increasing number of digital health interventions in low- and middle-income countries and other low-resource settings, little attention has been paid to systematically evaluating impacts of these interventions on health equity. In this article, we present a systematic approach for assessing equity impacts of digital health interventions modeled after the Health Equity Impact Assessment of the Ontario Ministry of Health and Long-Term Care. The assessment approach has 4 steps that address (1) scope, (2) potential equity impacts, (3) mitigation, (4) monitoring, and (5) dissemination strategies. The approach examines impacts on vulnerable and marginalized populations and considers various social determinants of health. Equity principles outlined by Whitehead and Dahlgren are used to ensure systematic considerations of all potential equity impacts. The digital health evaluation approach that is presented is applied to a case example of mobile personal health record application in Kenya.
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Affiliation(s)
- Martin C Were
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Chaitali Sinha
- International Development Research Centre, Ottawa, Ontario, Canada
| | - Caricia Catalani
- School of Public Health, University of California, Berkeley, Berkeley, California.,Design for Health, IDEO, Palo Alto, California, USA
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Short-Term Solutions to a Long-Term Challenge: Rethinking Disaster Recovery Planning to Reduce Vulnerabilities and Inequities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020482. [PMID: 31940859 PMCID: PMC7013733 DOI: 10.3390/ijerph17020482] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/30/2019] [Accepted: 01/02/2020] [Indexed: 11/17/2022]
Abstract
In the immediate aftermath of disaster, governments usually act quickly to reduce risk and to recover their communities’ socio-economic functioning. Policy makers in these situations need—but may not have the capacity or time for—substantial analysis and public debate about how to balance short- and long-term societal needs. Inadequate attention to this challenge may result in a deepening of the inequities that increase vulnerability to disaster impacts. We review case examples to illustrate how post-disaster policies may influence the nature, pace, and inclusiveness of community recovery. We then apply a vulnerability/inequity framework to conceptualize how to enhance disaster recovery and avoid perpetuating inequities when weighing the diverse needs of communities across long time horizons.
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Sadare O, Williams M, Simon L. Implementation of the Health Equity Impact Assessment (HEIA) tool in a local public health setting: challenges, facilitators, and impacts. Canadian Journal of Public Health 2019; 111:212-219. [PMID: 31755052 DOI: 10.17269/s41997-019-00269-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 10/09/2019] [Indexed: 11/17/2022]
Abstract
SETTING The Simcoe Muskoka District Health Unit (SMDHU) is a local public health agency in Ontario, serving the County of Simcoe and District of Muskoka's population of over 540,000 people in a mixed urban-rural environment. SMDHU has had a strategic focus on the determinants of health since 2007. INTERVENTION The use of the Health Equity Impact Assessment (HEIA) tool was encouraged throughout SMDHU. An online survey was conducted to assess the implementation of mitigation strategies identified through the HEIAs; in particular, the facilitators and barriers/challenges, and the impacts at both the program level and the level of priority populations, themselves, were assessed. OUTCOMES Agency programs reported 40 HEIAs conducted between 2013 and 2017. While three of the 40 HEIAs were at an early stage, the remaining 37 were at an advanced stage of implementing mitigation strategies, or beyond. Reports from these 37 advanced-stage HEIAs indicated that 30 of them observed or measured impacts on their programs, services, and/or policies (i.e., program-level impacts), following the implementation of HEIA mitigation strategies. These impacts included improved collaboration with external partners, development of more accessible and inclusive communication, increased availability of information and population health data, increased access to services for priority populations, reduced financial barriers for accessing services, and increased staff training on health equity and priority populations. However, few respondents had measured or purposefully assessed impacts on target populations themselves (i.e., population-level impacts); therefore, such impacts are unknown. Key facilitators to the implementation of mitigation strategies were availability of staff, collaboration and support from other areas of the organization, sufficient time, collaboration with community partners, and the inclusion of HEIAs in program operational plans. Absence of these facilitators was identified as a barrier to implementation of mitigation strategies. IMPLICATIONS FOR POLICY AND PRACTICE The use of HEIAs served as a catalyst for change in this local public health agency, leading to equity-oriented impacts on public health programming, planning, service delivery, and organizational policy. Support and capacity-building for measuring and evaluating impacts of mitigation strategies on intended priority populations themselves are recommended, to ensure more robust learning and improvement.
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Affiliation(s)
- Olamide Sadare
- Simcoe Muskoka District Health Unit, 15 Sperling Drive, Barrie, ON, L4M 6K9, Canada
| | - Megan Williams
- Simcoe Muskoka District Health Unit, 15 Sperling Drive, Barrie, ON, L4M 6K9, Canada
| | - Lisa Simon
- Simcoe Muskoka District Health Unit, 15 Sperling Drive, Barrie, ON, L4M 6K9, Canada.
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Buregeya JM, Loignon C, Brousselle A. Contribution to healthy places: Risks of equity free health impact assessment. EVALUATION AND PROGRAM PLANNING 2019; 73:138-145. [PMID: 30622062 DOI: 10.1016/j.evalprogplan.2018.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 11/09/2018] [Accepted: 12/22/2018] [Indexed: 06/09/2023]
Abstract
While health equity is central to health impact assessment [HIA], in reality, less is known about potential impacts of equity-free HIA on social inequalities. We assessed equity-free HIA case in a small city east of Montreal, which took place in a context of urban revitalization. We applied a combination of a quantitative review of community characteristics with a qualitative descriptive approach based on in-depth semi-structured interviews and a focus group with multiple stakeholders to shed light on the pitfalls of equity-free HIA. Our results pointed to gentrification process with a gradual relocation of low-income residents in the end. To mitigate mediating circumstances of gentrification and displacement, the municipality should support social housing or at least should ensure rent stabilization ordinance.
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Affiliation(s)
- Jean Marie Buregeya
- Clinical Sciences Program at the Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Faculty of Medicine and Health Sciences, Sherbrooke University, Longueuil Campus, Canada.
| | - Christine Loignon
- Department of Family Medicine at the Faculty of Medicine and Health Sciences, Sherbrooke University, Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada
| | - Astrid Brousselle
- School of Public Administration, University of Victoria -Victoria, Canada, Department of Community Health, Faculty of Medicine and Health Sciences, Sherbrooke University, Research Centre Charles-LeMoyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada
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Buse CG, Lai V, Cornish K, Parkes MW. Towards environmental health equity in health impact assessment: innovations and opportunities. Int J Public Health 2018; 64:15-26. [PMID: 29911285 DOI: 10.1007/s00038-018-1135-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 06/05/2018] [Accepted: 06/07/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales. METHODS A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review. RESULTS Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment. CONCLUSIONS Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.
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Affiliation(s)
- Chris G Buse
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada.
| | - Valerie Lai
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Katie Cornish
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
| | - Margot W Parkes
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
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Anaf J, Baum FE, Fisher M, Harris E, Friel S. Assessing the health impact of transnational corporations: a case study on McDonald's Australia. Global Health 2017; 13:7. [PMID: 28166801 PMCID: PMC5295215 DOI: 10.1186/s12992-016-0230-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/27/2016] [Indexed: 11/10/2022] Open
Abstract
Background The practices of transnational corporations affect population health through production methods, shaping social determinants of health, or influencing the regulatory structures governing their activities. There has been limited research on community exposures to TNC policies and practices. Our pilot research used McDonald’s Australia to test methods for assessing the health impacts of one TNC within Australia. Methods We adapted existing Health Impact Assessment methods to assess McDonald’s activities. Data identifying potential impacts were sourced through document analysis, including McDonald’s corporate literature; media analysis and semi-structured interviews. We commissioned a spatial and socioeconomic analysis of McDonald’s restaurants in Australia through Geographic Information System technology. The data was mapped against a corporate health impact assessment framework which included McDonald’s Australia’s political and business practices; products and marketing; workforce, social, environmental and economic conditions; and consumers’ health related behaviours. Results We identified both positive and detrimental aspects of McDonald’s Australian operations across the scope of the CHIA framework. We found that McDonald’s outlets were slightly more likely to be located in areas of lower socioeconomic status. McDonald’s workplace conditions were found to be more favourable than those in many other countries which reflects compliance with Australian employment regulations. The breadth of findings revealed the need for governments to strengthen regulatory mechanisms that are conducive to health; the opportunity for McDonald’s to augment their corporate social responsibility initiatives and bolster reputational endorsement; and civil society actors to inform their advocacy towards health and equity outcomes from TNC operations. Conclusion Our study indicates that undertaking a corporate health impact assessment is possible, with the different methods revealing sufficient information to realise that strong regulatory frameworks are need to help to avoid or to mediate negative health impacts.
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Affiliation(s)
- Julia Anaf
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia.
| | - Frances E Baum
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia
| | - Matt Fisher
- Southgate Institute for Health, Society and Equity, Flinders University, GPO Box 2001, Adelaide, SA, 5001, Australia
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney,, 2052, Australia
| | - Sharon Friel
- Regulatory Institutions Network, The Australian National University, Canberra,, ACT 2601, Australia
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Dannenberg AL. Effectiveness of Health Impact Assessments: A Synthesis of Data From Five Impact Evaluation Reports. Prev Chronic Dis 2016; 13:E84. [PMID: 27362932 PMCID: PMC4951082 DOI: 10.5888/pcd13.150559] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Since the 1990s, the use of health impact assessments (HIAs) has grown for considering the potential health impacts of proposed policies, plans, programs, and projects in various sectors. Evaluation of HIA impacts is needed for understanding the value of HIAs, improving the methods involved in HIAs, and potentially expanding their application. Impact evaluations examine whether HIAs affect decisions and lead to other effects. Methods I reviewed HIA impact evaluations identified by literature review and professional networking. I abstracted and synthesized data on key findings, success factors, and challenges from 5 large evaluations conducted in the United States, Europe, Australia, and New Zealand and published from 2006 through 2015. These studies analyzed impacts of approximately 200 individual HIAs. Results Major impacts of HIAs were directly influencing some decisions, improving collaboration among stakeholders, increasing awareness of health issues among decision makers, and giving community members a stronger voice in local decisions. Factors that contributed to successful HIAs included engaging stakeholders, timeliness, policy and systems support for conducting HIAs, having people with appropriate skills on the HIA team, obtaining the support of decision makers, and providing clearly articulated, feasible recommendations. Challenges that may have reduced HIA success were poor timeliness, underestimation of time and resources needed, difficulty in accessing relevant data, use of jargon in HIA reports, difficulty in involving decision makers in the HIA process, and absence of a requirement to conduct HIAs. Conclusion HIAs can be useful to promote health and mitigate adverse impacts of decisions made outside of the health sector. Stakeholder interactions and community engagement may be as important as direct impacts of HIAs. Multiple factors are required for HIA success. Further work could strengthen the role of HIAs in promoting equity, examine HIA impacts in specific sectors, and document the role of HIAs in a “health in all policies” approach.
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Affiliation(s)
- Andrew L Dannenberg
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Box 357234, Seattle WA 98195-7234. E-mail:
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Haigh F, Harris E, Harris-Roxas B, Baum F, Dannenberg AL, Harris MF, Keleher H, Kemp L, Morgan R, Ng Chok H, Spickett J. What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand. BMC Public Health 2015; 15:1009. [PMID: 26433492 PMCID: PMC4592749 DOI: 10.1186/s12889-015-2319-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 09/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While many guidelines explain how to conduct Health Impact Assessments (HIAs), less is known about the factors that determine the extent to which HIAs affect health considerations in the decision making process. We investigated which factors are associated with increased or reduced effectiveness of HIAs in changing decisions and in the implementation of policies, programs or projects. This study builds on and tests the Harris and Harris-Roxas' conceptual framework for evaluating HIA effectiveness, which emphasises context, process and output as key domains. METHODS We reviewed 55 HIA reports in Australia and New Zealand from 2005 to 2009 and conducted surveys and interviews for 48 of these HIAs. Eleven detailed case studies were undertaken using document review and stakeholder interviews. Case study participants were selected through purposeful and snowball sampling. The data were analysed by thematic content analysis. Findings were synthesised and mapped against the conceptual framework. A stakeholder forum was utilised to test face validity and practical adequacy of the findings. RESULTS We found that some features of HIA are essential, such as the stepwise but flexible process, and evidence based approach. Non-essential features that can enhance the impact of HIAs include capacity and experience; 'right person right level'; involvement of decision-makers and communities; and relationships and partnerships. There are contextual factors outside of HIA such as fit with planning and decision making context, broader global context and unanticipated events, and shared values and goals that may influence a HIA. Crosscutting factors include proactive positioning, and time and timeliness. These all operate within complex open systems, involving multiple decision-makers, levels of decision-making, and points of influence. The Harris and Harris-Roxas framework was generally supported. CONCLUSION We have confirmed previously identified factors influencing effectiveness of HIA and identified new factors such as proactive positioning. Our findings challenge some presumptions about 'right' timing for HIA and the rationality and linearity of decision-making processes. The influence of right timing on decision making needs to be seen within the context of other factors such as proactive positioning. This research can help HIA practitioners and researchers understand and identify what can be enhanced within the HIA process. Practitioners can adapt the flexible HIA process to accommodate the external contextual factors identified in this report.
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Affiliation(s)
- Fiona Haigh
- Centre for Health Equity Training, Research and Evaluation CHETRE, Ingham Institute, University of New South Wales, Sydney, 2052, Australia.
| | - Elizabeth Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia.
| | - Ben Harris-Roxas
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia.
| | - Fran Baum
- Southgate Institute for Health, Society & Equity, Flinders University, Adelaide, Australia.
| | | | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia.
| | - Helen Keleher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Lynn Kemp
- Centre for Health Equity Training, Research and Evaluation CHETRE, Ingham Institute, University of New South Wales, Sydney, 2052, Australia.
| | - Richard Morgan
- Centre for Impact Assessment Research and Training (CIART), Department of Geography, University of Otago, Dunedin, New Zealand.
| | - Harrison Ng Chok
- Centre for Health Equity Training, Research and Evaluation CHETRE, Ingham Institute, University of New South Wales, Sydney, 2052, Australia.
| | - Jeff Spickett
- WHO Collaborating Centre in Environmental Health Impact Assessment and School of Public Health, Curtin University, Bentley, Australia.
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14
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Heller J, Givens ML, Yuen TK, Gould S, Jandu MB, Bourcier E, Choi T. Advancing efforts to achieve health equity: equity metrics for health impact assessment practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:11054-64. [PMID: 25347193 PMCID: PMC4245599 DOI: 10.3390/ijerph111111054] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 10/14/2014] [Accepted: 10/15/2014] [Indexed: 12/02/2022]
Abstract
Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.
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Affiliation(s)
- Jonathan Heller
- Human Impact Partners, 304 12th Street, #2B, Oakland, CA 94607, USA.
| | - Marjory L Givens
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA.
| | - Tina K Yuen
- National Association of County and City Health Officials, 1100 17th Street NW, Seventh Floor, Washington, DC 20036, USA.
| | - Solange Gould
- School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720, USA.
| | - Maria Benkhalti Jandu
- Institute of Population Health, University of Ottawa, 1 Stewart Street, Room 300, Ottawa, ON K1N 6N5, Canada.
| | - Emily Bourcier
- Center for Community Health and Evaluation, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA.
| | - Tim Choi
- Solano County Health and Social Services Department, 275 Beck Avenue, MS 5-240, Fairfield, CA 94533, USA.
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