European Policy: Health Impact Assessment

This document emerges from the European Policy Health Impact Assessment (EPHIA) project, which was carried out by a team of public health researchers and practitioners from England, Germany, Ireland, and the Netherlands at the request of the European Commission. The remit was to synthesise a generic methodology on health impact assessment (HIA) for use in European Union (EU) policy development, to apply this methodology to selected EU policies, and to disseminate the results of this process through seminars and publications like this one. For more information on this project, please visit the International Health Impact Assessment Consortium (IMPACT) website.

As noted in this 28-page guide, HIA "has been defined as a combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population (Lehto & Ritsatakis, 1999). It aims to identify what potential changes in health determinants might result from a new policy or project, for example an employment or transport policy, and what effects these changes might have on the health of a population. The assessment of the differential distribution of effects across the population is essential to analysing the potential impact on health inequalities."

This document provides a step-by-step explanation of HIA procedures and methods, defining the purpose, skills needed, and outputs. In brief, EPHIA "is a collaborative process whose benefits are best realised through shared ownership...EPHIA has been designed to be practicable and the methods chosen for each assessment should be appropriate for the time and resources available. The process should be as democratic as possible, with the interests of population groups reflected either through representatives or through direct public involvement of community members themselves. EPHIA is concerned with reducing health inequalities and should assess the differential distribution of health impacts across the population. It should be objective in its identification of evidence of health impacts and data collected should be based on recognised research quality standards. It should be transparent with methods and procedures clearly stated. Recommendations developed through EPHIA should be practicable and achievable and should consider both short and long-term health impacts."

Examples of methods and tools derived from the EPHIA pilots are provided. For instance, some of the health indicators that were included in the HIA pilot of the European Employment Strategy are listed; they include:

• Healthy life expectancy at birth
• Proportion of population who are disabled
• Occupational morbidity

Examples of health determinant indicators include:

• Population by occupational class
• Proportion of unemployment/inactivity
• Proportion employed by status
• Trends in employment

"Through the application of the methodology, EPHIA aims to inform and influence decision-making in the policy development process, adding value to European policy by enabling decision-makers to consider the health implications of their policies".