Banken R
Conseil d'évaluation des technologies de la santé, Montréal, Québec.
Can J Public Health. 1999 Nov-Dec;90 Suppl 1(Suppl 1):S27-30. doi: 10.1007/BF03403575.
The present paper examines the historical evolution of health impact assessments as part of the environmental assessment process. The development of a coherent public health framework must be based on the model of determinants of health, integrating toxic and infectious risks and social impacts of projects. The integration of common concepts, processes and methodologies from the area of public health and social impact assessment challenges the quantitative model approach to risk assessment. The expert-driven risk assessment is transformed into a social learning process where local knowledge and scientific input foster a dialogue among stakeholders. The issue-oriented, iterative and participative assessment process may be applied to the health impact assessment of public policies. Sustainable development with its social objectives of empowerment, participation, equity, poverty alleviation, social cohesion, population stability and institutional development is an appropriate framework for conducting health impact assessments.
本文探讨了健康影响评估作为环境评估过程一部分的历史演变。连贯的公共卫生框架的发展必须基于健康决定因素模型，整合项目的有毒和传染性风险以及社会影响。将公共卫生和社会影响评估领域的共同概念、流程和方法相结合，对风险评估的定量模型方法提出了挑战。由专家主导的风险评估转变为一个社会学习过程，在此过程中，本地知识和科学投入促进了利益相关者之间的对话。以问题为导向、迭代式和参与式的评估过程可应用于公共政策的健康影响评估。以赋权、参与、公平、减贫、社会凝聚力、人口稳定和机构发展等社会目标为导向的可持续发展，是进行健康影响评估的合适框架。
