Including health in environmental impact assessments: is an institutional approach useful for practice?
Harris PJ, Haigh F: Including health in environmental impact assessments: is an institutional approach useful for practice? Impact Assessment and Project Appraisal 2015:1-7.
Internationally the inclusion of health within environmental impact assessment (EIA) has been shown to be limited. While health-focused research has focused on the technical provision of health information, policy analysis theory may enable description and explanation of the institutional conditions surrounding health inclusion in EIA. However, whether this framework is considered useful by practitioners has yet to be tested. To investigate this, data were collected via a workshop (n = 22) and the results were analysed using ?Institutionalist? units of analysis (ideas, actors, organisations and institutions). These results were then emailed to participants who were asked to undertake a follow-up survey about the analysis and approach (n = 9). The workshop results suggested various influences on how and why health is considered or not in EIAs. Overall the survey respondents agreed that the approach was conceptually and practically useful but that the framework alone is insufficient and further work is needed to convince potential users of the value of health in EIA. The findings support the need for more detailed research.
Povall SL, Haigh FA, Abrahams D, Scott-Samuel A. Health equity impact assessment. Health Promotion International. 2013.
The World Health Organization’s Commission on Social Determinants of Health has called for ‘health equity impact assessments’ of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, ‘downstream’ factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology.
Villawood East HIA Literature Review: Housing Estate Redevelopment and Health
Villawood East is a housing estate in South Western Sydney, NSW, Australia. It was built as a public housing estate, mostly during the early 1950s. The estate has been identified as being in need of improvement; the housing is of a low standard and in need of upgrading and is considered unsuitable for the current and future population. NSW Finance and Services and NSW Family & Community Services are developing a Master Plan for the redevelopment of the Villawood East area.
A HIA of the Master Plan has been carried out collaboratively by the Centre for Health Equity Training Research and Evaluation (CHETRE), Population Health South Western Sydney & Sydney Local Health Districts, the NSW Department of Family and Community Services (FACS) and the NSW Land and Housing Corporation HIA .
Ben Cave Associates were commissioned to carry out a literature review to inform the HIA focussing on the scoped areas of health impact: mental health, social cohesion, access to services and access to good quality space / urban design.
- Villawood East HIA Literature Review (print version)
- Villawood East Literature Review (screen version)
Harris P, Haigh F, Harris E. (2012) Incorporating health considerations in land-use planning and policy development: a review of activities in Stoke City Council in the UK and suggestions for application in NSW.
There has been increased interest in the relationship between health and the urban environment in recent years. However there has been limited knowledge about how to strategically develop collaborations between organisations which aim to influence ‘healthy’ planning practice. In Sydney, New South Wales, Australia an ongoing collaboration between the Sydney and South Western Sydney Local Health Districts and the Centre for Health Equity Training, Research and Evaluation at the University of New South Wales has been investigating the use of tools, processes and other ways to progress health and equity in urban focussed policy and planning. We have reviewed activities developed by ‘Stoke Healthy City’ in the U.K. to inform our work. The work in Stoke was intuitively appealing because of an explicit intention to work at multiple levels and with different tools and processes. These tools and activities are not particularly innovative in themselves. For example, the Sydney and South Western Sydney Local Health Districts already utilise HIA and health development checklists and have a long history of strong community engagement. However, what is unique about Stoke is that it has brought together a range of activities and tools that can be utilised at different stages within the planning and policy development process in order to mainstream the consideration of health into all levels of activity. Given the recent and upcoming changes to the land use and community strategic planning systems in New South Wales the activities detailed in this report provide practical examples of what is required to influence healthy urban planning and policy development.
Harris PJ, Kemp LA, Sainsbury P. The essential elements of health impact assessment and healthy public policy: a qualitative study of practitioner perspectives. BMJ Open. 2012 Nov 19;2(6).
Open Access, available from http://bmjopen.bmj.com/content/2/6/e001245.full
Objectives This study uses critical realist methodology to identify the essential and contingent elements of Health Impact Assessment (HIA) and Healthy Public Policy (HPP) as operationalised by practitioners.
Design Data collection—qualitative interviews and a workshop were conducted with HIA and HPP practitioners working in differing contexts.
Data analysis Critical realist analytical questions identified the essential elements of HIA and HPP, the relationship between them, and the influences of public policy and other contingencies on the practice of both.
Participants Nine interviews were conducted with purposively sampled participants working in Europe, USA and Australasia. 17 self-selected participants who worked in Europe, South East Asia and Australasia attended the workshop.
Results The results clarify that HIA and HPP are different but mutually supporting. HIA has four characteristics: assessing a policy proposal to predict population health and equity impacts, a structured process for stakeholder dialogue, making recommendations and flexibly adapting to the policy process. HPP has four characteristics: concern with a broad definition of health, designing policy to improve people’s health and reduce health inequities, intersectoral collaboration and influencing the policy cycle from inception to completion. HIA brings to HPP prediction about a policy’s broad health impacts, and a structured space for intersectoral engagement, but is one approach within a broader suite of HPP activities. Five features of public policy and seven contingent influences on HIA and HPP practice are identified.
Conclusions This study clarifies the core attributes of HIA and HPP as separate yet overlapping while subject to wider influences. This provides the necessary common language to describe the application of both and avoid conflated expectations of either. The findings present the conceptual importance of public policy and the institutional role of public health as distinct and important influences on the practice of HIA and HPP.
Housing density and health: A review of the literature and Health Impact Assessments
Haigh, F., Ng Chok, H. & Harris, P. (2011). Housing density and health: A review of the literature and Health Impact Assessments. Centre for Health Equity Training, Research and Evaluation (CHETRE), University of New South Wales: Sydney.