Health impact assessment of Roma housing policies in Central and Eastern Europe: A comparative analysis

Marginalised Roma communities in European countries live in substandard housing conditions the improvement of which has been one of the major issues of the Decade of Roma Inclusion, the ongoing intergovernmental European Roma programme. The paper presents EU-funded health impact assessments of national Roma housing policies and programmes in 3 Central and Eastern European countries in light of the evaluation of a completed local project in a fourth CEE country so as to compare predicted effects to observed ones. Housing was predicted to have beneficial health effects by improving indoor and outdoor conditions, access to services, and socioeconomic conditions. Negative impacts were predicted only in terms of maintenance expenses and housing tenure. However, observed impacts of the completed local project did not fully support predictions especially in terms of social networks, satisfaction with housing and neighbourhood, and inhabitant safety. In order to improve the predictive value of HIA, more evidence should be produced by the careful evaluation of locally implemented housing projects. In addition, current evidence is in favour of planning Roma housing projects at the local rather than at the national level in alignment with the principle of subsidiarity.     

Canadian insights: The challenges of an integrated environmental assessment framework

The paper draws results from a review of literature to examine the strengths and weaknesses of the integrated environmental assessment framework in Canada with respect to the inclusion of health impact assessment. Insights include the legislative nature, rigid structure and priority for the natural environment that may restrict progress and the pool of government agencies that need to be convinced of the benefits of health impact assessment that may provide a strong structure for compliance in the long term.     

环境质量评价中关键因子识别的方法研究

应用投影寻踪聚类方法分析环境影响指标的数据资料 ,不但可以根据数据内在特性确定各评价指标的相对权重 ,避免权重人为给定的任意性 ,而且还可以通过逐次筛选找出影响环境质量的关键因子。本文将该方法成功地应用于南京市秦淮河水环境评价中 ,筛选出了影响秦淮河水质的关键因子 ,可供秦淮河水环境监测和治理作参考。另一方面 ,该方法还可以推广应用于其它类似问题的综合分析研究中。     

Rethinking human health impact assessment

Most EIA programs around the world require the consideration of human health impacts. Yet relatively few EIA documents adequately address those impacts. This article examines how, why, and to what extent health impacts are analyzed in environmental impact assessments in the U.S. An empirical study of 42 environmental impact statements found that more than half contained no mention of health impacts. In the others, health impacts were analyzed narrowly, if at all, using risk assessment to quantify the carcinogenic potential of a single substance over a single generation. This analytic focus overlooks other significant morbidity and mortality risks, cumulative and intergenerational effects, and broader determinants of health. This article investigates these problems and provides recommendations to improve human health impact assessment, using strategic environmental assessment, qualitative health data, health outcomes in addition to cancer, and a precautionary approach to risk.     

Can health feasibly be considered as part of the planning process in Scotland?

The planning system is significant because of its capacity to determine the quality of the built environment as well as the health, well-being and quality of life of the individuals and communities therein. Development planning is especially important because of the long-term impact of the decisions. This paper was developed in response to increasing recognition amongst HIA practitioners in Scotland of the importance of planning for health. It focuses on the relationship between the planning system in Scotland, specifically the Development Planning element of it, and population health and considers how the health impact assessment (HIA) approach can facilitate and support joint working with planners. In particular, consideration is given to the potential impact of the introduction of Strategic Environmental Assessment (SEA) on the linkages between health, HIA and planning.     

Integrating environmental impact assessment with master planning: lessons from the US Army

The US National Environmental Policy Act (NEPA) requires agencies to consider environmental impacts in the early stages of planning and decision-making. Despite this mandate, agencies typically conduct EIA for projects, rather than for earlier and more strategic decisions, such as plans. This research investigated the extent to which a large federal agency, the US Army, has integrated NEPA analyses with master planning for their installations. Using in-depth case studies of 16 installations, we investigated how and why EIA was (or was not) integrated with planning, and identified the factors that promote or impede integration. Typically, integration has been regarded as concurrence, meaning that the EIA and planning processes are conducted together. Results of this research show, however, that integration can occur, even if the NEPA documents and master plans are not concurrently prepared. In this sense, integration can be viewed as the influence of the EIA process on agency planning and decision-making. Results also indicate that regulations are only one factor, and that several other factors influence the extent of integration, such as agency leadership and organizational incentives. Lessons from this study can help improve both the integration and the substantive implementation of EIA.     

Assessing health consequences in an environmental impact assessment: The case of Amsterdam Airport Schiphol

In this article a comprehensive approach for the evaluation of possible health effects in an environmental impact assessment (EIA) is described, illustrated with the example of Amsterdam Airport Schiphol. Unlike many EIAs, we estimated quantitatively the impact of aircraft-related pollution in terms of the number of affected people for aircraft noise annoyance, odour annoyance and hypertension. In addition, an analysis of health registry data on cardiovascular and respiratory diseases and a short survey on annoyance and risk perception were carried out. The scope of a health impact assessment depends on the situation, available knowledge and data, concern in the population about the impact and the number of people concerned. It is important to pay attention to the perception of risks and concerns from all parties involved. Moreover, the results demonstrate that far more people outside the area for which standards apply were affected than inside.     

广州经济技术开发区西区环境区域影响评价的回顾

目前国内对环境影响评价的回顾评价还较少,本文通过对广州经济技术开发区的西区污染现状的调查与资料收集、现场监测与评估,对广州经济技术开发区的西区环境区域回顾评价进行了探索。     

Evaluating the impact of HIA on urban reconstruction decision-making. Who manages whose risks?

Practitioners and academic researchers increasingly look to evaluation of health impact assessment (HIA) to improve its practice, its efficiency and its legitimacy. Evaluation is also used to account to policy-makers, who express doubts that the benefits of HIA justify its costs. Until recently evaluation of HIA focused on instrument design and procedures but now the focus needs to shift to analysis of the interaction of HIA and decision-making. Multiple case studies have been applied to identify the conditions in which HIA produces the desired benefits. These studies used analytical concepts derived from the literature on evaluation, knowledge utilization, science of sociology and knowledge management.This paper describes a case study in which the strategic motives of the decision-makers affected the impact of an HIA. This HIA comprised of a quantitative environmental model ‘City & Environment’ that was used to assess environmental health impacts of an urban reconstruction plan in a Dutch city. The evaluation of the HIA shows that the decision to follow the recommendations of the HIA was part of a damage control strategy. The more HIA goals deviate from the policy problem and the less HIA is embedded in institutional procedures, then the more HIA impact will be subject to strategic decision-making behaviour. Appropriate cognitive and social strategies are needed to avoid ‘negative learning’ in those the HIA seeks to influence.     

Environmental impact assessment (EIA) as collaborative learning process

A collaborative problem-solving approach was applied to environmental impact assessment of regional waste management strategy in Pirkanmaa, Finland. Various actors—interest groups, authorities, and experts—were invited to engage in joint fact finding and to exchange their views on the goals of alternative waste management strategies. The experiences of these encounters suggest that collaborative EIA can serve as a learning and civic discovery process where people can act together and find new solutions. During the process, the participants were able to reflect on their preferences and factual beliefs and to create a previously unconsidered waste management strategy that most parties found acceptable. The potential for learning and finding mutually acceptable solutions depended, however, on the legitimacy and institutional settings of the process: to what extent different perspectives were considered in the process, not only included, and how EIA was connected to a political decision-making process.     

Stakeholder participation in health impact assessment: A multicultural approach

The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture.     

The impact and effectiveness of health impact assessment: A conceptual framework

The use of health impact assessment (HIA) has expanded rapidly and there are increasing demands for it to demonstrate its effectiveness. This paper presents a conceptual framework for evaluating HIA and describes its development through (i) a review of the literature, (ii) a review of work undertaken as part of a major HIA capacity building project and (iii) an in-depth study of seven completed HIAs. The framework emphasises context, process and impacts as key domains in understanding and evaluating the effectiveness of an HIA. This new framework builds upon the existing approaches to evaluating HIA and extends them to reflect the broad range of factors that comprise and influence the effectiveness of HIAs. It may be of use in evaluating completed HIAs and in planning HIAs that are yet to be undertaken.     

HIA, the next step: Defining models and roles

If HIA is to be an effective instrument for optimising health interests in the policy making process it has to recognise the different contests in which policy is made and the relevance of both technical rationality and political rationality. Policy making may adopt a rational perspective in which there is a systematic and orderly progression from problem formulation to solution or a network perspective in which there are multiple interdependencies, extensive negotiation and compromise, and the steps from problem to formulation are not followed sequentially or in any particular order. Policy problems may be simple with clear causal pathways and responsibilities or complex with unclear causal pathways and disputed responsibilities. Network analysis is required to show which stakeholders are involved, their support for health issues and the degree of consensus.From this analysis three models of HIA emerge. The first is the phases model which is fitted to simple problems and a rational perspective of policymaking. This model involves following structured steps. The second model is the rounds (Echternach) model that is fitted to complex problems and a network perspective of policymaking. This model is dynamic and concentrates on network solutions taking these steps in no particular order. The final model is the “garbage can” model fitted to contexts which combine simple and complex problems. In this model HIA functions as a problem solver and signpost keeping all possible solutions and stakeholders in play and allowing solutions to emerge over time. HIA models should be the beginning rather than the conclusion of discussion the worlds of HIA and policymaking.     

Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys

The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed.     

Combining policy instruments for sustainable energy systems: An assessment with the GMM model

An assessment of the impact of an illustrative portfolio of policy instruments that address different sustainability concerns in the global energy system in areas of climate change, air pollution and introduction of renewable-energy resources is conducted. The effects of a policy set containing three instruments, implemented either individually or in combination, were examined. The policy instruments under examination in this work include: Cap-and-Trade policies imposing a CO₂ emission reduction target on the global energy system, a renewable portfolio standard that forces a minimum share of renewable electricity generation, and the internalisation of external costs of power generation associated with local pollution. Implementation of these policy instruments significantly changes the structure and environmental performance of the energy sector, and particularly the structure of the electric-generation sector. The positive effects are amplified when the policy instruments are simultaneously applied, illustrating the potential for synergies between these energy-policy domains. The analysis has been conducted with the multi-regional, energy-system Global MARKAL Model (GMM), a “bottom-up” partial-equilibrium model that provides a detailed representation of energy technologies and endogenizes technology learning. ^★A preliminary version of this paper has been presented at the 6th IAEE European Energy Conference on “Modelling in Energy Economics and Policy”, 1–3 September 2004, ETH Zürich, Switzerland.     

Fuzzy clustering analysis in environmental impact assessment — A complement tool to environmental quality index

In spite of rapid progress achieved in the methodological research underlying environmental impact assessment (EIA), the problem of weighting various parameters has not yet been solved. This paper presents a new approach, fuzzy clustering analysis, which is illustrated with an EIA case study on Baoshan-Wusong District in Shanghai, China. Fuzzy clustering analysis may be used whenever a composite classification of environmental quality/impact incorporates multiple parameters. In such cases the technique may be used as a complement or an alternative to comprehensive assessment. In fuzzy clustering analysis, the classification is determined by a fuzzy relation. After a fuzzy similarity matrix has been established and the fuzzy relation stabilized, a dynamic clustering chart can be developed. Given a suitable threshold, the appropriate classification can be accomplished. The methodology is relatively simple and the results can be interpreted to provide valuable information to support decision making and improve management of the environment.     

Health impact assessment and health equity in sub-Saharan Africa: A scoping review

BackgroundNatural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa.MethodologyWe conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community.ResultsOut of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators.ConclusionsWe found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals.     

Quantitative health impact assessment methodology for societal initiatives: A scoping review

Health initiatives are increasingly situated outside the institutionalised public health sector. The intersectoral character of societal initiatives, along with indirect relationships between initiatives and health, makes making projections of reach, impact and goal achievement complex. This scoping review of the peer-reviewed literature searches for appropriate methods to conduct quantitative health impact assessment for such initiatives. Database searches were done in PubMed and Web of Science, as well as a reference list search. Studies were then selected in a systematic manner. The review includes 64 studies. Most studies made estimates using simulation methods, notably with Monte Carlo, Markov and system dynamics modelling. Inputs for the models such as transition probabilities and price elasticities were taken from census, register and survey data, evidence from previous (scientific) studies and sometimes outcomes from stakeholder participation. Of different health outcome measures, the number of deaths was most frequently used, followed by QALYs and DALYs and life years. Health effect distribution is frequently mentioned, but not often estimated. Scientific methodological publications on HIAs focusing on civil society initiatives are relatively sparse, indicating possibilities for further methodological advancement. Estimating health effect distributions and incorporating stakeholder participation could make meaningful additions to standard practice.     

Fuzzy-based computational intelligence to support screening decision in environmental impact assessment: A complementary tool for a case-by-case project appraisal

Screening is a key stage in environmental impact assessment (EIA), but the most common approach based on policy delineation are inherently arbitrary. On the other hand, a case-by-case approach can be complex, slow, and costly. This paper introduces a computational intelligence based on hybrid fuzzy inference system (h-FIS), combining data-driven and expert knowledge, in order to assess its capability of supporting a case-by-case screening in project appraisal. For empirical research, a dataset with appraisal variables of projects highway was made available by a Brazilian environmental protection agency (EPA). Firstly, using this dataset, multivariate analyses were performed to find criteria (x_i) capable of indicating statistically significant differences among projects, previously screened by EPA experts into three types (simplified, preliminary, and comprehensive) of environmental impact study (EIS). Then, h-FIS was built through machine learning, using the FRBCS·W algorithm, with x_i as input predictors and the type of EIS as the output target. The performances of alternative approaches were compared using cross-validation accuracy tests and the kappa index, with a significance level of 0.05. As a result, the h-FIS achieved accuracy of 92.6% and a kappa index of 0.88, which represented almost perfect agreement between the screening decision provided by the h-FIS and the one performed by the EPA experts. In conclusion, the fuzzy-based computational intelligence was capable of dealing with the complexity involved in screening decision. Therefore h-FIS be considered a promising complementary tool for a case-by-case project appraisal in EIA. For further advances, future research should assess other algorithms, such as genetic fuzzy systems, in order to strengthen the proposed system and make it generally applicable in other projects subject to EIA.