Lessons from an International Initiative to Set and Share Good Practice on Human Health in Environmental Impact Assessment

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

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.

Trends, Issues and Future Directions of Urban Health Impact Assessment Research: A Systematic Review and Bibliometric Analysis

Health impact assessment (HIA) has been regarded as an important means and tool for urban planning to promote public health and further promote the integration of health concept. This paper aimed to help scientifically to understand the current situation of urban HIA research, analyze its discipline co-occurrence, publication characteristics, partnership, influence, keyword co-occurrence, co-citation, and structural variation. Based on the ISI Web database, this paper used a bibliometric method to analyze 2215 articles related to urban HIA published from 2012 to 2021. We found that the main research directions in the field were Environmental Sciences and Public Environmental Occupational Health; China contributed most articles, the Tehran University of Medical Sciences was the most influential institution, Science of the Total Environment was the most influential journal, Yousefi M was the most influential author. The main hotspots include health risk assessment, source appointment, contamination, exposure, particulate matter, heavy metals and urban soils in 2012–2021; road dust, source apposition, polycyclic aromatic hydrocarbons, air pollution, urban topsoil and the north China plain were always hot research topics in 2012–2021, drinking water and water quality became research topics of great concern in 2017–2021. There were 25 articles with strong transformation potential during 2020–2021, but most papers carried out research on the health risk assessment of toxic elements in soil and dust. Finally, we also discussed the limitations of this paper and the direction of bibliometric analysis of urban HIA in the future.

The Environmental Impact Assessment of Sanitation Projects in Chile: Overview and Improvement Opportunities Focused on Follow-Ups

The Environmental Impact Assessment (EIA) is a legal and administrative tool aimed to identify, predict, and interpret the impact of a project or activity on the environment and human health. The EIA also evaluates the accuracy of the predictions and audits the effectiveness of the established preventive measures. Regarding the sanitation sector, efficiency of wastewater treatments and sanitation networks determine the pollutant level of the discharged liquid effluents and the subsequent impact on the environment and human health. This problematic makes necessary to assess how proper the regulatory follow-ups of sanitation projects is. This paper evaluates the performance of the Chilean EIA System concerning to sanitation projects. Taking into account that the more restrictive Environmental Impact Study (EIS) and more permissive Environmental Impact Declaration (EID) are the ways for projects’ entry to the EIA System in Chile, 5336 sanitation projects submitted to EIA between 1994 and 2019 were complied. A representative sample of 76 projects (15 entered as EIS and 61 as EID) was analyzed by using a principal coordinate analysis (PCoA) through 14 selected performance indicators. Observed weaknesses have led to propose improvement opportunities of the EIA focused on the follow-ups after the environmental license is obtained, such as creation of a simplified sanctioning procedure, decentralization of decision-making, deadline establishment in each stage, and unified direct link for each project. These proposals seek to improve the effectiveness of monitoring and possible sanctions to early identify impacts of sanitation projects on the environment and human health. This paper introduces a robust methodology for evaluation criteria focused on the follow-ups analysis, which can be used in other countries that consider respectful sanitation projects have direct social and environmental benefits leading to long-term indirect cultural and economic values.

HIA and EIA Are Different, but Maybe Not in the Way We Thought They Were: A Bibliometric Analysis

Background: The fields of Health Impact Assessment (HIA) and Environmental Impact Assessment (EIA) have grown with increasing numbers of disciplines and sectors contributing to their advancements, but with it, perceived conflict over methodological and disciplinary approaches to integrate health in impact assessments. This study maps the current field of HIA and health in EIA to examine the scientific landscape of the field. Methods: We carried out a bibliometric analysis of HIA papers and EIA papers that included a health focus in peer-reviewed journals in the Web of Science Core Collection (n = 229). We carried out co-authorship and co-citation network analyses of authors and documents in VOSviewer. Results: We identified two main co-authorship and co-citation groupings. Our document co-citation analysis also identified four clusters with two major groups, the Defining HIA cluster and the Describing the fields cluster versus the Active transport quantitative HIA cluster, and the Quantitative modelling tools cluster. Conclusion: Our findings strongly suggest that there exist two groups of thought in the scholarly fields of HIA and health in EIA. Barriers to developing more methodologically integrated approaches to considering health within EIA are related more to disciplinary differences than field (HIA versus EIA)-based differences and we advocate for the development of transdisciplinary approaches to both HIA and EIA.

Using health impact assessment (HIA) to understand the wider health and well-being implications of policy decisions: the COVID-19 'staying at home and social distancing policy' in Wales

BACKGROUND

Health Impact Assessment (HIA) is promoted as a decision-informing tool by public health and governmental agencies. HIA is beneficial when carried out as part of policy development but is also valuable as a methodology when a policy is being implemented to identify and understand the wider health and well-being impacts of policy decisions, particularly when a decision needs to be taken rapidly to protect the population. This paper focusses on a HIA of the 'Staying at Home and Social Distancing Policy' or 'lockdown' in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA.

METHODS

A HIA was conducted following a standard HIA five step process. A literature review was undertaken alongside 15 qualitative semi-structured interviews with key stakeholders, and relevant health and demographic data were collated. The results were triangulated and analysed to form a holistic assessment of the policy decision and its impacts.

RESULTS

A wide range of major health and well-being impacts of the lockdown in Wales were identified across the determinants of health, which included positive and negative social, economic, environmental and mental well-being impacts beyond the impact on direct health. Populations affected included children and young people, those on low incomes and women as well as those whose health has been directly impacted by COVID-19 such as older people. The work highlighted the benefit that HIA can bring in emphasizing impacts which can inform policy and shared learning with others.

CONCLUSION

HIA is a largely underused tool to understand the impact of policy and political decisions, particularly when a decision has been taken at speed. This case study highlights how HIA provide evidence and information for advocacy and further work by public health institutes, health agencies and policy makers.