Health impact assessment as a policy tool

Recently the CMAJ wrote about the importance of health impact assessments as a policy tool. In June, The Canadian Medical Association told the Senate Finance Committee that evidence-based health impact assessments should be applied to all cabinet decision making.

What is a health impact assessment? It is a structured way to evaluate the potential impact of policies or programs on the population’s health. It means seeing health as not only the responsibility of the ministry of health, but of all government departments at all levels Health impact assessments can provide an integrated policy response to complex problems that might involve solutions from a variety of departments.

For example, our report, Stepping it up: moving the focus from health care in Canada to a healthier Canada, discusses income as a key determinant of health. Canadians with the lowest incomes are more likely to suffer from chronic conditions like diabetes, arthritis  and heart disease, live with a disability, be hospitalized for a variety of health problems, have many mental health issues and to die earlier.  So how can governments approach this complex issue using health impact assessments? A healthy population has to be viewed as the responsibility of governments and society as a whole, not just that of the ministries of health. Governments need to work collaboratively, among ministries, to identify solutions beyond just the acute care system that take a look at policies affecting the health of these populations, and develop appropriate solutions.

As the article says, Quebec already uses health impact assessments. We hosted a webinar last year and one of our presenters was Lyne Jobin, Director of Public Health Planning, Evaluation and Development, Ministère de la Santé et des Services Sociaux. She discussed the implementation of this strategy, and challenges that arose in the process (see her presentation slides here).