Policy Health Impact Assessment for the European Union

Hintergrund und Ziel: Health Impact Assessment (HIA) is a „combination of procedures, methods and tools by which a policy, programme or project may be judged as to it's potential effects on the health of a population, and the distribution of those effects within the population“ (ECHP, WHO). The Treaty of Amsterdam (1999) made explicit the commitment of the European Union to ensure that human health is protected in the definition and implementation of all Community polices and activities. However there is no accepted methodology for assessing the impacts of EU policies on health within the Community. Therefore the EC funded this project to develop a generic HIA methodology to assess the potential health impacts of European policies. Methoden: Available HIA methodologies and related literature were identified and analysed. Based on this, a generic policy HIA methodology was synthesised. The methodology was then piloted on a selected EU policy at national and EU level. The pilots were evaluated and the methodology refined. Ergebnisse: The European Policy Health Impact Assessment Methodology (EPHIA) was developed. Over 100 contacts in 19 countries were made and more than 160 HIA articles, reports and case studies analysed. Pilot HIAs of the European Employment Strategy were carried out in 4 member states and at European level. Based on the pilot studies the EPHIA methodology was further developed and refined. Diskussion: Pilot HIAs were carried out successfully with some difficulties encountered in gaining participation from relevant stakeholders. Predicting health impacts by modelling was shown to be possible for policy level HIA but was limited due to lacking data and evidence of dose response relationships. The pilots proved to be an effective tool for further refining and developing the approach, and EPHIA itself is applicable at different depths of HIA ranging from ‘desk top’ to comprehensive HIA. Schlussfolgerungen: It is expected that EPHIA will be an important tool at EU policy level and will also find application at member state level.