IAIA Health Quarterly March 2008

From Ben Cave, Co-Chair of the International Association for Impact Assessment Health Section

The latest issue of the IAIA HIA Quarterly is available for download from the IAIA website [PDF 380 Kb].

This issue includes the following articles:

• Ben Cave reports on a meeting between the World Health Organization, the
• International Finance Corporation and the World Bank;
• Maria João Heitor writes about a European meeting in Portugal looking at
• Health, and Health Systems, Impact Assessment;
• Mathias Wismar and Kelly Ernst write about a new publication on the
• effectiveness of HIA;
• Ben Harris-Roxas reports on the South East Asia and Oceania HIA Conference;
• Teresa Lavin and the HIA team at the Institute of Public Health in Ireland
• team describe the 8th International HIA conference held in Dublin;
• Dianne Katscherian describes the forthcoming session on climate change and
• health at IAIA08; and
• there is a round up of new publications and websites and forthcoming events.

We will soon issue a call for contributions to the next Quarterly via HIA listservs.

New South Wales HIA eNews Issue 19: HIA2007 Conference Special Issue

The latest copy of the New South Wales Health Impact Assessment Project eNews is available for download [PDF 960Kb].

In this issue:

• HIA2007 South East Asia and Oceania HIA Conference
• Health Impact Assessment: A Practical Guide
• Thailand: Recent Experiences
• Participate in the HIA2008 Conference in Chiang Mai, Thailand
• NSW Developmental HIA Sites : Coffs Harbour and Oran Park/Turner Road HIAs
• HIA Training 27-29 February 2008
• NZ HIA Support Unit : Building capacity for HIA in New Zealand
• To HIA or Not to HIA?
• Mental Wellbeing Impact Assessment A Toolkit from the UK
• What’s New? HIA Publications and Events

Past issues of the eNews can be downloaded from www.hiaconnect.edu.au/hia_e-news.htm

The New South Wales HIA eNews is produced by the Centre for Primary Health Care and Equity at the University of New South Wales, Australia as part of the NSW HIA Project funded by NSW Health.

Health Impact Assessment: A practical guide

The UNSW Centre for Health Equity Training, Research and Evaluation and NSW Health have published a guide to undertaking health impact assessments. Health Impact Assessment: A practical guide is informed by the experiences of more than twenty health impacts assessments that have been undertaken or supported through the New South Wales Health Impact Assessment Project over the past four years. The guide aims to provide people a practical understanding of HIA, its process, concepts and theories.

A PDF version can be downloaded from http://www.hiaconnect.edu.au/files/Health_Impact_Assessment_A_Practical_Guide.pdf

For a print copy of the guide and/or more information about HIA please phone +61 2 9612 0762 or email s.m.green@unsw.edu.au.

An online version of the guide, with additional materials, links to further resources, and online exercises, is being developed and will be released in 2008 on HIA Connect.

Part One: Overview of Key Concepts
What is HIA?
Why undertake HIA?
What do we mean by ‘health’?
How is health created?
What are health impacts?
HIA is prospective
Broad participation
Equity

Part Two: The Steps in HIA
1. Screening
2. Scoping
3. Identification
4. Assessment
5. Decision-making and recommendations
6. Evaluation and follow-up

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