221078 Health impact assessment as a tool for assuring social justice regarding interventions implemented on populations

Wednesday, November 10, 2010

Jordan Panayotov, MEc MPH (Health Economics) , Health Economics, Independent Centre for Analysis and Research of Economies, Melbourne, Australia
Development is interventions on populations with winners – people who benefit, and losers – people who benefit less. Therefore there are always opposing interests – who will benefit more. What should we strive for when allocating resources: increasing average health status, or decreasing health inequalities?

Health impact assessment tries to identify changes in health of populations which are affected by development. However, if nobody is worse-off HIA would stop at its first step – Screening. Even if HIA proceeds with recommendations to enhance potential positive effects, assuming no negative effects to be minimized, there are possibilities for creating and widening health inequalities.

For any intervention implemented on populations the distribution of the benefit is the most important factor influencing the outcomes, no matter whether the primary objective is improving health of whole populations, i.e. in public health, or the primary objective is different than health, i.e. in other sectors (transport, education, agriculture, etc.), however with impact on health of populations. Since this distribution can be different in any different case, the evidence about effectiveness becomes even more equivocal.

I've established that evidence for interventions on populations is relative and depends on the distribution of the benefit among population. Any appraisal of interventions should start with analyzing this distribution at local level. I have identified eight combinations of this distribution, leading to different results. Based on this decision-makers should tailor the interventions in order to maximize the outcome for whole populations in any specific case, which is premise for social justice.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health or related public policy
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1) Identify and Analyze the distribution of the benefit from interventions implemented on populations; 2) Compare previous and new "winners" and "losers"; 3) Evaluate possible recipients’ outcomes.

Keywords: Policy/Policy Development, Health Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I work for improving efficiency in relation to health and I have developed a model, which was presented at 11th World Congress on Public Health, on 36th and 37th Annual Conference of Public Health Association of Australia, on Canadian Public Health Association 2008 Annual Conference, on 9th International Health Impact Assessment Conference.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.