Dannenberg Andrew L
Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Box 357234, Seattle WA 98195-7234. E-mail:
Prev Chronic Dis. 2016 Jun 30;13:E84. doi: 10.5888/pcd13.150559.
Since the 1990s, the use of health impact assessments (HIAs) has grown for considering the potential health impacts of proposed policies, plans, programs, and projects in various sectors. Evaluation of HIA impacts is needed for understanding the value of HIAs, improving the methods involved in HIAs, and potentially expanding their application. Impact evaluations examine whether HIAs affect decisions and lead to other effects.
I reviewed HIA impact evaluations identified by literature review and professional networking. I abstracted and synthesized data on key findings, success factors, and challenges from 5 large evaluations conducted in the United States, Europe, Australia, and New Zealand and published from 2006 through 2015. These studies analyzed impacts of approximately 200 individual HIAs.
Major impacts of HIAs were directly influencing some decisions, improving collaboration among stakeholders, increasing awareness of health issues among decision makers, and giving community members a stronger voice in local decisions. Factors that contributed to successful HIAs included engaging stakeholders, timeliness, policy and systems support for conducting HIAs, having people with appropriate skills on the HIA team, obtaining the support of decision makers, and providing clearly articulated, feasible recommendations. Challenges that may have reduced HIA success were poor timeliness, underestimation of time and resources needed, difficulty in accessing relevant data, use of jargon in HIA reports, difficulty in involving decision makers in the HIA process, and absence of a requirement to conduct HIAs.
HIAs can be useful to promote health and mitigate adverse impacts of decisions made outside of the health sector. Stakeholder interactions and community engagement may be as important as direct impacts of HIAs. Multiple factors are required for HIA success. Further work could strengthen the role of HIAs in promoting equity, examine HIA impacts in specific sectors, and document the role of HIAs in a "health in all policies" approach.
自20世纪90年代以来，健康影响评估（HIA）的应用不断增加，用于考量各部门拟议的政策、规划、项目和方案可能对健康产生的影响。为了解健康影响评估的价值、改进健康影响评估所涉及的方法并可能扩大其应用范围，需要对健康影响评估的影响进行评价。影响评价考察健康影响评估是否会影响决策并导致其他效果。
我通过文献综述和专业网络确定了健康影响评估影响评价的相关内容。我从2006年至2015年在美国、欧洲、澳大利亚和新西兰开展并发表的5项大型评价中提取并综合了关于关键结果、成功因素和挑战的数据。这些研究分析了约200项个体健康影响评估的影响。
健康影响评估的主要影响包括直接影响一些决策、改善利益相关方之间的协作、提高决策者对健康问题的认识以及让社区成员在地方决策中拥有更强的话语权。促成健康影响评估成功的因素包括让利益相关方参与、及时性、开展健康影响评估的政策和系统支持、健康影响评估团队具备适当技能的人员、获得决策者的支持以及提供明确阐述且可行的建议。可能降低健康影响评估成功率的挑战包括及时性差、对所需时间和资源估计不足、获取相关数据困难、健康影响评估报告中使用行话、难以让决策者参与健康影响评估过程以及缺乏开展健康影响评估的要求。
健康影响评估有助于促进健康并减轻卫生部门以外做出的决策产生的不利影响。利益相关方互动和社区参与可能与健康影响评估的直接影响同样重要。健康影响评估的成功需要多个因素。进一步的工作可以加强健康影响评估在促进公平方面的作用，研究特定部门的健康影响评估影响，并记录健康影响评估在“所有政策均考虑健康”方法中的作用。
