Health impact assessment

doi:10.1136/bmj.320.7246.1395

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Karen Lock, specialist registrar in public health (klock@esbhhealth.cix.co.uk)

East Sussex, Brighton, and Hove Health Authority, Lewes, East Sussex BN7 2PB

Accepted 22 February 2000

It is widely accepted that the health of a population is determined by a range of factors and that the greatest scope for improving the public's health lies outside the control of the NHS. Health impact assessment (HIA) has emerged to identify those activities and policies likely to have major impacts on the health of a population.

Summary points

Health impact assessment is a structured method for assessing and improving the health consequences of projects and policies in the non-health sector

It is a multidisciplinary process combining a range of qualitative and quantitative evidence in a decision making framework

Applications include national policy appraisal, local urban planning, transport, and water and agricultural projects

Benefits include improved interagency collaboration and public participation

Limitations include a lack of agreed methods and gaps in the evidence base for health impacts

Health impact assessment

Health impact assessment is a means of evidence based policy making for improvement in health. It is a combination of methods whose aim is to assess the health consequences to a population of a policy, project, or programme that does not necessarily have health as its primary objective.1

Health impact assessment is a multidisciplinary process within which a range of evidence about the health effects of a proposal is considered in a structured framework. It takes into account the opinions and expectations of those who may be affected by a proposed policy. Potential health impacts of a proposal are analysed and used to influence the decision making process.

Potential users

A health impact assessment is based on a broad model of health, which proposes that economic, political, social, psychological, and environmental factors determine population health (box B1). For the first time these wider determinants of health have been acknowledged by the UK government in the white paper Saving Lives: Our Healthier Nation.2 This …