Institutionalizing health impact assessment in London as a public health tool for increasing synergy between policies in other areas☆
Received 27 July 2009; received in revised form 8 December 2009; accepted 14 January 2010. published online 02 March 2010.
Summary
Objectives
To describe the background to the inclusion of health impact assessment (HIA) in the development process for the London mayoral strategies, the HIA processes developed, how these evolved, and the role of HIA in identifying synergies between and conflicting priorities of different strategies.
Study design
Case series.
Methods
Early HIAs had just a few weeks for the whole HIA process. A rapid appraisal approach was developed. Stages included: scoping, reviewing published evidence, a stakeholder workshop, drafting a report, review of the report by the London Health Commission, and submission of the final report to the Mayor. The process evolved as more assessments were conducted. More recently, an integrated impact assessment (IIA) method has been developed that fuses the key aspects of this HIA method with sustainability assessment, strategic environmental assessment and equalities assessment.
Results
Whilst some of the early strategy drafts encompassed some elements of health, health was not a priority. Conducting HIAs was important both to ensure that the strategies reflected health concerns and to raise awareness about health and its determinants within the Greater London Authority (GLA). HIA recommendations were useful for identifying synergies and conflicts between strategies. HIA can be successfully integrated into other impact assessment processes.
Conclusions
The HIAs ensured that health became more integral to the strategies and increased understanding of determinants of health and how the GLA impacts on health and health inequalities. Inclusion of HIA within IIA ensures that health and health inequalities impacts are considered robustly within statutory impact assessments.
☆ Parts of this paper, and Fig. 1, Fig. 2, have appeared in a Canadian, French language, management journal Télescope and are published here with permission. Mindell J, Bowen C, Herriot N, Atkinson S. L'évaluation d'impact sur la santé: un instrument de santé publique dans le développement des stratégies régionales. [Health impact assessment: a public health instrument in the development of regional strategies]. Télescope 2008;14:26–37.
ABSTRACT