Health in Environmental Impact Assessment (EIA): Gaining strength - - PowerPoint PPT Presentation

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Health in Environmental Impact Assessment (EIA): Gaining strength from the “Family of health assessments” approach

rainer.fehr @ uni-bielefeld.de, www.rfehr.eu [19-06]

1Rainer Fehr, 2Julia Nowacki, 3,4Piedad Martin-Olmedo, 5Thomas

Claßen, 6Thomas Fischer, 4Marco Martuzzi, 3,5Odile Mekel

1University of Bielefeld (Germany), 2WHO European Centre for

Environment and Health (Germany), 3HIA-EUPHA, 4Andalusian School for Public Health (Spain), 5NRW Centre for Health (Germany), 6University of Liverpool (UK) 12th European Public Health Conference 2019 in Marseille, France: “Building bridges for solidarity and public health” Workshop (7.L) “Health in EIA”, 22 Nov 2019

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“Family of health assessments” approach

Structure

• 1. Background incl. (health-related) impact as-

sessments

• 2. Other health assessments
• 3. Options / suggestions for EIA development
• 4. Further benefits for (E)IA arising from „family“

perspective; and conclusion

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“Family of health assessments” approach

• 1. Background incl. (health-related) im-

pact assessments

For connecting “scientific knowledge” and “policy- making” with each other (on local, regional, in- ternational level): EIA is an important approach Both the idea and the legal regulations have a history of decades Health is meant to be included, from the beginning But: especially concerning health, the situation still appears as unsatisfactory.

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Health Impact Assessment (HIA)

2000 2010

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“Family of health assessments” approach

EIA, HIA and other impact assessments

From the beginning of work for HIA in Germany:

• a double pathway, pursuing both options: “health

in EIA” and “stand-alone” HIA, and

• a focus on “comparisons”; comparative analyses

were seen as highly useful sources for supple- menting own experiences, incl. avoidance of pit- falls, and improvement of efficiency From this background: decision to broaden the view and include “Family of Impact Assessments”.

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“Family of health assessments” approach

(Health-related) Impact assessments

2011

Fehr R, Viliani F, Nowacki J, Martuzzi M (eds.) (2014) by WHO-Europe, EUPHA, IAIA: Health in Environmental Im- pact Assessment (EIA) in Estonia, Norway, Sweden Health in Strategic Environ- mental Assessment (SEA) Sustainability assessment & Health Health in Social Impact As- sessment (SIA) Health Impact Assessment (HIA) Enhancing health in Impact Assessments Annex: Chronology 2009- 2014

2014

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“Family of health assessments” approach

• 2. Other (health) assessments

2011 “What is in a name?”

• Among the Impact As-

sessments, HIA is the

• ne most strongly foc-

used on health

• Among the Health As-

sessments, HIA is the

• ne focusing on Impact.

Question: Which are the

• ther types of Health As-

sessment?

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“Family of health assessments” approach

Health assessments

A goal was set to develop an integrated view of (governance-supporting) “health assessments” More recently, this was done by also building on EUPHA’s expertise Assessment types: Health reporting (Status quo assessment), Health Needs Assessment (HNA), Health Impact Assessment (HIA), Health Tech- nology Assessment (HTA), Health Systems Per- formance Assessment (HSPA), Programme eval- uation, Economic assessment.

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“Family of health assessments” approach

Health assessments

• Europ. J Public Health 2017,

vol.27, no.4, 609-616 In: Verschuuren M, Oers H von, (eds.) (2019): Population Health Monitoring – Climbing the Information Pyramid. Springer Nature Switzerland, Cham (CH)

2017 2019

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Commonalities amon health assessments

These health assessments are meant to inform policy-making and solve “real-world” problems, by organizing “evidence” Their place is not in research environments, but in society; results often remain unpublished For each type of assessment, there is a (dynamic) “culture” of traditions, resources, infrastructure (= presented in more detail in the HIA pre-confer- ence, 20 Nov 2019)

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“Family of health assessments” approach

Differences among health assessments

Not surprisingly, there are considerable differences among the assessments Part of these differences is related to the character

• f each assessment type, e.g. estimation of “fut-

ure impact” requires other methods than “obser- vation” does But other differences, apparently, are not so deep- ly rooted, they seem to point to transferable feat- ures, implying useful options (also) for EIA.

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“Family of health assessments” approach

• 3. Options / suggestions for EIA de-

velopment

Results from the comparative work can be used to connect EIA to other health-related assessments

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“Family of health assessments” approach

Options for EIA development, concerning “Methods”

From HNA: involvement of target groups via inter- views, informal discussions, complaint proced- ures, health forums, focus groups … From HTA: strong reliance on systematic reviews and meta-analyses From Economic analyses: in addition to traditional indicators (incidence, mortality) also using com- posite indicators, e.g. DALYs

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“Family of health assessments” approach

Options for EIA development, concerning “Institutionalization” and “Resources”

Institutionalization is particularly strong with HTA,

• incl. Network of Agencies for HTA (INAHTA) and

European Network for HTA (EUnetHTA) Resources: From (health) reporting: using a multitude of data sources; defined indictor sets; data presentation and visualization tools, e.g. gapminder From HTA: EUnetHTA’s “core model” of doing HTA, and “Horizon scanning”; INAHTA HTA database about ongoing and published HTAs

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“Family of health assessments” approach

Options for EIA development, concerning “Infrastructure”

From (health) reporting and HTA: there are whole sets of WHO collaborating centers From HSPA: there is a (very active) EC expert group; support is given by the European Observ- atory on Health Systems and Policies (Brussels)

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“Family of health assessments” approach

• 4. Further benefits for (E)IA arising from

„Family“ perspective; and conclusion

Existing local health (or environmental) reports provide baseline information, as required in im- pact assessments An existing HNA for the study population can point to vulnerable subpopulations – potentially relev- ant for expected impacts An existing HSPA can reveal specific weaknesses

• f local health care – same

Existing ex-post evaluations of similar projects can inform prospective IA.

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“Family of health assessments” approach

Collaboration, Project work, Teaching

Recommendable: close collaboration with institut- ions responsible for (health / environmental) reporting, which often have stable connections with stakeholders incl. data providers The competencies required for “health in EIA” do

• verlap with those required for other types of

health assessments, e.g., health reporting or evaluation -> joint teaching modules?

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“Family of health assessments” approach

Conclusion

The “family” perspective of health assessments promotes systematic exchange and debate across (health) assessments, helping:

• to derive impulses (options) for EIA practice and

future development (sect. 3)

• to harness further benefits incl. utilizing (local)

information from “other” assessments, and supporting each other (sect. 4) Thus, we can make best use of existing knowledge and capacities. .

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“Family of health assessments” approach

Optional addendum

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Health Impact Assessment (HIA)

Teil I Grundlagen und Konzepte

• Methods, Procedures
• Role of quantitative risk assess-

ment

• Valuation criteria
• Strategies to resolve conflicts
• Urban planning
• International comparison

Teil II Praxiserfahrungen

• Waste disposal (dump site ex-

pansion)

• Transport (new road)
• Local practice
• Administrative networking
• Cost and benefit

Teil III

• Perspectives
• Ministerial resolution 1992

1997

8 selected approaches: WHO- Europe, CPHA, EPA, ATSDR, CAPCOA, AUS, NZ, NL

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2004 European Policy Health Impact Assessment (EPHIA) project

• HIA of the European Employment Strategy (EES): across the European

Union / in Ireland / the Netherlands / Germany / United Kingdom

• HIA: un guide / a guide / en Leidraad / Empfehlung zum Vorgehen

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“Family of health assessments” approach

Health assessments

Reporting, Assessing, Evaluating

2012 2011

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Health impact quantification

2016 2010

with