Plenary 3 Chair: Stephen Palmer Health Impact Assessment: Making the Difference.

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Presentation transcript:

Plenary 3 Chair: 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 Koivusalo STAKES

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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 ( HIA mostly implemented at project and local level

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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 decisions Resources 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health European Union and HIA Finnish 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health Health in All Policies and the EU HiAP conference 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health HIA and European Union How 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health 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

National Research and Development Centre for Welfare and Health Knowledge for welfare and health HIA in Finland Human impact assessment website: HUIA: Health Inequalities: Health 2015 programme: Website: Health in all Policies (HiAP) presidency from Official web-site: