Environmental Sensitivities: Another vulnerable group for HIA to consider?

The old adage, 'one man's meat is another man's poison' succinctly captures the differing ways that we all can react to environmental factors. For instance, people with blue eyes, red hair, freckles and pale skin tend to be sensitive to sunshine, burning more readily than the rest of us.

Though sunburn is not nice, it's generally temporary, but some people have crippling reactions to such things as household chemicals e.g. air fresheners and detergents; the chemicals used to make furnishings fire retardant; and electromagnetic radiation from electricity generation and distribution.

The Canadian Human Rights Commission has commissioned a new report, The Medical Perspective on Environmental Sensitivities by Margaret E. Sears to look into his area and provide guidance on what can be done about it.

The report summarises the current scientific information on environmental sensitivities. It states that around 3% of Canadians have been diagnosed with environmental sensitivities, and many more are somewhat sensitive to traces of chemicals and/or electromagnetic phenomena in the environment. People experience a range of physical, mental and emotional symptoms with the avoidance of triggers being the key step in both regaining and maintaining health and wellbeing.

The report addresses issues such as the definition and prevalence of environmental sensitivities; recognition by medical authorities; education and training within the medical community; origins, triggers and symptoms of sensitivities; impact of environmental sensitivities in the workplace; government policies and standards for building codes, air quality and ventilation as they affect individuals with environmental sensitivities; and guidelines for accommodation within the workplace.

It also says that for people with environmental sensitivities, their health and ability to work rests with the actions of others, including building managers, co-workers and clients. Accommodating people with environmental sensitivities presents an opportunity to improve workplace environmental quality and workers’ performance, and may help prevent the onset of sensitivities in others.

For those interested in the original scientific and technical literature, an annotated bibliography is available on request from environmentalhealthmed@gmail.com.

In relation to HIA, it raises an interesting question for HIA practice. Should environmentally-sensitive individuals be considered a distinct vulnerable group in HIAs, one that is routinely considered?

Personally, while I do consider this issue, especially where it relates to EMG fields, I do not consider it formally and more importantly do not tend to suggest mitigation and enhancement measures routinely to ensure that environmental-sensitivity is not exacerbated or generated in development projects that I work on. Partly this is because I haven't researched them, and they haven't come to my attention, and secondly, arguably more importantly, the issues seems to affect so few people and seems so esoteric in the context of poverty, run-down urban environments and widening social and health inequalities that it doesn't merit more than a line or two if that.

However it could be that they are the proverbial 'canary in the coal mine', sentinel individuals who are highlighting a potentially wider problem that is affecting all of us to some extent though not enough for us to have actual physical symptoms.

I'm personally not sure how to handle this issue and would love to know what other people think, have you down a HIA where this was or became an issue?...

HIA2008 Conference in Chiang Mai, Thailand

The HIA2008 South East Asia and Oceania Health Impact Assessment Conference will be held in Chiang Mai, Thailand from 8-10 December 2008. The conference is being hosted by the Thai National Health Commission.

To find out more go to the conference website.

HIA2007 Conference Photos

Photos from the conference are available from www.flickr.com/groups/hia2007 (you can upload your own photos there as well). For more on the conference go to www.hia2007.com.

HIA2007 Conference: Plenary presentations, audio files and photos now online

The South East Asia and Oceania Regional Health Impact Assessment Conference was held in Sydney, Australia from 7-9 November 2007. The event was a success, with more than 180 HIA practitioners from across the Asia Pacific region coming together for the first time.

Conference Presentations
Conference plenary presentations are now available on the conference website (www.hia2007.com). Both slides and audio files are available.

Asia Pacific HIA Email List
An email list has been established to facilitate HIA practitioner exchange across the Asia Pacific. To subscribe send an email to majordomo@explode.unsw.edu.au with "subscribe hia-seao"as the body of the email. More information on the listserv is available here.

Scoring communities on health and wellbeing

We have GDP and GNP and other economic scores we also have SMRs that provide death and illness statistics at a community level but we don't have health and wellbeing scores and their respective scoring systems. The New Economic Foundation has a happiness index which is quite cool that works at national level, they have a report the Happy Planet Index: an index of human wellbeing and environmental impact but that doesn't work yet for local neighbourhoods.

There 8 Point Wellbeing Manifesto says:

• Reclaim time: we systematically over-estimate the amount of happiness extra income will bring us and work too many hours to get it.
• Ban advertising to children: young children can’t distinguish between facts and selling messages. The culture of materialism is not only bad for the environment, it also undermines our well-being.
  
• Invest in our future: the under threes and parenting. Extend parental leave to cover at least the first two years, and provide high-quality childcare and active parental support. Investment in the ‘zero to threes’ repays itself many times over in health, education and social benefits.
• Teach well-being: promote well-being and curiosity in schools, not performance against targets, with more sports, arts, creativity, and other engaging activities. Young people should be given the tools to make their own good life choices.
• Create a Citizen’s Service’ - like a jury service for volunteering, citizen’s panels etc. - and more opportunities for young people to engage in the community and politics
• Measure what really matters to people: create a set of national well-being accounts to assess levels of satisfaction, depression, meaning and stress to be able to track changes over time, integrate services and allocate funds more effectively and efficiently.
• Tax environmental “bads”, such as fossil fuels, not goods, such as high-quality work.
• Introduce a universal Citizen’s Income: this would redistribute to the poorest - a pound in the pocket of the poor is worth more in well-being terms than a pound to a rich person - end the “benefits trap” and help people reclaim their time.

So what do you think? Is happiness the same as wellbeing? Are they linked? If yes, how so? And what do you think of NEF's Wellbeing Manifesto?

Talking Back To Grownups: Healthy Children, Healthy Communities – a report on the social determinants of health and middle childhood in Canada

the Healthy Children, Healthy Communities (HC²) project engages Canadians (including children) in learning about and raising awareness of the social factors that affect the health of kids aged 9-12 years old. HC² envisions a Canada in which children’s health is a national priority and children themselves are engaged in understanding and influencing their own well-being.

Through community roundtables and a Child Health Perceptions Survey, children (aged 9-12) and people interested in child health exchange ideas and perceptions about social factors that impact health, including:

income housing social supports racism

education gender the environment

Participants of the Healthy Children, Healthy Communities project create plans to improve children's health and to bring their priorities to decision makers in schools, communities and governments. All levels of government are included, be they municipal, provincial, territorial, national, and international. The Healthy Children, Healthy Communities project has four objectives:

1. To identify child health PERCEPTIONS and PRIORITIES across Canada from the voices of children themselves, child health stakeholders and Canadians at large.
2. To exchange knowledge on the IMPACTS of SOCIAL FACTORS on children's health in diverse communities across Canada.
3. To develop MEASUREABLE and ACTIONABLE RECOMMENDATIONS for community development, provincial and national policy, and to bring these findings to the global community.
4. To ENGAGE and EMPOWER children to speak out, share their ideas, and take action on their own health priorities from a social determinants of health perspective.

Project Outcomes include:

• An expanded understanding of middle childhood health across Canada, which will emphasize the need to address underlying societal structures. Using prevention and health promotion principles, we will truly improve the health of communities.
• A Child and Youth Network, in partnership with other youth-serving organizations, will sustain the momentum and energy of the project.
• A Child Health Action Manual will highlight the creative actions developed by children across Canada, and will serve as a formal or informal curriculum tool for peer-to-peer education.
• Measurable and Actionable Programme Recommendations will be brought forward to decision makers across Canada (e.g. schools, communities, governments).
• Recommendations, which will be included in Canada's 2009 Report to the UN Committee on the Rights of the Child in 2009.

Link http://www.unac.org/hchc/en/about/index.php

Interim Report WHO Commission on the Social Determinants of Health

"Building a global movement for health equity. Health is a universal human aspiration and a basic human need. The development of society, rich or poor, can be judged by the quality of its population’s health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage as a result of ill-health. Health equity is central to this premise and to the work of the Commission on Social Determinants of Health. " Forward Interim Report (page 3)

The World Health Organization's Commission on the Social Determinants of Health has just published its interim report.

The final report is out next year 2008.

Of interest to HIA practioners is the creation of 9 thematic Knowledge Networks by the Commission to collect, collate and synthesise a diverse range of evidence on:

a) plausible causal relations
b) key areas in which action should take place
c) effective practices and interventions

for addressing socially determined health inequities globally.

The themes of the Knowledge Networks are:

1. Globalisation
2. Health systems
3. Urban settings
4. Employment and working conditions
5. Early child development
6. Social exclusion
7. Women and gender equity
8. Measurement and evidence
9. Priority public health conditions

The interim report outlines the keys issues and evidence that the Commission has collated to date.

***********************************************************************************

Main website http://www.who.int/social_determinants/en

To get regular updates of the work of the Commission sign up at:

http://www.who.int/social_determinants/contact/en/index.html

***********************************************************************************

HIA2007 Conference in Sydney: Update 3

Earlybird Registration Deadline Extended
There has been a positive response to the call for registrations so far. The conference organisers have extended the deadline for earlybird registrations by one week to Monday 1 October 2007. You can register for the conference online at http://www.hia2007.com/registration.htm

Sponsorship from the Victorian Department of Human Services
The Victorian Department of Human Services has sponsored the HIA2007 Conference, joining the conference's principal sponsors NSW Health and the UNSW Research Centre for Primary Health Care and Equity.

Public Health Walking Tour of Sydney on Friday 9 November 2007
Associate Professor Peter Sainsbury from Sydney South West Area Health Service will be leading a public health themed walking tour of Sydney on the morning of Friday 9 November 2007. The walking tour will depart from the conference venue and return in time for the conference start at 9:00am. Further information on the tour will be included in future conference updates.

Professor Richard Morgan added to Conference Program
Professor Richard Morgan, Director of the Centre for Impact Assessment Research and Training at the University of Otago, New Zealand, will be delivering a conference plenary on "Linking HIA and Other Forms of Impact Assessment: Lessons and experience". The opportunity for Professor Morgan to delivery a plenary was created when Professor Hugh Barton had to withdraw from the conference.

Dining Out in Sydney After the Conference Reception on Tuesday 7 November 2007
Following the conference reception on the evening of Tuesday 7 November 2007 the conference organisers will be leading groups to several nearby Sydney restaurants for dinner. Please let the organisers know at the reception if you're interested in coming along.

Visas for International Conference Delegates
Visas may be required for delegates travelling from outside Australia for the conference. Information on visas can be obtained from http://www.immi.gov.au/visitors/index.htm

Weather in Sydney
The weather in Sydney in November is usually mild with average daily minimum temperatures of 15 degrees and an average daily maximum of 23 degrees. The average monthly rainfall is 81mm, making it one of the driest months of the year. More information on Sydney's weather is available from http://www.bom.gov.au

Conference Website
For more information on the conference go to http://www.hia2007.com

New HIA Book: The Politics of Healthy Policies

By Marleen Bekker

Delft – On 12 September Marleen Bekker presented her research on the relationship between Health Impact Assessment and public policy at Erasmus University in Rotterdam.

Public health issues, such as obesity, lung disease from air pollution or mental health complaints from living in an unsafe neighbourhood, are complex, intractable policy problems. The causes are dispersed at the individual and the collective level among different societal sectors. One strategy to integrate health in other sectors’ policies for developing effective and cooperative policy solutions is to provide evidence in a Health Impact Assessment (HIA) from proposed policies and project plans. In 15 years of practising HIA, policymakers and academics nevertheless express concern about its effectiveness.

In The Politics of Healthy Policies a conceptual and empirical analysis is presented of the role of HIA in policy development. From a governance perspective the author identifies different purposes of HIA for indicating societal problems and democratic deficits. These suggest that a technical design of HIA to assess causes and effects insufficiently addresses the political and normative issues of cooperation without institutional requirements or incentives.

Four case studies are analysed of Dutch HIA practices at the national and local policy level, including a game simulation of health advocacy without HIA. The outcomes suggest that a re-orientation on HIA is necessary in order to mobilise other sectors to prevent or mitigate public health problems. Marleen Bekker proposes an interaction-oriented, reflective design and a new definition of HIA. The book is especially relevant to HIA practitioners and health policymakers at different governmental levels. Many of the implications are highly relevant to other forms of impact assessment as well.

Marleen Bekker is a Research Fellow at the Institute of Health Policy and Management at Erasmus MC, Rotterdam, the Netherlands.

Health Impact Assessment in Urban Settings - Special Issue of NSW Public Health Bulletin

A new issue of the New South Wales Public Health Bulletin is now available. The issue focuses on HIA in urban settings and describes the contribution HIA can make to sustainable urban growth by establishing health as a core outcome. The issue has nineteen articles on urban planning and HIA, including nine HIA case studies.

Health Impact Assessment in Urban Settings (Special Issue)
Volume 18, Number 9-10, 2007
http://www.publish.csiro.au/nid/226/issue/4093.htm

Health impact assessment in urban settings
Patrick J. Harris, Ben F. Harris-Roxas and Lynn Kemp

Influencing urban environments for health: NSW Health's response
Sarah V. Thackway, Andrew J. Milat and Elizabeth Develin

International perspective on health impact assessment in urban settings
Salim Vohra

Health impacts of urban development: key considerations
Anthony G. Capon

A planner's perspective on the health impacts of urban settings
Susan Thompson

Learning by doing: the value of case studies of health impact assessment
Ben F. Harris-Roxas and Patrick J. Harris

Bungendore health impact assessment: urban development in a rural setting
Andrew J. Gow and Lorraine G. Dubois

An equity-focussed social impact assessment of the Lower Hunter Regional Strategy
Venessa L. Wells, Karen E. Gillham, Milly Licata and Anne M. Kempton

Greater Granville Regeneration Strategy
Kay Tennant and Christine Newman

A health impact assessment of the Liverpool Hospital redevelopment
Michelle L. Maxwell

Rapid versus intermediate health impact assessment of foreshore development plans
Susan E. Furber, Erica Gray, Ben F. Harris-Roxas, Leonie M. Neville, Carolyn L. Dews and Sarah V. Thackway

Health and social impact assessment of the South East Queensland Regional Plan (2005–2026)
Kate J. Copeland and Andrea M. Young

Lessons in applying health impact assessment to regeneration schemes: the Victorian experience
Jessica McCormick

Greater Christchurch Draft Urban Development Strategy 2005
Anna Stevenson, Karen Banwell and Ramon Pink


Health impact assessments in London: assessing the London Mayoral strategies
Caron Bowen

An overview of the regulatory planning system in New South Wales: identifying points of intervention for health impact assessment and consideration of health impacts
Patrick J. Harris, Ben F. Harris-Roxas and Elizabeth Harris

Building health impact assessment capacity as a lever for healthy public policy in urban planning
Jenny L. Hughes and Lynn A. Kemp

Channelling Edwin Chadwick: beyond utopian thinking in urban planning policy and health
Stephen J. Corbett

Health impact assessment and urbanisation. Lessons from the NSW HIA Project
Patrick J. Harris, Ben F. Harris-Roxas, Elizabeth Harris and Lynn A. Kemp

Predicting a community's health and wellbeing, a game of 10 questions?

I was at a conference on planning and health a few months back. At the time the Conference Chair made a really interesting statement. He said "Show me any community anywhere in the world and I will tell you what their health is like. We know enough about public health to be able to do that."

At the time, without a second's hesitation, I nodded vigorously in agreement.

But now its got me thinking, if that's true then what are the key questions we would need to ask and have answered about a community to be able to predict its overall health and wellbeing?

Over the last few months I've been thinking and below are the ten key questions we would need to ask and why:

1. The income distribution within a community. The less the income differential between individuals within a community, above a certain minimum threshold, the better the health of a community overall.

2. The education distribution within a community. The greater the literacy and educational attainment within a community and the more equally/widely distributed that attainment the better the health of a community overall.

3. Availability and distribution of essential utilities - water, heat, light, waste disposal. The wider and better the availability and distribution of essential the better the health of a community overall.

4. Availability, accessibility and distribution of key amenities - food and retail shops, culture and leisure facilities, transportation, heath and social care, etc. The wider and better the availability, accessibility and distribution of key amenities the better the health of a community overall.

5. Availability, distribution and quality of shelter. The wider and better the availability, distribution and quality of shelter the better the health of a community overall.

6. Quality of the built environment - cleanliness, crime and safety, etc. the better the quality of the built environment the better the health of a community overall.

7. Availability, accessibility, distribution and quality of the natural environment and greenspace. The wider and better the availability, accessibility, distribution and quality of greenspace the better the health of a community overall.

8. Availability, accessibility, distribution and quality of employment. The wider and better the availability, accessibility, distribution and quality of employment the better the health of a community overall.

9. Availability, accessibility, distribution and quality of democratic and stable governance. The wider and better the availability, accessibility and distribution the better the health of a community overall.

10. The distribution, quality and richness of social networks and connections. The wider and better the distribution, quality and richness social networks and connections the better the health of a community overall.

Can you do better? What would your ten questions be? Should we replace one or more of the above key questions with others? Or do you have more that I should add on?

Plus, we haven't defined my terms, what do we mean by better? or democracy or social networks and connections? I'll leave that for you to work on!

New Zealand Ministry of Health HIA Advisor Position

The NZ Ministry of Health has advertised for a position for an advisor/senior advisor to join the Ministry's newly established Health Impact Assessment Suport Unit:

Advisor/Senior Advisor

Office of the Director of Public Health

This is an opportunity to join the Ministry of Health’s newly established Health Impact Assessment (HIA) Support Unit and make an important contribution to improving health and reducing health inequalities in New Zealand.

HIA has been identified as one of the key methods available to strengthen action for health across all sectors at a policy and project level.

You will be a suitably qualified advisor/senior advisor who, as part of the Unit, will be responsible for promoting and supporting the use of HIA across central and local government. You will have a degree or diploma in a relevant field, e.g. public policy, public health, resource management and a sound and practical knowledge of HIA. You will also have excellent communication skills and a proven record of building relations with people at all levels of the organisation.

This is a full time Fixed term/Secondment (two years) position located in Wellington. The closing date for applications is Friday 28 September 2007.

The Ministry of Health has a commitment to Equal Employment opportunities.

For more information and to apply, please contact Paula Hawley-Evans on (04) 816 2837 or Frances Graham on (04) 816 2672. Copies of the job profile and application form are available on the Ministry's website http://www.moh.govt.nz/vacancies.

New Centre for Health Impact Assessment is launched!

The Institute of Occupational Medicine (IOM), based in the UK, has set up a new Centre for Health Impact Assessment (CHIA) to take forward its work on environmental and occupational health and wellbeing.

The vision of CHIA is to be an international Centre of Excellence for:
1. HIA theory and practice
2. Evidence-based analysis of the impacts of policies and programmes on health
3. Understanding the wider determinants of health and wellbeing
4. Healthy urban planning and development
5. Tackling environmental and health inequalities

For more information on the work of the Centre and opportunities for collaborative working please contact:

Dr Salim Vohra MBChB MSc PhD
Director
Centre for Health Impact Assessment
Institute of Occupational Medicine
Research House Business Centre
Fraser Road
Perivale
Middlesex
UB6 7AQ

Mob: +44 (0)7 980 728 814
Tel: +44 (0) 208 537 3491/2
Fax: +44 (0) 208 537 3493
Email: salim.vohra@iom-world.org
Web: www.iom-world.org

HIA changes in Switzerland

On the 4th July 2007, an agreement was signed between the Department of Economy and Health of the Republic & Canton of Geneva (DES) and the University of Geneva (UNIGE).

This agreement stipulates that the Health Impact Assessment (HIA) unit of the Directorate of Public Health (DES) is assigned for 3 years to UNIGE, with the possibility of a final transfer at the end of this period. In addition to its main mission (Assistance to the Geneva government in carrying out whichever HIA that it has decided to undertake according to the Health Law), the HIA unit is in charge, among other things, of the development of research and training on HIA, contributing in this manner to turn UNIGE into a Competence Centre in the area of Environmental Health.

The unit is under the hierarchical responsibility of the Director of the new Institute of Environmental Sciences (ISE). The assignment will become effective on 1st September 2007, at the same time ISE becomes operational.

The key HIA contacts are Jean Simos and Nicola Cantoreggi.

They can both be reached at: ueis@unige.ch or nicola.cantoreggi@unige.ch

Information courtesy of a personal email from Jean and Nicola.

An Important Day for Thailand and HIA

As many of you will be aware, Thailand's first referendum on the draft permanent Thai constitution is being held today, Sunday 19 August 2007. What some fo you may not be aware of however, is that the draft constitution has far-reaching implications for HIA's use in Thailand.

Decharut Sukkumnoed, Director of the Thai Healthy Public Policy Foundation, has provided this translation of the relevant sections of the constitution:

Section 67(2)
"Any projects and activities, which may cause serious impacts on the environment, natural resources, and health, cannot be done without conducting an impact assessment on environment quality and health of population in the local community and organizing a public hearing process for affected people and stakeholders. Moreover, these projects and activities cannot be started without the comments and opinions from independent organizations, which are comprised of environmental and health NGOs, and the representatives from higher education institutes which provide education on environment, natural resources, and health."

Section 67(3)
"The rights of local people to sue against any governmental organizations in order to make them follow the privious principle [i.e. section 67(2)] will be protected by this constitution."

The constitution's provisions for HIA's use follows the Thai National Health Act B.E. 2550 (2007) that was proclaimed on the 9th of March, which allows Thai people the right to demand a HIA be conducted and to participate in the HIA process (more information in this post).

I'm sure we'll all follow developments in Thailand today with considerable interest.

Asia Pacific HIA Email List: Discussion about HIAs of oil and gas projects

James Edwin recently posted a message to the Asia Pacific HIA Email List:

I need some assistance with health impact assessment methodologies. I would like an identification of existing guidelines, models and/or practices in the area of health impact assessment specific to the oil and gas industry. I would appreciate a list of models, a review of the literature, case studies, practical applications, references, annotated bibliography, etc

This led to a number of very helpful responses, which I've included in the comments for this post. If you are aware of any other materials please include them in a comment.

HIA2007 South East Asia and Oceania HIA Conference Update 2: Draft Program

Draft Program

The HIA2007 conference is being held in Sydney from 7-9 November. A draft conference program has been released [PDF ]. Please note that this program is provisional and may be subject to change.

The conference promises to be a busy event with:

• 10 plenary addresses,
• 48 oral presentations,
• 3 pre-conference training workshops,
• 2 in-conference workshops,
• 3 practitoner meetings/forums,
• 18 posters, and
• a panel discussion.

Conference Registration

Please download a registration flyer [PDF] for the conference to circulate to your colleagues and contacts. Online registration has opened and can be accessed at http://www.hia2007.com/registration.htm

Numbers for some events, such as the pre-conference workshops, are limited so register soon to avoid disappointment.

HIA Job: Research Associate Position at Cardiff University

The Welsh Health Impact Assessment Support Unit is advertising a position for a research associate for a project looking at “Involving the Public in Health Impact Assessment: An evaluation of current practice”. Details available here.

Wacky HIAs: HIAs of free newspapers and public spitting

I'd love to someone to do a HIA on free newspapers.

In London, UK we now have at least four newspapers everyday that are given away at tube stations, railway stations and major bus stops. We have the Metro, the London Paper, London Lite and the City AM.

From a sustainability perspective this is unsupportable as all that paper is junked mostly in regular bins and not recycled. Worse from a public health and environmental perspective the is a huge amount of litter and hazard created by people throwing these papers in streets and inside stations.

And yet, free newspapers through their provision of news, ideas, information, entertainment and gossip do generate some form of social capital, social inclusion and civic engagement.

The question therefore is how to keep the positives and reduce the negatives?

I'd also love someone to do a HIA on public spitting. Everyday as I commute into central London I see spit and people spitting. On the streets, inside tube stations, on the platforms and on buses.

Okay, so public spitting in strict public health terms probably isn't so bad in a country like the UK, where infectious disease levels are low and yet there are social, civic and cultural effects from this. Spitting in public shows a disregard both for public spaces and for the people who use them. Or maybe I'm just getting old and taking things too seriously.

What do you think of my ideas? What novel and wacky HIAs would you like to carry out, or have carried out, if you had the chance?

UK ePetition on HIA

The United Kingdom Office of the Prime Minister has an online petition proposing that:

... the Prime Minister to initiate legislation that will make a health impact assessment (HIA) an explicit requirement for all proposals to augment UK roads infrastructure"

Edit: Comments on the petition from its initiator after the jump.

This response is by John Butler

I was indeed the one who posted the HIA petition yesterday. In North Wales (Gogledd Cymru - hence the affectionate "gogs"), where I live, officials at Transport Wales are planning a massive "Improvement", to 7-11 lane motorway standards of the modest A494/A55 dual carriage way highway that runs "across the top of Wales". If ever built, with parallel service roads, it would be up to 13 lanes wide and one of the widest roads in Britain!

Officials at Transport Wales/Welsh Assembly Government are saying that our economy will collapse if the road is not built and they are designing it to carry double the current number of vehicles to 130,000 cars and trucks each day! The fact that it passses through some of the most beautiful parts of The Principality, considered up to now to be a tranquil, rural gem seems to have escaped them.

Thousands of North Wales folk are saying that they don't want or need this massive, polluting construction - and have been building a case to oppose it for the past 18 months. You can read about some aspects (including a specially composed "anthem" now viewable on YouTube!) at our website.

The official documents produced by the proposers have never made any attempt to properly provide for an appraisal of Impacts on Human Health. Their justification for this is that since there is currently no statutory requirement for one there won't be one. Thats what prompted me to initiate the e-petition to our Prime Minister!

I have two small grandchildren. They are likely to attend schools very close to the proposed widened roads so, on their behalf, I decided to persue this startling omission by Transport Wales and also my local county authority who run the schools.

The need (absolute necessity!!) for a HIA for any scheme of this nature, was inspired by the Californian "Gauderman Survey" of early 2007. With encouragement from UK's emminent imunotoxicalogy clinician, Royal Commissioner Profesor Stephen Holgate, I arranged several meetings of concerned residents and local politicians with senior environmental officials at my Local County Hall (Flintshire County Council). It transpires that amongst the undoubted specialists they assembled to impress us, nobody has any clinical qualifications or competence - neither had they thought fit to confer with those who have.

I have now formally advised the Chief Executive of FCC that, if ever my grandchildren suffer future health problems as a result of their inaction now in not effecting an HIA, I will take legal against them. There is now a lot of behind-the-scenes buck-passing going on, especially as they are aware that I am preparing to get 3000 concerned parents to consider registering with me NOW for a "Class-Action" at some future date.

I believe transport Wales fears that if the project and all roadworks they have in the pipeline were to be subject to appraisal for Health Impacts using the criteria that recent research advocates, it would mark the end of ALL large scale road projects throughout Wales - and the UK......

Any help readers of the blog can render to those ordinary folk who oppose the injustice of this and who have natural concerns for those most vulnerable in Wales (UK) would be appreciated.

All North Wales Assembly Members and our local Parliamentary MP, Mark Tami MP have queried with incredulity the omission of a HIA and are now aware of the obfuscation that is taking place in the highest levels of our civil administration. This must never happen again!

I am urging those Assembly Members who have previously expressed support to immediately initiate a Bill in the Assembly that would make it a prerequisite for all future Welsh highway works of this type. The e-petition is simply another way to raise awareness of common concerns.

As a result of a concerted action by orinary folk to register their concerns, on 11 September 2007, there will be a Public Inquiry into all aspects of the current proposals. It is likely to be a landmark event in future considerations for HIAs. Can you help in any way?

Many thanks for your interest. Please recruit as much interest and additions to the petition as possible. Dont forget to check out the website. If you want to hear the campaign song it's on Youtube.

John Butler


NB: I can't necessarily vouch for the petition or its appropriateness within the UK regulatory or legislative context - Ben

HIA2007 South East Asia and Oceania HIA Conference Update

Abstracts Received
We have received a strong response to the call for abstracts, with submissions received from Australia, New Zealand, Thailand, Laos, Vietnam, Japan, Korea, India, Canada, Nepal and the United Kingdom. Abstracts will be reviewed by the scientific committee in coming weeks and the program will be posted online soon

Online Registration Now Open!
Online registration has opened and can be accessed at http://www.hia2007.com/registration.htm

Early bird registration closes 24 September.

Conference Opening
The conference will be opened by The Hon. Verity Firth, a Minister in the New South Wales Government. Her appointments include:

• Minister for Science and Medical Research
• Minister for Women
• Minister Assisting the Minister for Climate Change, Environment and Water (Environment)
• Minister Assisting the Minister for Health (Cancer)

The Minister is also a Councillor for the City of Sydney.

AusAID Funding
We have been successful in securing funding under AusAID's International Seminar Support Scheme for a group of delegates from Vietnam, Laos and Cambodia to attend the conference. We hope this will further strengthen the conference's regional outlook.

For more on the conference got to www.hia2007.com

HIA Community Wiki gets a facelift!

The HIA Community Wiki has just had a redesign. There's been a lot of little tidying up but the four main changes are:

• The International HIA Blog gets pride of place on the front page through a swish new free widget from Springwidget.
• There's a new free Flickr photo badge that refreshes every time you visit the site.
• Check out the HIAwiki's visitor and hit rate through the 'Visitors to the site' page on he main menu bar at the top.
• There also a new calendar list on the Conferences/events page.
  

HIA eNews Issue 18 Avaiable

Issue 18 of the NSW Health Impact Assessment Project eNews is now available. This issue looks at:

• Ways Forward for HIA in Local Government: Considering health and wellbeing at the local level
• What’s the Future of the HIA Gateway?
• New Thai National Health Act: Participatory HIA enshrined in law
• Planning and Health: Findings from the UK Royal Commission on Environmental Pollution

Download [PDF 520Kb]

New HIA Listserv: Asia Pacific Health Impact Assessment Email List

A meeting of HIA practitioners from across the Asia Pacific region was held during the recent International Association for Impact Assessment conference in Seoul. It was decided during the meeting that there was a need for an email discussion list to facilitate information exchange across the region.

I have established an Asia Pacific HIA Email List. The list currently has over 120 subscribers from 18 countries. If you would like to join the list please send an email to majordomo@explode.unsw.edu.au with "subscribe hia-seao" as the body of the email (further details below).

Members
This email list is intended for practitioners and those with an interest in health impact assessment from across the Asia Pacific region.

Purpose
To provide an mechanisms for information exchange and networking across the Asia Pacific region.

To subscribe
Send an email to majordomo@explode.unsw.edu.au with "subscribe hia-seao"as the body of the email.

To unsubscribe
Send an email to majordomo@explode.unsw.edu.au with "unsubscribe hia-seao"as the body of the email.

To send an email to the list
Send your email to hia-seao@explode.unsw.edu.au
Attachments up to 1 Mb are permitted, though not encouraged. Links to files hosted on the web are preferred.

Deadline Extended: Abstracts for HIA2007 South East Asia and Oceania Health Impact Assessment Conference

The deadline for submission of abstracts for the HIA2007 South East Asia and Oceania Health Impact Assessment Conference has been extended until Monday 2 July 2007. Abstracts can be submitted online at www.hia2007.com and are invited under the following themes:

• Health Impact Assessment in Practice
• Health, Community Wellbeing and Sustainability
• Creating Environments for Health
• Liveable Urban Communities
• Working with Other Sectors

The conference is being held in Sydney, Australia from 7-9 November 2007. Further information is available from http://www.hia2007.com

South East Asian Regional Training Course on HIA

By Suphakij Nuntavorakarn and Nuntana Sabrum, Thai Healthy Public Policy Foundation

The Thai Health Systems Research Institute recently held an “HIA Interactive Training Course: A Learning Tool for Healthy Community and Society” in Khon Kaen province of Thailand.

The five-day training course was carried out during 15th to 19th October 2006 through a diversity of processes such as lectures, group work, open discussion and field visits in order to strengthen essential HIA skills and knowledge and to create framework for collaborative research and networking within Southeast Asia and Oceania.

Twelve regional and nineteen local health experts and practitioners attended the event. The regional participants were from Lao PDR, Vietnam, Cambodia, Malaysia, and Australia. Suggestions and ideas shared during the training have led to further HIA development in the region including the development of HIA training manual for developing countries, expert exchange and technical visits. One of the concrete outcomes is that more HIA work has been produced by the new faces from Mekong River Basin and will be presented in the upcoming international events such as the IAIA07 conference in South Korea and HIA2007 conference in Australia.

The training and subsequent activities are part of the “HIA Development for Developing Countries Project” supported by Thai-Health Global Linkage Initiative Program (T-GLIP), which is funded through the Thai Health Promotion Foundation. The need for the project arose from an increasing awareness of trans-boundary health impacts and the need to prevent and manage them through regional collaboration.

Copies of the training manual developed by the Healthy Public Policy Foundation are now available. Forfm more information contact Wipawa Chuenchit.

Planning and Health: Findings from the UK Royal Commission on Environmental Pollution

by Andrew Buroni, RPS Group

The UK Royal Commission on Environmental Pollution (RCEP) is an independent body established to advise the Queen, the Government, Parliament and the public on environmental issues.

The Commission's advice is mainly in the form of reports, of which their most recent is on the Urban Environment. In this report the RCEP acknowledges current shortcomings in the planning system and recommends that the UK government and devolved administrations develop a statutory framework for including Health Impact Assessments in the planning process.

This article provides a summary of the RCEP report, detailing the recommendations to Government and future HIA planning requirements.

Planning and Health
The planning system offers an important opportunity for a more coherent effort to develop cities and improve the health and wellbeing of urban inhabitants.
Evidence suggests that planning can not only be applied to tackle and offset many of the adverse health effects of an urban environment, but can also be applied to address and prevent many of today’s significant physical, mental and social health issues.

The mode of health effect is complex and represents a mixture of physical influences such as the removal of environmental risks, social influences brought about through improved connectivity and support through to behavioral responses from improved perceptions of the environment.

Potential outcomes from more health conscientious planning therefore reflect real opportunities to contribute in reducing cardiovascular and respiratory ailments, obesity, diabetes, road traffic accidents, antisocial behavior and crime and foster improved self-rated health, wellbeing and ultimately healthier communities.
The ethical and financial benefits of preventative health measures over treatment are key to Government policy represented through the White Paper, ‘Saving Lives: Our Healthier Nation’ and supported by the Department of Health, the National Institute of Clinical Excellence and regional Health Authorities.

However, to date, consideration of health and wellbeing has had little influence in urban design and planning and the present planning system is still unable to adequately deal with complex public health issues.

Planning applications for large-scale developments often require an Environmental Impact Assessment (EIA). These assessments can include data on environmental problems like air pollution that can cause health effects, but while they may predict environmental emissions from future developments to compare with relevant standards, they do not always look at health impacts in terms of a population’s vulnerability and exposure to health risks.

EIAs and planning applications therefore tend to not consider health and wellbeing issues in a systematic manner do not recognise the complex interrelations between social and environmental factors and rarely identify measures to enhance health benefits.

Recognition of the planning systems failure to adequately address health is not new. The RCEP’s previous report on Environmental Planning, highlighted the general issues and recommended the Government integrate processes such as Health Impact Assessment (HIA) within EIA back in 2002.

In its response, the government recognised the benefits of HIA, but stated that it was “not persuaded that detailed Health Impact Assessments, which require different expertise and methodologies, should form an integral part of Environmental Impact Assessment at individual project level”.

However, during the most recent RCEP study, the Department of Health supported the inclusion of HIA within the EIA process as the best means of considering health issues in the planning process, and the RCEP strongly concur.
The RCEP therefore reinforces its recommendation that Health Impact Assessments be incorporated explicitly in Sustainability Appraisals, Strategic Environmental Assessments and Environmental Impact Assessments.

In order to implement this, the RCEP further recommend that the UK government and devolved administrations develop a statutory framework for including Health Impact Assessments in the planning process.

Future HIA Requirement in the Planning Process
The RCEP’s study reinforces the consensus view of UK health organisations and Local Government in that a formal requirement to assess the potential health effects of development is long overdue.

In the absence of leadership from Government and a lack of a formal requirement to conduct HIA, Local and Regional Government are developing their own initiatives to ensure that health is addressed in the planning process.

• In London, the Greater London Authority Act (1999) places a duty on the Greater London Authority (GLA) to promote the health of Londoners and to take into account the effect of its policies on health and inequality. Supporting the GLA Act, the Mayor appointed the London Health Commission to drive health improvement in priority areas across London, to investigate specific health issues if it wishes and to drive the practice of HIA across London. Complementing the GLA Act, the Mayor of London has recently released Best Practice Guidance setting out how health inequalities can be tackled through more informed planning, policies and proposals subject to HIA.
  The Welsh Assembly have recently published a Draft Interim Planning Policy Statement on Planning, Health and Well-being, forming the first planning requirement for HIA in the UK.
• The Department of Health and the Health Protection Agency are developing guidance to advise health authorities on how to integrate health into Strategic Environmental Assessment (SEA).
• Primary Care Trusts and Strategic Health Authorities are becoming more involved in the planning process and specifically requesting HIA.
• Developers are voluntarily commissioning HIA to identify potential health risks, to facilitate health improvements and avoid often-costly remediation.

In light of the growing demand and clear benefits of HIA, the RCEP recommendation is likely to be the precursor for the development of the first UK statutory requirement to conduct HIA.

Any further delay by Government may be perceived as a deliberate attempt to avoid tackling the often-emotive topic of health.

New Thai National Health Act: Participatory HIA Enshrined in Law

The Thai National Health Act B.E. 2550 (2007) was recently approved and entered into force on 19th of March. The ambitious legislation includes several sections on HIA, which cover the rights of Thai people to demand a HIA be conducted and to participate in HIA process, as well requiring the development of guidelines and procedures for HIA to be developed by the newly established National Health Committee.

According to the Act, HIA is designed to be a “social learning process”, which has been developed so that all stakeholders in society can be involved in examining the health impacts of policies, projects or activities that have already affected or may affect groups of people. This social learning process involves identifying and supporting the most appropriate alternative in public decision-making processes with the goal of protecting and promoting the health of all people in Thai society.
For more information on the Act email suphakijn@yahoo.com

This post was written by Suphakij Nuntavorakarn from the Thai Healthy Public Policy Foundation and originally appeared in the International Association for Impact Assessment's HIA Quarterly.

Speakers Announced for HIA2007 Conference

The speakers for the HIA2007 South East Asia and Oceania Health Impact Assessment Conference have been announced. The eleven keynote speakers are leaders in their fields and have a diverse array of expertise, ranging from sustainability to healthy urban environments to healthy equity and HIA practice.

To find out more about the HIA2007 South East Asia and Ocean HIA Conference go to http://www.hia2007.com

Confirmed speakers include:

Hugh Barton
WHO Collaborating Centre for Healthy Cities and Urban Policy, University of West England, Bristol

Professor Hugh Barton has conducted extensive research on sustainability, planning and the health impacts of urban environments.

Robert Bos
Sanitation and Health, World Health Organization, Geneva

Robert Bos has an extensive history of developing methods and capacity to use HIA on water resource developments as part of the WHO’s Water, Sanitation and Health Program.

Andrew Gilman
Sustainable Solutions International, Ottawa

Dr Andrew Gilman has had an extensive career working on sustainability and health issues in Canada and internationally. He is the former Director of Health Canada’s Office of Sustainable Development.

Ashley Gould
Welsh Local Government Association, Cardiff

Ashley Gould has worked on a number of health improvement initiatives at the local government level in Wales, including HIA. His current work focuses on capacity building and partnership working for health and wellbeing.

Elizabeth Harris
Research Centre for Primary Health Care and Equity, University of New South Wales, Sydney

Elizabeth Harris’ research led to the development of the Equity Focused Health Impact Assessment Framework. Her work has focused on the development and implementation of policy and practice interventions to reduce health inequalities.

Richard Morgan
Centre for Impact Assessment Research and Training, University of Otago, Dunedin

Professor Richard Morgan has extensive experience in environmental management and HIA. He was president of the International Association for Impact Assessment in 2004.

Rob Quigley
Quigley and Watts Associates, Wellington

Rob Quigley has played a key role in the development of HIA in England and New Zealand. He is actively involved in a range of HIAs across New Zealand.

Wiput Phoolcharoen
Thai Healthy Policy Foundation, Bangkok

Dr Wiput Phoolcharoen has wide-ranging expertise in public health issues in the South East Asian Region. He is the former Director of the Thai Health Systems Research Institute and currently the President of the Thai Healthy Public Policy Foundation

Decharut Sukkumnoed
Thai Healthy Policy Foundation and Kasetsart University, Bangkok

Dr Decharut Sukkumnoed has guided the development of HIA and healthy public policy in Thailand over the past seven years. His work on the health impacts of energy policy has influenced

Daniel Tarantola
Initiative on Health and Human Rights, University of New South Wales, Sydney

Professor Daniel Tarantola has had a distinguished career as an advisor World Health Organization and was involved in the creation of Médecins Sans Frontières. He is best known for his influential work in the area of HIV/AIDS and human rights.

Gareth Williams
Cardiff Institute of Society, Health and Ethics, Cardiff University, Cardiff

Professor Gareth Williams has over 20 years of experience in the sociology of health and wellbeing. His current research looks at the relationships between economic regeneration, community development and sustainable health.

The reflective HIA practitioner

“In a practitioner’s reflective conversation with a situation [an initiative]…she functions as agent/experient.
Through her transaction with the situation, she shapes it and makes herself part of it.”
The Reflective Practitioner by Donald Schön

Journal Watch: New HIA publications and reports

Bhatia R. Protecting Health Using an Environmental Impact Assessment: A case study of San Francisco land use decisionmaking, American Journal of Public Health, 97(3):406-413, 2007.
http://dx.doi.org/10.2105/AJPH.2005.073817

CST. Health Impacts: A strategy across governments (Submission Paper), Council for Science and Technology: London, 2006.
http://www2.cst.gov.uk/cst/reports/files/personal-information/csthealthimpacts.pdf

Jay S et al. Environmental impact assessment: Retrospect and prospect, Environmental Impact Assesment Review, Corrected Proof in Press, 2007.
http://dx.doi.org/10.1016/j.eiar.2006.12.001

Lee K et al. Bridging health and foreign policy: the role of health impact assessments, Bulletin of the World Health Organization, 85(3):207-211, 2007.
http://www.who.int/entity/bulletin/volumes/85/3/06-037077.pdf

Lomas J. The In-Between World of Knowledge Brokering, British Medical Journal, 334:129-132, 2007.
http://www.bmj.com/cgi/reprint/334/7585/129

Mannheimer L et al. Introducing Health Impact Assessment: An analysis of political and administrative intersectoral working methods, The European Journal of Public Health, Corrected Proof in Press, 2007
http://dx.doi.org/10.1093/eurpub/ckl267

OGP & IPIECA. A Guide to Health Impact Assessments in the Oil and Gas Industry, International Petroleum Industry Environmental Conservation Association & International Association of Oil & Gas Producers: London, 2005.
http://www.ipieca.org/downloads/health/hia/HIA.pdf

Scott-Samuel A, O’Keefe E. Health impact assessment, human rights and global public policy: a critical appraisal, Bulletin of the World Health Organization, 85(3):212-217, 2007.
http://www.who.int/entity/bulletin/volumes/85/3/06-037069.pdf

Smith B et al. WHO Health Promotion Glossary: New terms, Health Promotion International, 21(4):340-345, 2006.
http://dx.doi.org/10.1093/heapro/dal033

Developers and Businesses: HIA's forgotten stakeholders

I work with developers and businesses every day and there are times when it can be frustrating to get them to understand why they need to consider health and wellbeing issues beyond occupational health and safety. But often they do engage and do listen though they don't immediately jump to doing HIAs they are thoughtful enough to ask pertinent questions.

One of the most striking things about international policy and practice around project-level HIAs is the complete absence of discussion and debate about how we engage with developers and businesses. For me, they are 'HIA's forgotten stakeholders' or perhaps they are the proverbial 'elephant in the room' everyone knows they're there but doesn't want to look at them or discuss their presence.

Developers are seen as being, and sometimes can be, obstructive and hostile to HIA and its ethos. But often the fault lies as much with us in the public health and HIA community as with developers and businesses. We espouse values of openness and transparency but that seems to extend only to communities, NGOs and public institutions. We see developers as antagonists rather than fellow protagonists in the HIA drama. Society's 'villains' rather than its 'heroes'.

Often we don't even see them as stakeholders, let alone important stakeholders, in the HIA process. And in some cases, apart from wanting to access their environmental and health information, they are actively excluded from the process.

Quite rightly, there are concerns that developers, and businesses in general, have considerable financial power and political influence but we in the HIA community should not be afraid to engage, discuss and debate with them.

We need to be more active in educating, persuading and lobbying these key stakeholders about HIA, it value and how they can become enthusiastic and co-operative partners in the HIA process. Okay, so some of you are going to say 'Enthusiastic partners, never gonna happen!'. Maybe so, but with corporate social responsibility, ethical funds and sustainable actions growing in prominence developers and businesses are beginning to understand that need to grapple with the health and wellbeing implications of their plans and projects.

The lack of an active engagement programme, anywhere in the world, that reaches out to and engages with this group is startling and a critical weakness of current HIA policy and practice. Why so? Because ultimately it is businesses and local communities who tend to foot the bill for HIAs either directly or through taxes.

Having a proactive engagement process with developers and businesses has more pros than cons if we are strong in our values. It is only by proactively engaging with them and winning them over that we can transform their vision of the world and the free market to include health and wellbeing - alongside sustainability and the environment - as a critical factor in enhancing their business success.

Lastly, if Greenpeace and Friends of the Earth can do it why shouldn't and why can't we?

Post-Normal Science, Community Knowledge and HIA

Post-normal science is a philosophical framework which argues that when normal science cannot predict future consequences with any degree of certainty and decisions with a strong social and political dimension need to be made, i.e. when facts are uncertain and decisions urgent, then using an extended peer community of affected stakeholders to review and ‘quality assure’ the facts and help develop a consensus way forward leads to more accurate and robust scientific decision-making.

Post normal science argues that 'normal' science works best when the uncertainty is limited and the importance of the decision is low. In such contexts the 'technical' uncertainty is reduced by using statistics. When uncertainty is greater and the decision stakes higher then professional judgement and consensus are used to reduce the uncertainty (alongside statistics). However, in contexts with high uncertainty and high decision stakes statistics and professional consensus are not enough. In these situations creating a larger peer review community made up of both professionals and lay people is also needed to 'quality assure' and enhance the accuracy and robustness of the predictions, judgements and decisions made.

What are the implications of this for HIA practice?

HIA involves the prediction of health and wellbeing impacts of a diverse group of individuals and communities, via compex pathways and over long periods of time. This high uncertainty is often married to high stakes local and regional or national decision-making e.g. the siting of waste and major other facilities.

The primary goal of community engagement in HIA is therefore less about consulting, involving or empowering (though these are important objectives in themselves) and more about uncovering the localised experiential knowledge base that communities have about both the existing negative impacts in their neighbourhoods and the potential impacts that might emerge if a proposed plan, programme or project is implemented.

Communities have valuable experiential knowledge about how their comunities work and how projects and plans have fared in the past that is crucial to gaining a holistic understanding of the potential health and wellbeing impacts. However, it is not enough or scientifcally acceptable just to ask communities about what they would like and what they think the positive and negative health impacts might be of a plan or project; but also - and more importantly - why they think so and what evidence they have that what they say is likely to happen.

HIA practitioners need to weigh up and evaluate this community evidence and assess its worth just as they would do with any other form of evidence. Who is saying what and why, how long have they lived in the area, do they cite examples and provide evidence that can be verified through other sources, how much agreement and disagreement is their between individual members of a community and on what issues.

Community evidence can therefore be critically reviewed in much the same way that other scientific evidence is reviewed and evidence review structures need to be developed to accommodate this kind of evidence. Post-normal science provides the foundations for developing such structures and processes.

Post-normal science makes it scientifcally possible to incorporate community experiential knowledge into the HIA process and provide justification for the importance of community knowledge and how this knowledge makes impact assessments more robust, rigourous and relevant.