Guest post by Michiko Hoshiko
Health
Impact Assessment (HIA) is not yet a routine part of public decision-making in
Japan, though there are an increasing number of examples of HIA’s use.
Before
any regulatory assessment measure can be adopted in Japan it’s necessary to
demonstrate its economy, efficiency and effectiveness, so this forms the focus
of much current HIA activity. In 2011 the Japanese Public Health Association
produced guidance on HIA 1), focusing on how to do it.
The
Kurume University School of Medicine and the University of Occupational
Environmental Health have been centres for the development of HIA in Japan to
date. The case studies below describe some of the HIAs and research that
has been conducted.
Kurume
University School of Medicine
1) Health impact assessment of the
transition to a core city in Japan2)
The city
of Kurume became a core city in 2008, which is a more autonomous level of
regional government that some cities in Japan are eligible for. A core city
requires a population at least 300,000 people and allows the transfer of
administrative authority from prefecture to more independent municipal
government. A rapid HIA was conducted on the transition to a core city because
potential health impacts were identified for public servants in Kurume as well
as residents.
2) Assessing the validity of health impact
assessment predictions regarding a Japanese city’s transition to core city
status: A monitoring review3)
The
validity of health impact assessment predictions has not been accurately
assessed comparing predictions with subsequent data. An HIA into the transition
of Kurume to a core city was conducted before the transition, but the
recommendations were not accepted and adopted by city officials. A monitoring
review was performed one year after the transition to guage the accuracy of the
HIA predictions by evaluating the correlation between the predicted impacts and
what ended up happening.
3) Prioritization of
health impact assessment on the management transformation of a
municipal hospital in Japan
Municipal hospitals in Japan are
currently facing a serious eonomic management crisis because of operating
deficits and doctor shortages. Unprofitable departments, including obstetrics
and paediatrics, have been closed at some hospitals, which has caused controversy
in a number of local communities. The aim of our study was to examine the health-related impacts
of management and service changes at a municipal hospital close to the Kurume
University School of Medicine on residents, patients, and hospital staff.
4)
Development of a Health Impact Assessment
Screening Tool for Use at the Municipal Level4)
The aim of this study was to make an HIA
screening tool for use at the municipal level in Japan. The HIA screening checklist is versatile and applicable across a range of
projects. The intended users are municipal officers and as such we wanted it to
be short and usable.
University
of Occupational Environmental Health)
5) Development of
HIA screening tools for policies and projects5)6)
In
screening you try to identify as many potential health impacts as possible.
This should include not only scientific knowledge but also “lay knowledge” that
incorporates information such as the anxieties and fears of stakeholders. This
screening tool allows stakeholders to participate in the identification of
potential health impacts and to characterize them in terms of being positive
and negative, as well as their potential severity. This is then used in the
decision to proceed with the HIA or not.
6) HIA of closing
a research laboratory7)
Due to
changes in the economic climate a major laboratory for an international
corporation was closed. An HIA was conducted to look at the potential impacts
on workers, who are both domestic and come from overseas.
7) HIA for
introducing for reemployment system after retirement8)
Japan is
facing a rapidly ageing population, with reduced birth rates and the retirement
of the post-war Baby Boomers. A number of companies have reintroduced
“re-employment” shemes for workers who have already retired to address workforce
shortages. This HIA looked at the potential positive and negative health
impacts of re-employment schemes.
