WHO
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Health impact assessment

    Overview

    Health impact assessments (HIA) provide decision-makers with sound information about the health implications of policies, programmes and projects, ranging, for example, from construction of a waste incinerator to the redesign of an urban neighbourhood.

    WHO response

    WHO/Europe provides support to Member States on HIA by developing methodologies and tools, carrying out assessments and reviews, and advising on policy options.

    Commonly agreed upon tools for carrying out HIAs are not yet available, although provisions for HIA in policy-making are included in international legislation (e.g. European Union directives), legally binding agreements (e.g. the Strategic Environmental Assessment or SEA Protocol), and policy commitments (such as those of the ministerial conferences on environment and health).

    As mandated by ministerial conference declarations, WHO/Europe works to fill this gap by developing HIA methodologies and tools for use by national or local authorities or institutions. Such methodologies and tools are usually piloted through projects.

    WHO/Europe also promotes the integration of health in environmental assessments through building capacity at local, national and subregional level and supporting Member States in the implementation of the SEA Protocol.

    Integrated HIAs focus on how policies, plans or projects affect health through their environmental, economic and social impacts. Examples include integrating health issues and policies in environmental performance reviews and making recommendations for progress in environmental health.

    Our work

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    Reducing environmental health inequalities

    Reducing environmental health inequalities

    WHO / Malin Bring
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    Overview

    WHO is working to reduce environmental health inequalities so that everyone across the WHO European Region can live healthy lives.

    Environmental conditions are a major determinant of health and well-being, but they are not the same for everyone everywhere. Inequalities in environmental risk are interlinked with almost all contemporary environmental challenges, including exposure to air pollution, noise, chemicals, contaminated soil and polluted water, and inadequate access to urban nature. The risk of being affected by extreme weather events is also distributed unequally across populations.

    In addition, environmental risks related to housing conditions, such as polluting fuels for cooking and heating, inadequate water and sanitation supply, dampness, and crowding, are also characterized by inequalities. This puts disadvantaged and less wealthy individuals at higher risk of environmental exposures and related health outcomes.

    Environmental health inequalities can be significant, and represent a challenge for many national and local governments in ensuring health for all. Although most countries have achieved environmental improvements, the most affected population subgroups have not benefitted equally. The following list reflects some of these persistent inequalities.

    • Households below the relative poverty threshold are at least 3 times more likely to live in overcrowded conditions in many countries.
    • In some countries, the proportion of the population without access to adequate drinking-water sources is over 5 times higher in the lowest wealth quintile than in the highest.
    • Energy poverty is 3–4 times more frequent in households below the relative poverty threshold in most countries across the Region.
    • In some countries in the eastern part of the Region, polluting fuels are used by 90% of the least affluent population groups.

    At WHO/Europe’s 7th Ministerial Conference on Environment and Health, held in July 2023 in Budapest, Hungary, Member States committed to address the cross-cutting challenge of environmental health inequalities, and to establish equitable environments to support health and sustainable development.

    WHO compiles evidence to support action on environmental health inequalities, quantifying the magnitude of intra-country inequalities for selected environmental health risks in order to identify country-specific priorities for tackling environmental injustice. Furthermore, WHO encourages national and subnational authorities to:

    • collect equity-sensitive data on environmental conditions;  
    • incorporate inequality aspects into environmental, health and infrastructural policies; and
    • address inequality challenges through participatory planning approaches such as health impact assessments and environmental impact assessments.

     

    Publications

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    Implementation of health impact assessment and health in environmental assessment across the WHO European Region

    Health impact assessments (‎HIAs)‎ offer crucial support to decision-makers within and outside the health sector to identify and estimate possible...

    Enabling the implementation of health impact assessment in Portugal

    Health impact assessment (‎HIA)‎ is a means of assessing the health impacts of policies, plans and projects in diverse economic, social and environmental...

    Assessing the health impacts of waste management in the context of the circular economy

    The circular economy (‎CE)‎ is about increasing re-use, recycling and energy recovery from existing resources, whilst minimizing disposal. This...

    Learning from practice: case studies of health in strategic environmental assessment and environmental impact assessment across the WHO European Region

    Health is routinely considered in strategic environmental assessment (‎SEA)‎ and environmental impact assessment (‎EIA)‎, following requirements...

    Policy briefs

    Generic guidelines and tools: policy briefs on health impact assessments and incorporating health into environmental assessments

    This policy brief aims to provide information on the availability of guidance documents and tools to support teams conducting health impact assessments...

    Methodological challenges and data needs: Policy briefs on health impact assessments and incorporating health into environmental assessments

    This policy brief aims to provide information about the availability of guidance and tools to support health impact assessments (HIAs) and incorporating...

    Setup, roles and tasks of a support unit: policy briefs on health impact assessments and incorporating health into environmental assessments

    This policy brief provides background information on establishing a health impact assessment (HIA) and health assessment in environmental assessment (EA)....

    Policy briefs on health impact assessments and incorporating health into environmental assessments: an overview

    This series of policy briefs aims to inform policy- and decision-makers of countries in the WHO European Region about health impact assessments (HIAs);...