Supporting health impact assessment in practice

Health impact assessment (HIA) is a process that aims to predict potential positive and negative effects of project, programme or policy proposals on health and health inequalities. It is recommended by national government and internationally. Supporting health impact assessment is one of the roles of English Public Health Observatories.The few centres in England with accredited health impact training centres have inadequate resources to meet demand. Currently, the London Health Observatory is providing the bulk of the training nationally. Some Public Health Observatories are currently investigating the preferences for support of those commissioning or conducting health impact assessment within their regions.The availability of published guidance on how to conduct health impact assessments has increased substantially over the past few years. The Department of Health has funded a research project led by the London Health Observatory to develop advice for reviewing evidence for use in health impact assessment. Completed health impact assessments can be useful resources. Evaluation of the process and impact of health impact assessment is important in order to demonstrate its usefulness and to learn lessons for the future.The focus for Public Health Observatories is to train and support others to conduct health impact assessment according to good practice, rather than undertaking health impact assessments themselves. The aim is to create sufficient skilled capacity around the country to undertake health impact assessments. The London Health Observatory plans to share its support models and to roll out a train the trainer programme nationally to enable effective local delivery of their national health impact assessment programme. (c) 2005 The Royal Institue of Public Health. Published by Elsevier Ltd. All rights reserved

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

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

Income-based inequalities in hypertension and in undiagnosed hypertension: analysis of Health Survey for England data

Objective: To quantify income-based inequalities in hypertension and in undiagnosed hypertension. Methods: We used nationally representative data from 28 002 adults (aged 16 years and older) living in private households who participated in the cross-sectional Health Survey for England 2011–2016. Using bivariate probit regression modelling, we jointly modelled hypertension and self-reported previous diagnosis of hypertension by a doctor or nurse. We then used the model estimates to quantify inequalities in undiagnosed hypertension. Inequalities, using household income tertiles as an indicator of socioeconomic status, were quantified using average marginal effects (AMEs) after adjustment for confounding variables. Results: Overall, 32% of men and 27% of women had survey-defined hypertension (measured blood pressure ≥140/90 mmHg and/or currently using medicine to treat high blood pressure). Higher proportions (38% of men and 32% of women) either self-reported previous diagnosis or had survey-defined hypertension. Of these, 65% of men and 70% of women had diagnosed hypertension. Among all adults, participants in low-income versus high-income households had a higher probability of being hypertensive [AMEs: men 2.1%; 95% confidence interval (CI): −0.2, 4.4%; women 3.7%; 95% CI: 1.8, 5.5%] and of being diagnosed as hypertensive (AMEs: men 2.0%; 95% CI: 0.4, 3.7%; women 2.5%; 95% CI: 1.1, 3.9%). Among those classed as hypertensive, men in low-income households had a marginally lower probability of being undiagnosed than men in high-income households (AME: −5.2%; 95% CI: −10.5, 0.1%), whereas no difference was found among women. Conclusion: Our findings suggest that income-based inequalities in hypertension coexist with equity in undiagnosed hypertension

Impaired Glucose Metabolism among Those with and without Diagnosed Diabetes and Mortality: A Cohort Study Using Health Survey for England Data.

The extent that controlled diabetes impacts upon mortality, compared with uncontrolled diabetes, and how pre-diabetes alters mortality risk remain issues requiring clarification

Control in the technical societies: a brief history

By the time control engineering emerged as a coherent body of knowledge and practice (during and just after WW2) professional engineering societies had existed for many decades. Since control engineering is an interdisciplinary branch of the profession, new sections devoted to control were quickly established within the various existing technical societies. In addition, some new bodies devoted specifically or primarily to control were established. This article, a revised version of a paper presented at the IEEE 2009 Conference on the History of Technical Societies, describes how control engineering as a distinct branch of engineering became represented in technical societies in a number of countries

Systematics and conservation of the hook-billed kite including the island taxa from Cuba and Grenada

Taxonomic uncertainties within the genus Chondrohierax stem from the high degree of variation in bill size and plumage coloration throughout the geographic range of the single recognized species, hook-billed kite Chondrohierax uncinatus . These uncertainties impede conservation efforts as local populations have declined throughout much of its geographic range from the Neotropics in Central America to northern Argentina and Paraguay, including two island populations on Cuba and Grenada, and it is not known whether barriers to dispersal exist between any of these areas. Here, we present mitochondrial DNA (mtDNA; cytochrome B and NADH dehydrogenase subunit 2) phylogenetic analyses of Chondrohierax , with particular emphasis on the two island taxa (from Cuba, Chondrohierax uncinatus wilsonii and from Grenada, Chondrohierax uncinatus mirus ). The mtDNA phylogenetic results suggest that hook-billed kites on both islands are unique; however, the Cuban kite has much greater divergence estimates (1.8–2.0% corrected sequence divergence) when compared with the mainland populations than does the Grenada hook-billed kite (0.1–0.3%). Our findings support species status for the Cuban form, as Chondrohierax wilsonii , and subspecific status for the Grenada form. For mainland taxa, we do not find support for the currently recognized subspecies Chondrohierax uncinatus aquilonis in western Mexico, but we do find evidence for a genetic subdivision between populations in Central and South America, a difference previously unsuspected. The results of this study help identify conservation priorities associated with these unique Neotropical raptors. This information is of immediate interest because the Cuban kite has not been reliably seen since 1992, and <50 hook-billed kites currently inhabit Grenada.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72922/1/j.1469-1795.2007.00118.x.pd