Public Health Wales, Cardiff/Wrexham, Wales, UK.
Department of International Health, Care and Public Health Research Institute - CAPHRI, Maastricht University, Maastricht, The Netherlands.
BMC Public Health. 2021 Jul 27;21(1):1456. doi: 10.1186/s12889-021-11480-7.
Health Impact Assessment (HIA) is promoted as a decision-informing tool by public health and governmental agencies. HIA is beneficial when carried out as part of policy development but is also valuable as a methodology when a policy is being implemented to identify and understand the wider health and well-being impacts of policy decisions, particularly when a decision needs to be taken rapidly to protect the population. This paper focusses on a HIA of the 'Staying at Home and Social Distancing Policy' or 'lockdown' in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA.
A HIA was conducted following a standard HIA five step process. A literature review was undertaken alongside 15 qualitative semi-structured interviews with key stakeholders, and relevant health and demographic data were collated. The results were triangulated and analysed to form a holistic assessment of the policy decision and its impacts.
A wide range of major health and well-being impacts of the lockdown in Wales were identified across the determinants of health, which included positive and negative social, economic, environmental and mental well-being impacts beyond the impact on direct health. Populations affected included children and young people, those on low incomes and women as well as those whose health has been directly impacted by COVID-19 such as older people. The work highlighted the benefit that HIA can bring in emphasizing impacts which can inform policy and shared learning with others.
HIA is a largely underused tool to understand the impact of policy and political decisions, particularly when a decision has been taken at speed. This case study highlights how HIA provide evidence and information for advocacy and further work by public health institutes, health agencies and policy makers.
健康影响评估（HIA）被公共卫生和政府机构宣传为一种决策辅助工具。HIA 在政策制定过程中进行时是有益的，但在实施政策以确定和理解政策决策对更广泛的健康和福祉的影响时，也是一种有价值的方法，特别是在需要迅速做出决策以保护民众时。本文聚焦于威尔士国家公共卫生研究所针对 COVID-19 大流行而进行的“居家和社交隔离政策”或“封锁”的 HIA。它描述了该过程和发现，捕捉了学习成果，并讨论了如何利用该过程更好地理解政策决策对直接健康危害以外的更广泛的健康和福祉的影响。它还考察了公共卫生机构在促进和使用 HIA 方面的作用。
遵循标准 HIA 五步流程进行 HIA。进行了文献综述，同时对 15 名关键利益相关者进行了 15 次定性半结构式访谈，并收集了相关健康和人口数据。对结果进行了三角分析和综合分析，以形成对政策决策及其影响的整体评估。
在威尔士，封锁对健康的各种决定因素产生了广泛的重大健康和福祉影响，这些影响包括超出直接健康影响的积极和消极的社会、经济、环境和精神健康影响。受影响的人群包括儿童和年轻人、低收入人群以及妇女，以及那些健康受到 COVID-19 直接影响的人群，如老年人。这项工作强调了 HIA 可以带来的益处，即强调可以为政策提供信息并与他人共享学习成果的影响。
HIA 是一种了解政策和政治决策影响的工具，尤其是在迅速做出决策时，这种工具在很大程度上未得到充分利用。本案例研究强调了 HIA 如何为公共卫生研究所、卫生机构和政策制定者提供宣传和进一步工作的证据和信息。
