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What do we need for robust and quantitative health impact assessment?

Mindell, J.; Hansell, A.; Morrison, D.; Douglas, M.; Joffe, M.; (2001) What do we need for robust and quantitative health impact assessment? Journal of Public Health Medicine , 23 (3) pp. 173-178. Green open access

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Abstract

Health impact assessment (HIA) aims to make the health consequences of decisions explicit. Decision-makers need to know that the conclusions of HIA are robust. Quantified estimates of potential health impacts may be more influential but there are a number of concerns. First, not everything that can be quantified is important. Second, not everything that is being quantified at present should be, if this cannot be done robustly. Finally, not everything that is important can be quantified; rigorous qualitative HIA will still be needed for a thorough assessment. This paper presents the first published attempt to provide practical guidance on what is required to perform robust, quantitative HIA. Initial steps include profiling the affected populations, obtaining evidence from for postulated impacts, and determining how differences in subgoups' exposures and suscepibilities affect impacts. Using epidemiological evidence for HIA is different from carrying out a new study. Key steps in quantifying impacts are mapping the causal pathway, selecting appropriate outcome measures and selecting or developing a statistical model. Evidence from different sources is needed. For many health impacts, evidence of an effect may be scarce and estimates of the size and nature of the relationship may be inadequate. Assumptions and uncertainties must therefore be explicit. Modelled data can sometimes be tested against empirical data but sensitivity analyses are crucial. When scientific problems occur, discontinuing the study is not an option, as HIA is usually intended to inform real decisions. Both qualitative and quantitative elements of HIA must be performed robustly to be of value.

Type: Article
Title: What do we need for robust and quantitative health impact assessment?
Open access status: An open access version is available from UCL Discovery
Publisher version: http://pubmed.oupjournals.org/cgi/reprint/23/3/173...
Language: English
Additional information: This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journal of Public Health Medicine following peer review. The definitive publisher-authenticated version of Mindell, J. and Hansell, A. and Morrison, D. and Douglas, M. and Joffe, M. (2001) What do we need for robust and quantitative health impact assessment? Journal of Public Health Medicine, 23 (3). pp. 173-178. is available online at: http://pubmed.oupjournals.org/cgi/reprint/23/3/173.pdf.
Keywords: health impact assessment, public policy, quantitative, reproducibility of results
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: http://discovery.ucl.ac.uk/id/eprint/892
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