CAN HEALTH IMPACT ASSESSMENT (HIA) BE A PLATFORM FOR SYNERGY BETWEEN ENVIRONMENT AND HEALTH? A CROSS-COUNTRY COMPARISON

M. Negev, N. Davidovitch, H. Levine, R. Bhatia, J. Mindell

Research output: Contribution to conferenceAbstract

Abstract

Background and aims: Natural and manmade physical environments are influential determinants of health. Sound public policy requires consideration of health, and working across diverse institutions; however, institutional fragmentation and interdisciplinary specialization are potent barriers to this end. HIA practice is promoted internationally as a means of assessing health impacts of policies, plans and projects. We examine whether using HIA in decision-making has led to changes in intersectoral collaboration.
Methods: We utilize a case study approach, describing the evolution and outcomes of HIA initiatives in three countries. We examine whether HIA has led to procedural and substantive outcomes changes, including working relationships between environmental and health disciplines; inclusion of health in assessment and design practices; public and political understanding of the health-environment nexus; and policy, legislation, and regulations. We identify obstacles to inter-sectoral cooperation that HIA may trigger or expose.

Results: The country cases demonstrate diverse relationships, coalitions and disputes between environment and health professionals. In the USA, HIA has demonstrated the need for and feasibility of greater inclusion of health effects in the existing EIA process. It has been a catalyst for advancing health objectives with participation of economic development, transportation, and land-use planning institutions. In Israel, HIA exposed tensions between environment and health professionals, partially overcome in joint work to legislate HIA within EIA, stemming from realization of mutual interests. In the UK, HIA has often been undertaken in cases in which EIA is not conducted, such as policies and urban regeneration, developed and conducted by health practitioners independently of environmental practitioners.
Conclusions: The coalitions of health and environment experts recently formed around promoting HIA demonstrate it is a common ground for advancing mutual interests. While these interdisciplinary coalitions are complex and differences are hard to mitigate, they enable overcoming antagonism, and can serve as a platform for synergy.
Original languageEnglish
StatePublished - 5 Sep 2011

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