IN RECENT years, interest has been growing around the issue of health impact assessment. As defined by the World Health Organization's European office, health impact assessment is "a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population and the distribution of those effects within the population." In short, its aim is to make sure policies and projects don't harm human health.
In the United States, health impact assessment is an outgrowth of the National Environmental Policy Act of 1969, which specified that effects on health, public health and safety be considered when creating policies or projects. Despite the law, broadly conceived health impact assessments have not been routinely included in environmental impact reports.
Some progress has been made, however. Aaron Wernham, MD, MS, of the Alaska Inter-Tribal Council in Fairbanks, Alaska--who has been a key informant for me on this issue--led the first reported health impact assessment formally integrated into a federal environmental impact assessment. In the project, Alaska Natives from the state's North Slope worked with public health professionals and regulatory agencies to include health assessments in federal environmental impact statements for oil and gas development. The assessment identified health risks of such development, including increased injury rates and exposure to pollutants, and recommended mitigation measures.
Among the reasons health impact assessment has been attracting attention is that it is based on the values of democracy, equity, sustainable development and the ethical use of evidence. …