By Marla Orenstein, Habitat Health Impact Consulting
The Canadian Senate Subcommittee on Population Health has released an interim report on its study of the determinants of health. The purpose of the interim report is to outline the major issues facing the development of population health policy in Canada; to present policy options to improve overall health status and reduce health disparities; and to launch a public debate on the role of the federal government in population health policy.
One of the policy options considered in the report is establishing a federal requirement for the application of HIA to all new public policy proposals. This requirement - if implemented - would bring Canada in line with Sweden and New Zealand, where HIA has become an integral government process.
The report forms the basis for public hearings and consultations that will be held across Canada. Public input is being sought through June 30, 2008. Specific questions relevant to HIA that the subcommittee has raised include: Should the federal government establish a mechanism to allow for or require the application of HIA to all new public policy proposals? Would new legislation be required to do so? Is it realistic to envision HIA as a routine component of all new federal policies and programs? If HIA were to be introduced as a component of federal population health policy, what should be the role and responsibilities of Health Canada, the Public Health Agency of Canada, and central agencies such as Finance Canada and the Treasury Board?
Do you have strong opinions about these issues? Even if you are not in Canada, I urge you to respond directly to the committee at SOC-AFF-SOC@sen.parl.gc.ca
I have been working in HIA some years ago. Since about 7 years, I have been working in Health Technology Assessment, but my past in HIA has caught up with me, I just received an invitation be testify as an expert for the Canadian Senate Subcommittee on Population Health.
ReplyDeleteI have got mixed feelings about the initiative. On one hand I am very enthusiastic about another opportunity for HIA becoming mandatory. (By the way it is mandatory in Québec as well.) On the other hand, I do believe it may be much better to get a strong Health component into SEA, rather than seperating Health from the other dimensions in sustainable development.
Does anybody has some thoughts about the reasons why Health does not seem to be a strong part in SEA? Or are there examples of a good integration of Health into SEA?
Reiner Banken
reiner.banken@aetmis.gouv.qc.ca
Reiner,
ReplyDeleteI like you am ambivalent on the mandatory versus good practice debate and have increasingly tended towards the good practice/voluntary approach to HIAs as having the best traction in terms of getting measures suggested/recommended in HIAs adopted.
The question I have though is whether making it mandatory accelerates the development of HIA methodology because a large critical mass of people start doing them over an extended period of time akin to EIA. Though arguably despite all the time and effort in EIA there are still important gaps.
I also agree with you that hetting a strong health component into SEA should be an important element in HIA practice rather than just stand alone HIAS though I do think there is value in the stand alone HIA as it gives time and greater scope to consider the issues.
There seems to be a varietu of reasons in the UK from our Environment Department (and others) concerned about expanding the scope of SEA and potentially moving it away from its environmental focus to lack of appreciation and ignorance on the part of local authorities and environmental consultancies about the value of incorporating Health/HIA.
In the UK we are moving slowly to developing better SEA and health linkages through some good practice guidance on SEA and health as a first step. The Mayor of London has commissioned a number of SEA/HIAs (or in the UK Sustainability Appraisals/HIA) and I have seen some goodish ones in relation to SEAs of Transport Plans (again in the UK). However many of the good ones were two seprate assessment under the same report cover i.e. because the SEA and HIA teams were seperate the integration between the two elements was not as good.
I did some fairly preliminary work looking at Transport Plan SEAs and health which can be found at Scribd at:
http://www.scribd.com/doc/3588250/LTPs-SEA-and-health-paper-4th-UK-TPM-FINAL