Definitions of key concepts in public health, health impact assessment, healthy urban planning and healthy public policy that I use in my work.

WHO Definitions

Health is the extent to which an individual or group is able to realise aspirations and satisfy needs, and to change or cope with the environment. Health is therefore a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities.

Health is a state of complete physical, social and mental wellbeing and not simply the absence of disease or infirmity.

Reference: World Health Organization. (1984). Health Promotion: A Discussion Document on the Concepts and Principles. WHO Regional Office for Europe. Copenhagen. | World Health Organization. (1948). Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference. New York, 19-22 June 1946, and entered into force on 7 April 1948.

My working definition

HIA is a key systematic approach to predicting the magnitude and significance of the possible health and wellbeing impacts, both positive and negative, of new plans and projects.

HIA works within an explicit ethos (value framework) of aiming to be equitable, democratic/participatory, sustainable, ethical/transparent in its use of evidence, accountable and sees maximising health for all as a social good.

HIA uses a range of structured and evaluated sources of qualitative and quantitative evidence that includes public and other stakeholders' perceptions and experiences as well as public health, epidemiological, toxicological and medical knowledge.

HIA is particularly concerned with the distribution of effects within a population, as different groups are likely to be affected in different ways, and therefore looks at how health and social inequities/inequalities might be reduced or widened by a proposed plan or project.

The aim of HIA is to support and add value to the decision-making process by providing a systematic analysis of the potential impacts as well as recommending options, where appropriate, for enhancing the positive impacts, mitigating the negative ones and reducing health inequalities/inequities.

HIA uses both a biomedical and social definition of health, recognising that though illness and disease (mortality and morbidity) are useful ways of measuring health they need to be fitted within a broader understanding of health and wellbeing to be properly useful.

Reference: Hurley F and Vohra S. (2010). Chapter 63 Health Impact Assessment. Environmental Medicine. Hodder Arnold. London.

International Association for Impact Assessment (IAIA) definition

A combination of procedures, methods and tools that systematically judges the potential, sometimes unintended, effects of a policy, plan, programme or project on the health of a population, including the distribution of those effects within the population, and identifies appropriate actions to manage those effects.

Reference: International Association for impact Assessment. (2006). Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5. Fargo, USA.

Gothenburg Consensus definition

A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.

Reference: WHO European Centre for Health Policy. (1999). Health Impact Assessment: main concepts and suggested approach. Gothenburg Consensus Paper. WHO Regional Office for Europe.

Health Risk Assessment (HRA) is the quantitative and fixed criteria based assessment of the adverse direct physical health impacts of individuals and groups exposed to single or multiple hazards. These hazards are generally environmental and occupational exposure to chemical pollutants released or transferred into the air, water and soil. Often the focus is on the extent to which current and possible future exposures are responsible for negative physical health impacts, and the term ‘burden of disease’ is used to describe the accumulation of associated impacts from the specified pollutants.

HRA is applicable to policies, plans, programmes and projects, insofar as their effects are mediated through exposure to pollutants or other hazardous substances.

HRA is made up of the following steps:

• Hazard Identification
• Exposure Measurement
• Quantifying Dose-Response Relationships
• Risk Characterisation

HRA is therefore one important aspect of HIA. HIA tends to be a broader and more holistic form of assessment that analyses the potential direct and indirect health impacts of a proposal and examines the influences not only of chemical emissions but also the impacts on the wider determinants of health e.g. employment and economy; housing and shelter; transport and connectivity; learning and education; crime and safety; health and social care; shops and retail amenities; social capital and community cohesion; culture, spirituality and faith; arts and leisure; lifestyle and daily routines; governance and institutional structures; energy and waste; and land and spatial factors.

Reference:

Healthy urban planning and design is an approach to planning that puts people - individuals, families and communities – and their health and wellbeing at the heart of the planning and regeneration process. The physical environment, which is shaped by planning decisions, affects health and wellbeing through enabling people’s ability to walk, cycle and enjoy the outdoors; by encouraging social interactions between neighbours and other local people; by providing good quality housing; and access to jobs, shops, services and public transport.

Reference: