22 September 2006

New Zealand inlcudes commitment to HIA in childhood obesity prevention strategy

New Zealand Prime Minister Helen Clark yesterday announced that policy HIA will be included as part of a portfolio of initiatives aimed at childhood obesity prevention
We are here today to launch Mission-On, a new $67 million government-wide package of initiatives to help New Zealand's children and young people become healthier, so they can lead active and successful lives.

...Finally, policy makers will be required to carry out health impact assessments when developing new policy and legislation.

Read speech in full

It will be interesting to see how this commitment to HIA develops in practice. The New Zealand Public Health Advisory Committee has developed guidelines on policy HIA which will be readily applicable.

Media Coverage of the Mission-On launch
Helen Clarks' Speech (Scoop)
Opposition Response (Stuff)
Unhealthy Foods Get Chop from Tuck Shops (NZ Herald)
Launch of $67 Million Campaign to Fight Obesity (Radio New Zealand
Campaign Pressures Schools Over Junk Food (Bay of Plenty Times)

20 September 2006

Health in All Policies: New publication from the Finnish Ministry of Social Affairs and Health

The mark the Finnish presidency of the European Union (as we've mentioned before) the Finnish Ministry of Social Affairs and Health has published a book entitled Health in All Policies: Prospects and potentials [PDF 1.9 Mb]. The publication presents a number of examples of "health in All policies" in sectors such as education, the environment, water and sanitation, planning, labour, housing, traffic, agriculture and nutrition.

The book has five sections:
  • Health in All Policies: The wider context
  • Sectoral Experiences
  • Governance
  • Health Impact Assessment
  • Conclusions and the Way Forward

15 September 2006

HIA: What's new on the web?

The London Health Observatory has released a Guide to Reviewing Published Evidence for Use in Health Impact Assessment. The guide has been through quite a rigorous testing and peer-review process and a revised edition, incorporating user-feedback, is planned for 2008. I haven't had a chance to use if yet and I'd be interested to hear about your experiences using it.

The European Public Health Alliance has an interesting page comparing the health impact assessments that have been done on US and European food and agricultural policies.

Mary Mahoney, from the Deakin University HIA Unit, recently spoke about a retrospective HIA that she has undertaken on drought relief in rural Victoria in Australia. The ABC has a page with details on the conference and Mary's HIA, along with an MP3 file of their interview with Mary (MP3, 1.6 Mb).

7 September 2006

Is HIA a Science?

About six months ago, I re-read the Merseyside Guidelines, the leading guidance on HIA in the UK. It's the guidance that every practioner in the UK, and I'm one of them, has read or says they've read. Okay, so first time round I read them quite quickly and I liked what I read. What I hadn't done three years ago, when I was a novice HIA practitioner still learning the ropes, was to read them critically. That's what I did second time around. Imagine my shock, as a signed up champion of science, when on re-reading them I found, at the back, this definition of HIA:
"Is health impact assessment a science?
It is important to emphasise that HIA is not strictly a science.
Having said this, it most certainly draws on a scientific knowledge base.
Scientific evidence on health impacts of specific determinants forms the backbone of this creative, interdisciplinary form of enquiry.
But each HIA is uniquely located in time, space and local conditions though its evidence base can be evaluated, and the rigour with which procedures and methods were implemented can (and should) be assessed.
Uncertainties encountered during the undertaking of HIAs will frequently dictate the need to make assumptions, which may result in challenges to the HIA’s validity: such assumptions are acceptable as long as they are stated explicitly, so that the reader is free to agree or disagree. ”
I agree with every part of this quote except the phrase "HIA is not strictly a science" because for me it describes perfectly what it means to apply scientific knowledge to the real world outside the lab.

For me, both HIA and science in all its myriad forms are "interdisciplinary forms of enquiry"; to misquote John Donne 'No science is an island entire unto itself every science is a piece of the continent, a part of the main'.

HIA for me is:

1. a systematic endeavour;
2. it uses knowledge and methods from other scientific disciplines e.g. epidemiology, sociology, toxicology and biology;
3. it aims for rigour,
4. it actively avoids bias and confounding;
5. the findings of one HIA have some applicability to communities of a similar social and cultural mix as that studied by the HIA; and
6. its results are subject to revision when new evidence or information comes to light that contradicts and refutes previous knowledge.

For me, this quote illustrates a misreading of science as about numbers and quantitative findings and about universal laws that transcend time and space. That works for the physical world (most of the time) but doesn't work so well for our social and cultural worlds where general laws and theories need to take account of local context. In fact even the universal laws of physics have to take account of local context. Science is about systematic enquiry where the resulting knowledge is always provional and subject to revision.

What's even more interesting is that environmental impact assessment practitioners don't have any qualms about calling EIA a science. Neither do economists or sociologists.

But public health professionals and HIA practitioners, in my experience, seem to have a problem with saying that HIA is a public health science? Or maybe I've got it wrong?