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Quantitative health impact assessment: current practice and future directions
J L Veerman1, J J Barendregt, J P Mackenbach
1Department of Public Health, Erasmus MC-University Medical Centre Rotterdam, Netherlands. j.veerman@erasmusmc.nl
Journal of Epidemiology and Community Health
|April 16, 2005
Summary
Quantitative health impact assessment (HIA) is rarely performed. Available methods for exposure and outcome assessment exist for environmental health but require further research for socioeconomic and behavioral factors.
Area of Science:
- Public Health
- Environmental Health
- Health Policy
Background:
- Quantitative health impact assessment (HIA) is crucial for evaluating policy effects on population health.
- Current methods for quantifying health impacts in HIA are not consistently applied or well-established.
- There is a need to understand the methodologies employed in quantitative HIA to identify research gaps.
Purpose of the Study:
- To systematically assess the methods used in quantitative health impact assessment (HIA).
- To identify areas requiring future research and development to enhance quantitative HIA.
Main Methods:
- Review of 98 prospective HIA reports.
- Assessment of methods for quantifying policy effects on health determinants (exposure impact assessment).
- Evaluation of methods for quantifying health outcomes from exposure changes (outcome assessment).
Main Results:
- Only 17 out of 98 HIA studies reported quantitative exposure changes, and 16 reported quantified health outcomes.
- Eleven categories of determinants were quantified to health outcomes.
- Exposure impact assessment utilized routine data, modeling (traffic, environmental), expert estimates, and assumptions. Health outcomes were calculated using epidemiological/toxicological risk assessment and mathematical models.
Conclusions:
- Quantitative HIA is infrequently conducted.
- Methods are available for environmental health, traffic accidents, infectious diseases, and behavioral factors, but their reliability is uncertain.
- Future research should focus on socioeconomic/behavioral determinants, user-friendly models, summary health measures, expert opinion, scenario building, and validity/reliability research.