Abstract
Objectives
As global environmental change drives inequitable health outcomes, novel health equity assessment methodologies are increasingly required. We review literatures on equity-focused HIA to clarify how equity is informing HIA practice, and to surface innovations for assessing health equity in relation to a range of exposures across geographic and temporal scales.
Methods
A narrative review of the health equity and HIA literatures analysed English articles published between 2003 and 2017 across PubMed, PubMed Central, Biomed Central and Ovid Medline. Title and abstract reviews of 849 search results yielded 89 articles receiving full text review.
Results
Considerations of equity in HIA increased over the last 5 years, but equity continues to be conflated with health disparities rather than their root causes (i.e. inequities). Lessons from six literatures to inform future HIA practice are described: HIA for healthy cities, climate change vulnerability assessment, cumulative health risk assessment, intersectionality-based policy analysis, corporate health impact assessment and global health impact assessment.
Conclusions
Academic reporting on incorporating equity in HIA practice has been limited. Nonetheless, significant methodological advancements are being made to examine the health equity implications of multiple environmental exposures.
Similar content being viewed by others
References
Anaf J, Baum FE, Fisher M, Harris E, Friel S (2017) Assessing the health impact of transnational corporations: a case study on McDonald’s Australia. Glob Health 13:7. https://doi.org/10.1186/s12992-016-0230-4
Barton H, Grant M (2013) Urban planning for healthy cities. J Urban Health Bull N Y Acad Med 90:129–141. https://doi.org/10.1007/s11524-011-9649-3
Baum FE, Sanders DM, Fisher M, Anaf J, Freudenberg N, Friel S, Labonté R, London L, Monteiro C, Scott-Samuel A, Sen A (2016) Assessing the health impact of transnational corporations: its importance and a framework. Glob Health 12:27. https://doi.org/10.1186/s12992-016-0164-x
Betts KS (2012) Characterizing exposomes:kec tools for measuring personal environmental exposures. Environ Health Perspect 120:158–163
Bhatia R, Wernham A (2008) Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice. Environ Health Perspect 116:991–1000. https://doi.org/10.1289/ehp.11132
Bishwakarma R, Hunt VH, Zajicek A (2008) Beyond one-dimensional policy frameworks: a practical guide for an intersectional policy analysis. Himalaya Res Bull 27(1–2):19–30
Braubach M, Tobollik M, Mudu P, Hiscock R, Chapizanis D, Sarigiannis DA, Keuken M, Perez L, Martuzzi M (2015) Development of a quantitative methodology to assess the impacts of urban transport interventions and related noise on well-being. Int J Environ Res Public Health 12:5792–5814. https://doi.org/10.3390/ijerph120605792
Braveman P (2006) Health disparities and health equity: concepts and measurement. Ann Rev Public Health 27:167–194
Braveman P, Gruskin S (2003) Defining equity in health. J Epidemiol Community Health 57:254–258. https://doi.org/10.1136/jech.57.4.254
Briggs DJ (2008) A framework for integrated environmental health impact assessment of systemic risks. Environ Health 7:61. https://doi.org/10.1186/1476-069X-7-61
Brown H, Spickett J (2014) Health consequence scales for use in health impact assessments of climate change. Int J Environ Res Public Health 11:9607–9620. https://doi.org/10.3390/ijerph110909607
Brown H, Spickett J, Katscherian D (2014) A health impact assessment framework for assessing vulnerability and adaptation planning for climate change. Int J Environ Res Public Health 11:12896–12914. https://doi.org/10.3390/ijerph111212896
Browne GR, Rutherfurd ID (2017) The case for “environment in all policies”: lessons from the “health in all policies” approach in public health. Environ Health Perspect 125:149–154. https://doi.org/10.1289/EHP294
Buck LGM, Sundaram R (2012) Exposome: time for transformative research. Stat Med 31:2569–2575
Campbell-Lendrum D, Corvalán C (2007) Climate change and developing-country cities: implications for environmental health and equity. J Urban Health 84:109–117. https://doi.org/10.1007/s11524-007-9170-x
Center for Disease Control (2017) Healthy places—health impact assessment (HIA). https://www.cdc.gov/healthyplaces/hia.htm. Accessed 14 Dec 2017
Chiu WA, Euling SY, Scott CS, Subramaniam RP (2013) Approaches to advancing quantitative human health risk assessment of environmental chemicals in the post-genomic era. Toxicol Appl Pharmacol 271:309–323
Clandinin DJ (2006) Handbook of narrative inquiry: mapping a methodology. SAGE Publications, Thousand Oaks
Corburn J (2017) Urban place and health equity: critical issues and practices. Int J Environ Res Public Health. https://doi.org/10.3390/ijerph14020117
Corburn J, Curl S, Arredondo G, Malagon J (2014) Health in all urban policy: city services through the prism of health. J Urban Health 91:623–636. https://doi.org/10.1007/s11524-014-9886-3
Corvalan C, Hales S, McMichael AJ (Core Writing Team), Butler C et al (Extended writing team), Sarukhán J et al (Review editors) (2005) Ecosystems and human well-being: health synthesis. WHO, Geneva
Cote I, Anastas PT, Birnbaum LS, Clark RM, Dix DJ, Edwards SW et al (2012) Advancing the next generation of health risk assessment. Environ Health Perspect 120:1499–1502. https://doi.org/10.1289/ehp.1104870
de Blasio A, Girán J, Nagy Z (2012) Potentials of health impact assessment as a local health policy supporting tool. Perspect Public Health 132:216–220. https://doi.org/10.1177/1757913910391039
de Leeuw E (2012) Do healthy cities work? A logic of method for assessing impact and outcome of healthy cities. J Urban Health Bull N Y Acad Med 89:217–231. https://doi.org/10.1007/s11524-011-9617-y
de Leeuw E (2013) Evaluating WHO healthy cities in Europe: issues and perspectives. J Urban Health Bull N Y Acad Med 90:14–22. https://doi.org/10.1007/s11524-012-9767-6
Dora C, Racioppi F (2003) Including health in transport policy agendas: the role of health impact assessment analyses and procedures in the European experience. Bull World Health Organ 81:399–403
Fakhri A, Maleki M, Gohari M, Harris P (2014) Investigating underlying principles to guide health impact assessment. Int J Health Policy Manag 3:17–22. https://doi.org/10.15171/ijhpm.2014.50
Farhang L, Bhatia R, Scully CC, Corburn J, Gaydos M, Malekafzali S (2008) Creating tools for healthy development: case study of San Francisco’s Eastern Neighborhoods Community Health Impact Assessment. J Public Health Manag Pract JPHMP 14:255–265. https://doi.org/10.1097/01.PHH.0000316484.72759.7b
Freudenberg N, Galea S (2008) Cities of consumption: the impact of corporate practices on the health of urban populations. J Urban Health 85(4):462–471
Friel S, Hattersley E, Snowdon W, Thow A-M, Lobstein T (2013) Monitoring the impacts of trade agreements on food environments. Obes Rev 14(Supp S1):120–134
Gillingham MP, Halseth GR, Johnson CJ, Parkes MW (2016) The integration imperative: cumulative environmental, community and health impacts of multiple natural resource developments. Springer International Publishing AG, Cham
Grant MJ, Booth A (2009) A typology of reviews: an analysis of 14 review types and associated methodologies. Health Inf Libr J 26:91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
Green BN, Johnson CD, Adams A (2006) Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. J Chiropr Med 5:101–117. https://doi.org/10.1016/S0899-3467(07)60142-6
Haigh F, Harris E, Harris-Roxas B, Baum F, Dannenberg AL, Harris MF, Keleher H, Kemp L, Morgan R, Ng Chok H, Spickett J (2015) What makes health impact assessments successful? Factors contributing to effectiveness in Australia and New Zealand. BMC Public Health 15:1009. https://doi.org/10.1186/s12889-015-2319-8
Hambling T, Weinstein P, Slaney D (2011) A review of frameworks for developing environmental health indicators for climate change and health. Int J Environ Res Public Health 8:2854–2875. https://doi.org/10.3390/ijerph8072854
Hankivsky O, Cormier R (2011) Intersectionality and public policy: some lessons from existing models. Polit Res Q 64(1):217–229. https://doi.org/10.1177/1065912910376385
Hankivsky O, Grace D, Hunting G, Giesbrecht M, Fridkin A, Rudrum S, Ferlatte O, Clark N (2014) An intersectionality-based policy analysis framework: critical reflections on a methodology for advancing equity. Int J Equity Health. https://doi.org/10.1186/s12939-014-0119-x
Harris-Roxas B, Haigh F, Travaglia J, Kemp L (2014) Evaluating the impact of equity focused health impact assessment on health service planning: three case studies. BMC Health Serv Res 14:371. https://doi.org/10.1186/1472-6963-14-371
Heller J, Givens ML, Yuen TK, Gould S, Benkhalti Jandu M, Bourcier E, Choi T (2014) Advancing efforts to achieve health equity: equity metrics for health impact assessment practice. Int J Environ Res Public Health 11:11054–11064. https://doi.org/10.3390/ijerph111111054
Hickens MT, Gragg R, Hu H (2011) How cumulative risks warrant a shift in our approach to racial heath disparities: the case of lead, stress, and hypertension. Health Affair 30:1895–1901
Hirono K, Haigh F, Gleeson D, Harris P, Thow AM, Friel S (2016) Is health impact assessment useful in the context of trade negotiations? A case study of the Trans Pacific Partnership Agreement. BMJ Open 6:e010339. https://doi.org/10.1136/bmjopen-2015-010339
Houghton A, English P (2014) An approach to developing local climate change environmental public health indicators, vulnerability assessments, and projections of future impacts. J Environ Public Health. https://doi.org/10.1155/2014/132057
Ison E (2013) Health impact assessment in a network of European Cities. J Urban Health Bull N Y Acad Med 90:105–115. https://doi.org/10.1007/s11524-011-9644-8
James P, Ito K, Buonocore JJ, Levy JI, Arcaya MC (2014) A health impact assessment of proposed public transportation service cuts and fare increases in Boston, Massachusetts (U.S.A.). Int J Environ Res Public Health 11:8010–8024. https://doi.org/10.3390/ijerph110808010
Johnson Thornton RL, Greiner A, Fichtenberg CM et al (2013) Achieving a healthy zoning policy in Baltimore: results of a health impact assessment of the TransForm Baltimore Zoning Code Rewrite. Public Health Rep 128:87–103
Juarez PD, Matthews-Juarez P, Hood DB, Im W, Levine RS, Kilbourne BJ, Langston MA, Al-Hamdan MZ, Crosson WL, Estes MG, Estes SM, Agboto VK, Robinson P, Wilson S, Lichtveld MY (2014) The public health exposome: a population-based, exposure science approach to health disparities research. Int J Environ Res Public Health 11:12866–12895. https://doi.org/10.3390/ijerph111212866
Kawachi I, Subramanian SV, Almeida-Filho N (2002) A glossary for health inequalities. J Epidemiol Community Health 56:647–652. https://doi.org/10.1136/jech.56.9.647
Kjellstrom T, Friel S, Dixon J, Corvalan C, Rehfuess E, Campbell-Lendrum D, Gore F, Bartram J (2007) Urban environmental health hazards and health equity. J Urban Health 84:86–97. https://doi.org/10.1007/s11524-007-9171-9
Korfmacher KS, Aviles K, Cummings BJ, Daniell W, Erdmann J, Garrison V (2015) Health impact assessment of urban waterway decisions. Int J Environ Res Public Health 12:300–321. https://doi.org/10.3390/ijerph120100300
Krewski D, Westphal M, Andersen ME, Paoli GM, Chiu WA, Al-Zoughool M, Croteau MC, Burgoon LD, Cote I (2014) A framework for the next generation of risk science. Environ Health Perspect 122:796–805. https://doi.org/10.1289/ehp.1307260
Kumaresan J, Prasad A, Alwan A, Ishikawa N (2010) Promoting health equity in cities through evidence-based action. J Urban Health Bull N Y Acad Med 87:727–732. https://doi.org/10.1007/s11524-010-9500-2
Mahboubi P, Parkes MW, Chan HM (2015) Challenges and opportunities of integrating human health into the environmental assessment process: the Canadian experience contextualised to international efforts. J Environ Assess Policy Manag 17:1550034. https://doi.org/10.1142/S1464333215500349
Mansfield TJ, MacDonald Gibson J (2015) Health impacts of increased physical activity from changes in transportation infrastructure: quantitative estimates for three communities. Biomed Res Int. https://doi.org/10.1155/2015/812325
Marmot M (2007) Achieving health equity: from root causes to fair outcomes. Lancet 370:1153–1163. https://doi.org/10.1016/S0140-6736(07)61385-3
Martenies SE, Wilkins D, Batterman SA (2015) Health impact metrics for air pollution management strategies. Environ Int 85:84–95. https://doi.org/10.1016/j.envint.2015.08.013
Mathias KR, Harris-Roxas B (2009) Process and impact evaluation of the Greater Christchurch Urban Development Strategy Health Impact Assessment. BMC Public Health 9:97. https://doi.org/10.1186/1471-2458-9-97
Monteiro C, Cannon G (2012) The impact of transnational “big food” companies on the South: a view from Brazi. PLoS Med 9:e1001252
Mwatsama MK, Wong S, Ettehad D, Watt NF (2014) Global health impacts of policies: lessons from the UK. Glob Health 10:13. https://doi.org/10.1186/1744-8603-10-13
Nadrian H, Nedjat S, Taghdisi MH, Shojaeizadeh D (2014) Urban traffic-related determinants of health questionnaire (UTDHQ): an instrument developed for health impact assessments. Med J Islam Repub Iran 28:84
Parkes MW (2012) Diversity, emergence, resilience: guides for a new generation of ecohealth research and practice. EcoHealth 8:137–139
Parkes MW (2016) Cumulative determinants of health impacts in rural, remote, and resource-dependent communities. In: Gillingham PM, Halseth RG, Johnson JC, Parkes WM (eds) The integration imperative: cumulative environmental, community and health effects of multiple natural resource developments. Springer International Publishing, Cham, pp 117–149
Pennington A, Dreaves H, Scott-Samuel A, Haigh F, Harrison A, Verma A, Pope D (2017) Development of an urban health impact assessment methodology: indicating the health equity impacts of urban policies. J Public Health 1:56–61. https://doi.org/10.1093/eurpub/ckv114
Pies C, Barr M, Strouse C, Kotelchuck M, Team Best Babies Zone Initiative (2016) Growing a best babies zone: lessons learned from the pilot phase of a multi-sector, place-based initiative to reduce infant mortality. Matern Child Health J 20:968–973. https://doi.org/10.1007/s10995-016-1969-1
Povall SL, Haigh FA, Abrahams D, Scott-Samuel A (2014) Health equity impact assessment. Health Promot Int 29:621–633. https://doi.org/10.1093/heapro/dat012
Prochaska J, Kelley H, Linder S, Sexton K, Sullivan J, Nolen LB (2012) Health inequities in environmental justice communities: relevant indicators to reflect a variety of health threats. Int J Equity Health 11:A7. https://doi.org/10.1186/1475-9276-11-S1-A7
Ross CL, Leone de Nie K, Dannenberg AL, Beck LF, Marcus MJ, Barringer J (2012) Health impact assessment of the Atlanta BeltLine. Am J Prev Med 42:203–213. https://doi.org/10.1016/j.amepre.2011.10.019
Sartorius B (2013) Modeling determinants, impact, and space-time risk of age-specific mortality in rural South Africa: integrating methods to enhance policy relevance. Glob Health Action 6:19239. https://doi.org/10.3402/gha.v6i0.19239
Schaff K, Desautels A, Flournoy R, Carson K, Drenick T, Fujii D, Lee A, Luginbuhl J, Mena M, Shrago A, Siegel A, Stahl R, Watkins-Tartt K, Willow P, Witt S, Woloshin D, Yamashita B (2013) Addressing the social determinants of health through the Alameda County, California, place matters policy initiative. Public Health Rep 128:48–53
Sen G, Iyer A, Mukherjee C (2009) A methodology to analyse the intersections of social inequalities in health. J Hum Dev Capab 10(3):397–415. https://doi.org/10.1080/19452820903048894
Serrano E, Larranaga I, Morteruel M et al (2016) Urban regeneration as population health intervention: a health impact assessment in the Bay of Pasaia (Spain). J Equity Health. https://doi.org/10.1186/s12939-016-0424-7
Sexton K, Linder SH (2010) The role of cumulative risk assessment in decisions about environmental justice. Int J Environ Res Public Health 7(11):4037–4049
Sexton K, Linder SH (2011) Cumulative risk assessment for combined health effects from chemical and nonchemical stressors. Am J Public Health 101(1):S81–S88
Shankardass K, Renahy E, Muntaner C, O’Campo P (2015) Strengthening the implementation of health in all policies: a methodology for realist explanatory case studies. Health Policy Plan 30:462–473. https://doi.org/10.1093/heapol/czu021
Simos J, Spanswick L, Palmer N, Christie D (2015) The role of health impact assessment in Phase V of the Healthy Cities European Network. Health Promot Int 30:i71–i85. https://doi.org/10.1093/heapro/dav032
Spickett JT, Brown HL, Katscherian D (2011) Adaptation strategies for health impacts of climate change in Western Australia: application of a health impact assessment framework. Environ Impact Assess Rev 31:297–300. https://doi.org/10.1016/j.eiar.2010.07.001
Stuckler D, McKee M, Ebrahim S, Basu S (2012) Manufacturing epidemics: the role of global producers in increased consumption of unhealthy commodities including processed foods, alcohol, and tobacco. PLoS Med 9(6):e1001235
Tuomisto JT, Niittynen M, Pärjälä E, Asikainen A, Perez L, Trüeb S, Jantunen M, Künzli N, Sabel CE (2015) Building-related health impacts in European and Chinese cities: a scalable assessment method. Environ Health 14:93. https://doi.org/10.1186/s12940-015-0082-z
Weiss D, Lillefjell M, Magnus E (2016) Facilitators for the development and implementation of health promoting policy and programs—a scoping review at the local community level. BMC Public Health 16:140. https://doi.org/10.1186/s12889-016-2811-9
WHO (2007) The health impact assessment procedure. http://www.who.int/hia/tools/process/en/. Accessed 1 Dec 2017
Wier M, Sciammas C, Seto E et al (2009) Health, traffic, and environmental justice: collaborative research and community action in San Francisco, California. Am J Public Health 99:S499–S504. https://doi.org/10.2105/AJPH.2008.148916
Wild CP (2012) The exposome: from concept to utility. Int J Epidemiol 41:24–32
Wiles R, Crow G, Pain H (2011) Innovation in qualitative research methods: a narrative review. Qualitative Research 11:587–604. https://doi.org/10.1177/1468794111413227
Winkler MS, Utzinger J (2014) The search for underlying principles of health impact assessment: progress and prospects. Int J Health Policy Manag 3:107–109. https://doi.org/10.15171/ijhpm.2014.69
Wise M, Harris P, Harris-Roxas B, Harris E (2009) The role of health impact assessment in promoting population health and health equity. J Aust 20:172–179
Yuen TK, Payne-Sturges DC (2013) Using health impact assessment to integrate environmental justice into federal environmental regulatory analysis. New Solut 23:439–466
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to declare.
Additional information
This article is part of the special issue “Environmental and health equity”.
Rights and permissions
About this article
Cite this article
Buse, C.G., Lai, V., Cornish, K. et al. Towards environmental health equity in health impact assessment: innovations and opportunities. Int J Public Health 64, 15–26 (2019). https://doi.org/10.1007/s00038-018-1135-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00038-018-1135-1