Its Definition
Health impact assessment (HIA) is usually defined as a combination of procedures, methods and tools by which a policy, a program or a project can be judged or evaluated on the basis of its potential effects on the health of a population. HIA is most frequently used to assess proposals that are outside of the traditional health care sector, and which do not target health as their principal goal. The approach involves attempting to estimate, with the help of contextual and scientific information, the possible effects on health and well-being with a goal of minimizing the negative effects while maximizing the positive effects.
Acting upon the determinants of health
HIA is highlighted in current theories of population health, and responds to the need to act upstream as much as possible to prevent illnesses and health problems by acting upon the determinants of health.
Many policies, programs and projects could be considered to be "determinants of determinants". HIA is a structured, active approach that can influence public policies in order to ensure that they will have outcomes favourable to health.
Recognizing the importance of social, economic and cultural determinants of health, it is also recognized that levers for improving population health can be found outside of the health care sector. Public health actors must therefore work in partnership with those working in the sectors where these levers are to be found (for example, in employment, education, housing, transportation, etc.). While decisions made in different sectors can have an influence on the health of the population, likewise, the state of health of the population can influence the capacity of society to develop. Also, the development and preservation of the health of the population calls for a collective social responsibility that includes all sectors of society, as much for the private as for the public sector.
Decision-making informed by reliable information
HIA aims to clarify the decision-making process by providing scientific evidence that allows not only a broader view of the stakes involved, but also information about the mid- and long-term consequences of the decisions made. In this sense, HIA responds to modern challenges in managing public services and benefits.
Its Popularity
The practice of Health Impact Assessment of projects, programs and policies is performed in several countries and its popularity is growing. In Canada, supportive efforts have been accepted for several years in the environmental sector, where it is used to add a human dimension to environmental impact assessments. British Columbia was one of the first jurisdictions to consider introducing impact assessments of public policies in a centralized and routine manner. Today, other jurisdictions including Quebec, Thailand and the Netherlands have also reached this point. The successes realized in the environmental sector, the proliferation of intersectoral responsibilities and the interest shown by academics, health sector practitioners and decision-makers towards this approach have led to its rapid development. Today, those who take an interest in this field will find that there are many resources at their disposal.
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