Improving the effectiveness of project assessment - Introduction to Environmental Impact Assessment - page 346

relationship between developing public participation approaches and the fuller inclusion
of socioeconomic impacts. SIA can establish the baseline of groups which can provide
the framework for public participation to further identify issues associated with a
development proposal. Such issues may be more local, subjective, informal and
judgemental than those normally covered in EIA, but they cannot be ignored. Perceptions
of the impacts of a project and the distribution of those impacts often largely determine
the positions taken by various groups on a given project and any associated controversy.
11.3.5 Health impact assessment (HIA)
Health impact assessment (HIA) is a major growth area in the field of impact assessment,
as evidenced by the popularity in recent years of the HIA 'track' in the annual conference
of the influential International Association for Impact Assessment (IAIA). There has been
a surge of academic papers, reviews, guidelines and websites relating to HIA (Ahmad
2004), but what is HIA, where is it best practised, how is it practised and how does it
relate to EIA as discussed in this topic?
Health includes social, economic, cultural and psychological well-being—and the
ability to adapt to the stress of daily life (Health Canada 1999). Health impact refers to a
change in the existing health status of a population within a defined geographical area
over a specified period of time. HIA is a combination of procedures and methods by
which a policy, plan, programme or project (PPPP) may be judged as to the effects it may
have on the health of a population. It provides a useful, flexible approach to helping those
developing and delivering proposals to consider their potential (and actual) impacts on
people's health, and on health inequalities, and to improve and enhance a proposal
(Taylor and Quigley 2002, Taylor and Blair-Stevens 2002, WHO Regional Office for
Europe 2003, Douglas 2003).
HIA is well advanced in a number of developed countries, particularly Canada, the
Netherlands, in parts of Scandinavia, and more recently in the UK. Some developing
countries are also finding it very relevant to their needs (see Phoolchareon et al. 2003, for
Thailand). Policy drivers can be found at various levels of government. In the UK for
example, see Secretary for State for Health (1999). In the EU, the Directive on SEA
specifically refers to the impact of plans and programmes on human health (see Section
12.3.4).
The main stages in the HIA process are similar to those used in EIA, including:
screening, scoping, profiling (identifying the current health status of people within the
defined spatial boundaries of the project using existing health indicators and population
data), assessment (HIA stresses the importance of consultation with community groups to
identify potential impacts), implementation and decisionmaking, and monitoring and
continual review (Douglas 2003). Of particular use to practitioners are the procedures and
methods, known as the 'Merseyside guidelines for HIA' (Scott-Samuel et al. 2001).
The overlap between HIA and EIA in terms of process, and in terms of many
categories of baseline data, does raise questions as to why HIA and EIA are not better
integrated. Ahmad (2004) suggests an interesting list of reasons as to why health has been
overlooked in EIA. These include, for example: difficulty of establishing causality
between population health and multiple pollutants; limitations on resources to carry out
such assessments within the often tight timeframes of EIA; confidentiality of some health