Interesting editorial in the latest issue of
Environmental Health Perspectives. Below are the extracts that I liked that has relevance for HIA [emphasis added and phrases in square brackets]:
"...In the early 1900s, the environment was already well understood to be an important contributor to health, and its importance was routinely taught to [medical and nursing] students. Think of
Florence Nightingale’s 6 Ds of disease: dirt, drink (clean drinking water), diet, damp, drafts, and drains (proper drainage and sewage systems). With the advent of high-tech medicine, however, these fundamentals began to receive short shrift in graduate education. At the same time, the house call - a home visit that allowed the physician to view the environment in which the patient lived - became increasingly rare, and doctors’ visits began to take place in the confines of modern offices or hospitals, far removed from the day-to-day surroundings of the family. Over time, the environment became “invisible” to the medical practitioner.
...Why has it been so difficult to move from knowing to doing? First, many of the decisions affecting children are made not by those in the health sector, but by our professional colleagues in the agriculture, education, energy, housing, mining, and transportation sectors.
Just as “men are from Mars and women are from Venus,” it seems as if professionals in each of these sectors are from different planets. Although we may speak the same language, we rarely have more than a cursory understanding of the forces that shape one another’s decisions and other considerations...
Professionals in the health sciences may work alongside professionals in other sectors, but we are absorbed in our own activities and usually have little interaction outside them. Instead of sitting at the table with urban planners, housing specialists, and energy experts when health professionals are planning an approach to a child health problem such as asthma, we usually move forward to design a study, implement it, analyze the results, and then present it as a fait accompli to our colleagues in other economic sectors, and hope that they will find it useful.
...This is not the ideal way to engage them. We medical professionals need to fully engage with other sectors as we launch our attempts to find solutions to child health problems. Major breakthroughs are likely to occur in protecting children from hazards in the environment only when we establish strong working relationships with those who haven’t been trained as we have and who don’t think as we do. One tool that helps different sectors to interact is Health Impact Assessment, pro- moted by the WHO (2010b) and by many countries including the United States. Health Impact Assessment helps decision makers make choices about alternatives and improvements to prevent disease/injury and to actively promote health. A recent White House Task Force on Childhood Obesity report recommends that communities consider integrating Health Impact Assessment into local decision-making processes before undertaking any major new development or planning initiative (White House Task Force on Childhood Obesity 2010."
Click here to go to the October 2010 Table of Contents.
Click here to download the article as a PDF.
Image Source: Salim Vohra
