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The Politics of Healthy Policies: Redesigning health impact assessment to integrate health in public policy
- Publication date
- 12 September 2007
- Publisher
- Public health issues, such as obesity, lung disease
from air pollution or mental health complaints from living in an
unsafe neighbourhood, are complex, intractable policy problems. The
causes are dispersed at the individual and the collective level among
different societal sectors. One strategy to integrate health in other
sectors’ policies for developing effective and cooperative policy
solutions is to provide evidence in a Health Impact Assessment (HIA)
from proposed policies and project plans. In 15 years of practising
HIA, policymakers and academics nevertheless express concern about
its effectiveness.
In The Politics of Healthy Policies a conceptual and empirical
analysis is presented of the role of HIA in policy development. From
a governance perspective the author identifies different purposes of
HIA for indicating societal problems and democratic deficits. These
suggest that a technical design of HIA to assess causes and effects
insufficiently addresses the political and normative issues of
collaborative policymaking without institutional requirements or
incentives. Four case studies are analysed of Dutch HIA practices at
the national and local policy level, including a game simulation of
health advocacy without HIA. The outcomes suggest that a re-
orientation on HIA is necessary in order to mobilise other sectors to
prevent or mitigate public health problems.
The author proposes an interaction-oriented, reflective design and a
new definition of HIA. The book is especially relevant to HIA
practitioners and health policymakers at different governmental
levels. Many of the implications are highly relevant to other forms
of impact assessment as well.