Health impact assessment: The contribution of the right to the highest attainable standard of health

doi:10.1016/j.puhe.2008.09.002

Public Health

Volume 123, Issue 4, April 2009, Pages 302-305

https://doi.org/10.1016/j.puhe.2008.09.002 Get rights and content

Summary

There are growing demands for governments to carry out human rights impact assessments prior to adopting and implementing policies. This article outlines a preliminary human rights impact assessment methodology, using the right to the highest attainable standard of health as the case study. The authors recommend a mainstreaming approach, which involves integrating human rights into existing impact assessment methodologies. Accordingly, they identify considerations that, from a human rights perspective, governments should incorporate into existing impact assessment methodologies in order to comply with their legal obligations to realize human rights. To test the mainstreaming methodology, the authors propose integrating the right to the highest attainable standard of health into health impact assessment.

Section snippets

The right to the highest attainable standard of health (Box 1)

The right to the highest attainable standard of health is enshrined in numerous national constitutions,³ the Constitution of the World Health Organization,⁴ the Declaration of Alma-Ata⁵ and numerous international human rights treaties. Every country in the world has ratified at least one international human rights treaty that includes the right to health. The International Covenant on Economic, Social and Cultural Rights contains the most widely applicable provision on this fundamental human

Human rights impact assessment

In this context, there are growing demands for governments to carry out human rights impact assessments prior to adopting and implementing new policies, programmes and projects. Human rights bodies, such as the United Nations Committee on the Rights of the Child, require states to carry out human rights impact assessments to ensure that children's rights, including the right to health, are respected in legislation and in policy development and delivery at all levels of government.²⁰ The United

Conclusion

Human rights impact assessments are an aid to equitable, inclusive, robust and sustainable policy-making. They bring a set of values to impact assessment methodologies. They are one way of ensuring that the right to health – especially of marginalized groups, including the poor – is given due weight in all national and international policy-making processes. From the right-to-health perspective, an impact assessment methodology is a key feature of a health system. Without such a methodology, how

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Cited by (24)

Health impact assessment: One way to introduce health in all policies. SESPAS Report 2010
2010, Gaceta Sanitaria
La evaluación del impacto en la salud es una herramienta de carácter predictivo, de ayuda a la toma de decisiones. La experiencia acumulada muestra que podría desempeñar un papel primordial en el desarrollo de la estrategia de salud en todas las políticas. La evaluación del impacto en la salud ha sido ampliamente utilizada en otros países europeos, en diversos ámbitos sectoriales y administrativos. En la mayoría de los casos se ha introducido de forma no obligatoria e independiente de otros tipos de evaluación del impacto de las políticas sectoriales. Su uso en España es relativamente reciente, escaso, y principalmente limitado a experiencias en el ámbito local y al cribado de actuaciones de una comunidad autónoma. La reforma normativa y organizativa de la salud pública actualmente en curso en España es una gran oportunidad para impulsar el desarrollo de la evaluación del impacto en la salud. Entre las barreras para su desarrollo destacan el predominio de la visión biomédica de la salud entre los profesionales, los responsables políticos y la población general; la desafección política, la escasa cultura de participación ciudadana y de tradición evaluadora en la elaboración de políticas públicas; y el insuficiente desarrollo del trabajo intersectorial. Dado el potencial de la evaluación del impacto en la salud para avanzar en el logro de una mejor salud poblacional y en la reducción de las desigualdades sociales en salud, deberían dedicarse esfuerzos políticos, formativos y de investigación para que esta evaluación se introduzca y desarrolle en los distintos ámbitos administrativos y sectoriales.
Health impact assessment is a predictive tool to support decisions in policy-making. Current experience shows that health impact assessment could play an important role in the development of the Health in All Policies strategy. This strategy has been extensively used in other European countries and in a wide range of policy and administrative sectors. Health impact assessment is hardly ever mandatory and is frequently carried out separately from other impact assessments. The use of this process in Spain is relatively new, limited and fundamentally based on local level experiences and the screening of regional interventions. The current normative and organizational reform of public health in Spain provides an excellent opportunity to promote the development of health impact assessment.
Some of the barriers to the development of this process are related to the biomedical model of health prevailing among health professionals, politicians, and the general population, political disaffection, lack of assessment culture, underdevelopment of community participation processes, and insufficient intersectoral work. Health impact assessment provides an opportunity to move toward improving the population’s health and reducing inequalities in health. Consequently, political commitment, as well as investment in education and research, is needed to introduce and develop health impact assessment in all administrative settings and policy sectors.
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MinisymposiumHealth impact assessment: The contribution of the right to the highest attainable standard of health

Summary

Section snippets

The right to the highest attainable standard of health (Box 1)

Human rights impact assessment

Conclusion

Health impact assessment, human rights and global public policy: a critical appraisal

Bull World Health Organ

Provisions for health and health care in the constitutions of the countries of the world

Cornell Int Law J

Minisymposium
Health impact assessment: The contribution of the right to the highest attainable standard of health