A review of health impact assessment frameworks

Background: Consideration of health impacts of non-health sector policies has been encouraged in many countries, with health impact assessment (HIA) increasingly used worldwide for this purpose. HIA aims to assess the potential impacts of a proposal and make recommendations to improve the potential health outcomes and minimize inequalities. Although many of the same techniques can be used, such as community consultation, engagement or profiling, HIA differs from other community health approaches in its starting point, purpose and relationship to interventions. Many frameworks have been produced to aid practitioners in conducting HIA. Objective: To review the many HIA frameworks in a systematic and comparative way. Study design: Systematic review. Method: The literature was searched to identify published frameworks giving sufficient guidance for those with the necessary skills to be able to undertake an HIA. Results: Approaches to HIA reflect their origins, particularly those derived from Environmental Impact Assessment (EIA). Early HIA resources tended to use a biomedical model of health and examine projects. Later developmentswere designed for usewith policy proposals, and tended to use a socio-economic or environmental model of health. There aremore similarities than differences in approaches to HIA, with convergence over time, such as the distinction between ‘narrow’ and ‘broad’ focus HIA disappearing. Consideration of health disparities is integral to most HIA frameworks but not universal. A few resources focus solely on inequalities. The extent of community participation advocated varies considerably. Conclusion: It is important to select an HIA framework designed for a comparable context, level of proposal and available resources

Change in prevalence of chronic kidney disease in England over time: comparison of nationally representative cross-sectional surveys from 2003 to 2010

Design: Cross-sectional analysis of nationally representative Health Survey for England (HSE) random samples.Setting: England 2003 and 2009/2010.Survey participants: 13?896 adults aged 16+ participating in HSE, adjusted for sampling and non-response, 2009/2010 surveys combined.Main outcome measure: Change in prevalence of estimated glomerular filtration rate (eGFR) <60?mL/min/1.73?m2 (as proxy for stage 3–5 CKD), from 2003 to 2009/2010 based on a single serum creatinine measure using an isotope dilution mass spectrometry traceable enzymatic assay in a single laboratory; eGFR derived using Modified Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) eGFR formulae.Analysis: Multivariate logistic regression modelling to adjust time changes for sociodemographic and clinical factors (body mass index, hypertension, diabetes, lipids). A correction factor was applied to the 2003 HSE serum creatinine to account for a storage effect.Results: National prevalence of low eGFR (<60) decreased within each age and gender group for both formulae except in men aged 65–74. Prevalence of obesity and diabetes increased in this period, while there was a decrease in hypertension. Adjustment for demographic and clinical factors led to a significant decrease in CKD between the surveyed periods. The fully adjusted OR for eGFR <60?mL/min/1.73?m2 was 0.75 (0.61 to 0.92) comparing 2009/2010 with 2003 using the MDRD equation, and was similar using the CKDEPI equation 0.73 (0.57 to 0.93).Conclusions: The prevalence of a low eGFR indicative of CKD in England appeared to decrease over this 7-year period, despite the rising prevalence of obesity and diabetes, two key causes of CKD. Hypertension prevalence declined and blood pressure control improved but this did not appear to explain the fall. Periodic assessment of eGFR and albuminuria in future HSEs is needed to evaluate trends in CKD

Blood pressure profiles, and awareness and treatment of hypertension in Europe - results from the EHES Pilot Project

Highlights: We examine hypertension, and awareness and treatment of hypertension in Europe; Large proportion of people are unaware and untreated for their hypertension; Wide differences in hypertension, awareness and treatment exist in Europe.info:eu-repo/semantics/publishedVersio

Standardization of physical measurements in European health examination surveys - Experiences from the site visits

Background Health examination surveys (HESs) provide valuable data on health and its determinants at the population level. Comparison of HES results within and between countries and over time requires measurements which are free of bias due to differences in or adherence to measurement procedures and/or measurement devices. Methods In the European HES (EHES) Pilot Project, 12 countries conducted a pilot HES in 2010-11 using standardized measurement protocols and centralized training. External evaluation visits (site visits) were performed by the EHES Reference Centre staff to evaluate the success of standardization and quality of data collection. Results In general, standardized EHES protocols were followed adequately in all the pilot surveys. Small deviations were observed in the posture of participants during the blood pressure and height measurement; in the use of a tourniquet when drawing blood samples; and in the calibration of measurement devices. Occasionally, problems with disturbing noise from outside or people coming into the room during the measurements were observed. In countries with an ongoing national HES or a long tradition of conducting national HESs at regular intervals, it was more difficult to modify national protocols to fulfil EHES requirements. Conclusions The EHES protocols to standardize HES measurements and procedures for collection of blood samples are feasible in cross-country settings. The prerequisite for successful standardization is adequate training. External and internal evaluation activities during the survey fieldwork are also needed to monitor compliance to standards. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved