„Family“ of health-related impact assessments – opportunities to support rational policy-making

Background: Internationally, a host of Impact Assessments (IAs) has emerged to provide appraisal of (future, concurrent, or past) impacts of policies, plans, programs, and projects. Many of such IAs are related to human health. An initiative was started in 2009 to study inter-relationships among different members of the „family“ of health-related IAs, especially in order to harness synergies. Methods and Materials: Based on expert judgement and literature searches, this paper looks at seven types of IA with major relations to human health: Health IA (HIA), Environmental IA (EIA), Strategic Environmental Assessment (SEA), Social IA, Sustainability IA, IA as practiced by the European Community (ECIA), and Health Technology Assessment (HTA). For each IA, key documents, web portals, EC projects and/or „flagship“ examples were identified, then analyzed according to a pre-defined set of descriptive criteria. Results: For all IAs, specific „cultures“ have emerged, i.e. manifestos and conventions, driver institutions, infrastructure such as guidelines, tools, and landmark examples. Within the European Union, several IAs, espec. EIA and SEA are based on legal bases and performed systematically. In contrast, other IAs are voluntary procedures, performed with variable frequency and ambition in different countries. While HIA (and HTA, in a characteristically different but still related way) obviously are devoted to human health, the coverage of health in the other approaches tends to be highly variable. Conclusions: Existing IAs provide ample opportunity to harness synergies, e.g. concerning subtopics covered and methods applied. The „family“ of health-related IAs provides opportunities for rational policy-making which still tend to be under-utilized. – Within the „family“ initiative, it is planned to continue especially along the following lines: suggesting solutions for situations where more than one single IA is being conducted on a given topic; and to discuss pro's and con's of integrated IAs.