Calls for mandatory 'health proofing'

Health Impact Assessments (HIAs) should be made mandatory in the same way that environmental impact assessments (EIAs) are for major projects, a conference will be told today.

Though the Department of Health's 2001 Health Strategy - Quality and Fairness listed introducing HIAs as part of the public policy development process, there is still no obligation to provide one.

HIAs, also known as health proofing, measures the potential effects of a policy on the health of the population and are commonplace in many countries.

In Ballyfermot, a HIA on traffic and transport identified a need for more walking and cycling facilities in the area, more walk-to-school initiatives and greater dissemination of information on public transport services.

A similar HIA was carried out in Donegal County Council's local area plan and its accommodation programme for travellers, but most private and public schemes in Ireland are carried out without one.

HIAs are mandatory in London as part of the Mayor of London's statutory strategies for the city and have been widely praised in Britain for best practice.

HIAs have been carried out to date in London on aspects of policy for which the mayor has responsibility including culture, air quality, urban planning, biodiversity, waste management, the treatment of old people and creche facilities.

The co-ordinator of the London Health Commission, Gail Findlay, is one of the guest speakers at the eighth annual international conference on HIAs taking place in Dublin Castle today and tomorrow.

She said the cost of including HIAs in major policy initiatives is about £17,000 (€25,000) in London but the potential benefits are three to four times that figure, and should be done in a mandatory fashion as EIAs are often done.

"HIAs can take as little as six weeks to complete and need not be expensive," she said. "As a result of HIAs, major plans for London have been amended to effect better outcomes for health such as greater cycling and pedestrian facilities.

"Carrying them out will have a significant benefit for the health of London in the long term, particularly in terms of narrowing health inequalities. I would strongly recommend greater adoption of HIAs in Ireland," she said.

Other speakers at today's conference will include Prof Paul Hunt, UN special rapporteur on the right to health, and Dr Josep Figueras, the director of the European Observatory on Health Systems and Policies. He will give an overview of HIAs in Europe.

The conference is hosted by the Institute of Public Health. Its associate director, Owen Metcalfe, said the lack of consideration of health issues in the planning process in Ireland has been a contributory factor in the building of vast estates without proper infrastructure.

"We know there is a problem with obesity in this country. It does not make sense to build community facilities which can only be accessed by cars. Similarly, when schools are built, consideration should be given to whether children can walk or cycle to it.

"When you are developing policies, the health dimension is not accorded the priority it merits in this country. We tend to think of health in terms of illness and treatment, not in terms of the promotion of a healthy lifestyle in the first place. If we were more systematic in dealing with health as an issue, public policy would make a great strive forwards," said Mr Metcalfe.

The public health institute has developed booklets on HIAs on employment, transport and the built environment and has received a favourable response from planners and architects. It is hoping to expand the range of HIAs to take in public policy on issues including alcohol and nutrition.