plenary 3 chair: stephen palmer health impact assessment: making the difference

Plenary 3Chair: Stephen Palmer

Health Impact Assessment: Making the Difference

Meri Koivusalo

Researcher, National Research and Development Centre for Health (STAKES),

Helsinki, Finland

Health Impact Assessment: Making the Difference

National Research and Development Centre for Welfare and Health

Knowledge for welfare and health

Health impact assessment and Health in all policies – Finnish experiences and policy issues

Meri KoivusaloSTAKES



HiAP and HIA – the Finnish policy context

Health in all policies (HiAP) - a broad approach to integrating health in all policies which incorporates methods such as health impact assessment (HIA)

HiAP is grounded in a tradition of active public health policies, population-based measures and “healthy public policies”

Long history in Finland North Carelia project and focus on diet and cardiovascular diseases Public policies to change work-place and school diets Influencing pricing and consumer choice towards healthier products and tackling the

current “pizza epidemic”

Administrative tradition of supporting intersectoral consultation, but HiAP generally has to operate in a more contested environment



Health impact assessment

Since 1994 part of statutory environmental impact assessment (EIA) procedures

EIA defined broadly and also covers human health and social impacts

Human impact assessment integrates health and social impact assessments (www.stakes.fi/sva/huia/)

HIA mostly implemented at project and local level



HIA as part of public health programme HEALTH 2015

Commitments to develop and implement HIA Health impacts of other sectoral policies are assessed every fourth year as part of the public health report Commitment to guidance for action on HIA at the level of policies and decisionsResources for Finnish Ministry of Social Affairs and Health to develop and maintain HIA related activities Commitment to enhancing HIA at local level in municipalities and within business



HIA & HIAP – politics, policies and practice

HIA supported, but has limited institutional strength

National level action constrained Decentralisation of administration and independence of municipalities Increasing importance of European level priorities and commercial

policies

Complexity of HIA decisions on nuclear power and departure from environmental policy aims with respect to dioxin levels in Baltic herring Overall policy priorities do not seem to be geared towards healthy public policies, but are more driven by the quest towards innovation and competitiveness

Health care dominates health policy debates Overall productivity aims aimed to diminish size and functions of public

administration



European Union and HIAFinnish longer term aim to emphasise the role and relevance of HiAP approach as part of European Union public health strategy

European Union policies are used to promote the importance of the HiAP approach and HIA in the context of national policies

New debate and discussion in the context of the proposed Constitutional Treaty and health systems

Impact of EU policies felt in relation to required changes in alcohol policies and taxation



Health in All Policies

A special Finnish presidency theme in health

Opens a political window of opportunity at European level

Increasing concerns over not just the health impacts of other policies but health system impacts, and in particular internal markets, trade and interpreting the four freedoms within European Union



Health in All Policies and the EU

HiAP conference 20-21.9.2006 and a book on HiAP High level Expert Conference Plenaries to take up also HIA issues and work

Six preliminary workshops - Health inequalities- Nutrition, physical activity and major diseases- Health targeted alcohol policy- Transport policy and health & planning- Mental Health

Expected outcomes: Draft conclusion on HiAP for European Commission policies and Member State activities

Conclusions for adoption by the Ministerial Council



HIA and European UnionHow to influence the ways in which impact assessment is implemented in EU?

Is a bad HIA process better than no process? Opportunities for stakeholder lobbying prior to policy debate

The importance of impacts on health systems and regulatory measures of governments to promote and protect health being raised at European Union level



The Paradox and Potential of HIA

Institutionalisation of knowledge and practice of HIA remains a challenge in Finland

The promise of HIA is still greater than the practice

The quality and implementation of HIA varies at local and project level

Future prospects depend on the realisation of existing commitments

Potential for gains from strengthening the European dimension of work, training and action



HIA as an aid to Policy Making Should we more effectively use the legislative and policy-making potential of HIA

To support an emphasis on broader social determinants of health To support health systems impact assessment

HIA could be seen as mechanism for promoting transparency, debate and active policy-making

Moving from an emphasis on win-win to a method for challenging conflicting policy aims between sectors and creating space for health arguments

Limiting free movement of advertisements Regulation and use of pricing mechanisms to guide consumption



HIA in Finland

Human impact assessment website: www.stakes.fi/sva/huia/

HUIA: [email protected]

Health Inequalities: [email protected]

Health 2015 programme: [email protected] Website: www.terveys2015.fi/english.html

Health in all Policies (HiAP) presidency from 31.05.2005

Official web-site: www.eu2006.fi

plenary 3 chair: stephen palmer health impact assessment: making the difference

Documents

public health programme

human health

hia health impacts

health stakes

level of policies

development centre

policies hiap

finnish policy context