Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Rom 380A, Baltimore, MD, 21205, USA.
Health Impact Project, The Pew Charitable Trusts, 901 E Street NW, Washington, DC, 20004, USA.
BMC Public Health. 2019 Jul 3;19(1):862. doi: 10.1186/s12889-019-7165-7.
As part of efforts to expand Health in All Policies (HiAP) in Washington State in the U.S., the Washington State Board of Health (BOH) received statutory authority in 2006 to conduct Health Impact Reviews (HIRs). HIRs analyze the potential impacts of proposed legislation and budget decisions on health and health disparities. Public health professionals who are aware of HIRs are interested in adopting a similar process in their states; however, there is limited information about HIRs, how they are perceived, and how they could advance HiAP.
This research involved a descriptive analysis of a sample of HIRs and semi-structured interviews with a purposive sample of 17 key informants. For the descriptive analysis, all HIRs requested or completed between January 1, 2007 and April 1, 2016 that had a request form submitted by a legislator or the governor that was available in the BOH's online database were reviewed. Information was collected on several variables including the bill number and title, sponsor and political affiliation, and the sector to which the bill or budgetary proposal pertained. A purposeful sample of legislators, staff, advocates, and lobbyists who were involved with HIRs during the study period were invited to participate in semi-structured interviews. Topic coding was used to identify key themes from the qualitative data.
During the study period, 20 legislators requested 36 HIRs; 32 HIRs were completed. HIRs were requested for several bill topics, including education (11/36) and labor and employment (9/36). Legislators who requested HIRs felt they provided valuable data on health and health disparities for proposed bills. Individuals who were less supportive of HIRs perceived them as an advocacy or political tool. The main barrier to widespread use of HIRs in Washington was a lack of awareness among legislators.
HIRs are one strategy to advance HiAP for state policy decisions. HIRs are a potentially effective tool for highlighting how legislative proposals and budgets positively and negatively impact health and health disparities. Future efforts should promote awareness and highlight shared benefits of HIRs among legislators and their staff, as well as their scientific integrity, methodological rigor, and objectivity.
作为美国华盛顿州扩大“健康政策中的一切”（HiAP）努力的一部分，华盛顿州卫生局（BOH）于 2006 年获得法定授权，以进行健康影响评估（HIRs）。HIRs 分析拟议立法和预算决策对健康和健康差距的潜在影响。了解 HIRs 的公共卫生专业人员有兴趣在其所在州采用类似的程序；然而，关于 HIRs 的信息有限，人们对其的看法以及它们如何推进 HiAP。
本研究对 2007 年 1 月 1 日至 2016 年 4 月 1 日期间提交给 BOH 在线数据库的立法者或州长提交的请求表进行了描述性分析，并对 17 名关键信息提供者进行了半结构式访谈。在描述性分析中，审查了所有 HIRs 请求或完成的信息，这些 HIRs 请求或完成是在 2007 年 1 月 1 日至 2016 年 4 月 1 日期间由立法者或州长提交的，并且在 BOH 的在线数据库中可用。收集了法案编号和标题、赞助人和政治派别以及法案或预算提案所属部门等几个变量的信息。邀请了参与研究期间 HIRs 的立法者、工作人员、倡导者和游说者参加半结构式访谈。使用主题编码从定性数据中确定关键主题。
在研究期间，有 20 名立法者要求进行 36 次 HIRs；完成了 32 次 HIRs。HIRs 是针对多个法案主题提出的，包括教育（11/36）和劳动就业（9/36）。提出 HIRs 请求的立法者认为，这些请求为拟议法案提供了有价值的健康和健康差距数据。对 HIRs 不太支持的人认为它们是一种宣传或政治工具。HIRs 在华盛顿州广泛使用的主要障碍是立法者缺乏意识。
HIRs 是推进州政策决策中 HiAP 的一项战略。HIRs 是突出立法提案和预算对健康和健康差距产生积极和消极影响的一种潜在有效工具。未来的努力应提高立法者及其工作人员对 HIRs 的认识，并突出其科学完整性、方法严谨性和客观性，以及共享利益。
