6. Health Impact Assessments Flashcards
health
complete physical, mental, social well-being beyond absence of disease
determinants of health
enviro conditions (impacting physical and mental health), social factors, economic factors
broad impact on well-being
interplay of determinants shapes individual and community-level health outcomes
HIA
evaluates health impacts of diverse policies, plans and projects systematically
aims to promote health equity and ensure vulnerable populations benefit from inclusive decision-making processes
integrates health considerations across sectors (enviro, social services, econ development) for cohesive policies
centers on the potential impacts on public health, addressing broad range of health outcomes including indirect factors (housing, service access, social cohesion, equity)
equality vs equity
equality; everyone same to produce equal outcomes
equity; what is right, fair, moral. interventions adjusted in ways attentive to unique needs to produce fairer health outcomes
HIA steps
- screening; HIA necessary based on potential health impacts?
–> identify significant effects= HIA - scoping; key health issues, data sources, affected populations, HIA objectives/framework
- assessment; baseline, predict outcomes, assess impacts on vulnerable populations
–> ensure communicated to stakeholders
–> ensure integration of health considerations in EIA - recommendations; actions to enhance health benefits, reduce risk, mitigate impacts through design changes/project modifications
- reporting; stand alone report or integrated into EIA
- follow-up/monitoring/evaluation; track implementation, monitor health outcomes, assess HIA effectiveness to inform future assessments, make needed adjustments
HIA = diverse methodologies
quantitative
qualitative
participatory research techniques
enhance prospective and retrospective evaluations
–> not just about predictions based on project, but understanding legacy effects
HIA = engagement
engage public, stakeholders throughout process to support comprehensive understanding of health impacts and community’s concerns.
–> communication
–> strong learning function
4 types of HIA
- mandated; legally required conducted within formal assessments to meet statutory health requirements
- decision-support; voluntary evaluations to improve decision-making, provide health insights
- advocacy; conducted by individuals/orgs seeking to influence decision-making process of specific project for fairer/better outcomes
- community-led; initiatives of local communities seeking to influence decision-making process of specific project for fairer/better outcomes
HIA in BC
mandates HIAs for new projects to embed health considerations into EIAs
health now identified pillar of EIA legislation in BC (standalone HIA = rare, often commisioned independent of EIAs)
–> evolving health policy landscape trends indicating policies increasingly focus on social determinants, emphasizing comprehensive health impact evaluations
HIA in canada (federal)
IAAC = interim guidance on HIA
IAAC = practioner guidelines for social and health IAs, strong focus on upstream determinants across multiple life cycles and contexts
strong interest in evaluating pathways of effects from project development through decommissioning + health impacts
HIA recognized, not mandated
HIA includes both… effects on populations
direct effects
indirect effects
–> benefits; enhanced social cohesion or mental health
–>potential negative indirect impact: increased housing insecurity
HIA challenges
- equity assessment gaps
–> limited methodologies hindering effective equity assessments = insufficient connections between health determinants across time - methodological limitations; exisiting HIA frameworks overlook CEs of health impacts, linking past, present, future stressors
- data limitations; data to understand context, impacts, outcomes, pathways
- advancements; need to integrate equity considerations systematically in better way (need innovative methods)
–> how define well-being?
- integration with EIA; (defined later)
HIAs demonstrate the necessity of integrating health within enviro. assessments for effectiveness and improved socio-enviro. outcomes.
Integrative approach
effective HIAs acknowledge cumulative and legacy effects, contribute directly to promoting health equity by addressing social determinants, connect project impacts on well-being and are woven into EIA and decision-making
promoting health equity
exposure pathways in HIA
- health impact pathways:
toxic exposures, ecosystem changes, behavioural modifications, workplace conditions affecting health equity
–> common, preferred by proponents/regulators - significance for equity:
pathways can emphasize need for equitable policy and decision-making addressing social determinants of health disparities
–> challenge in EIA - environmental justice considerations: how impacts important to ensure enviro. justice and promote fair health outomes for all
–> challenge in EIA
Many environmental health challenges now have been unfolding across broad geographic areas over period decade/centuries. These enviro. challenges are drivers of…
health inequities
integrated assessment approaches offer significant potential to understanding multiple drivers of … (4) to ecosystem communities and human health. they can strengthen the social license to operate. making linkages means better understanding of …(2)
change, pressures, exposures and impacts
impacts + how to mitigate them
challenge of integration
social ecological systems = complexities need to be integrated assessment methodologies to address interconnected challenges.
–> means connecting different types of information
–> improved mitigation tools = essential for integrating health assessments, ensuring comprehensive understanding of cumulative impacts
Federal Impact Assessment Act:
“effects means, unless the context requires otherwise, changes to …. and the positive and negative consequences of these changes
- effects within federal jurisdiction means, with respect to a physical activity or a designated project
…. (2) - sustainability means the ability to protect the environment, contribute to the social and
economic well-being of the people of Canada and preserve their …..
the environment or to health, social or economic conditions
– any change occurring in Canada to the health, social or economic conditions of the Indigenous peoples of Canada;
– any change to a health, social or economic matter that is within the legislative authority of Parliament that is set
out in Schedule 3.
health in a manner that
benefits present and future generations”
