PHM-Exch> Health equity impact assessment

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crossposted from: EQUIDAD at listserv.paho.org


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*Health equity impact assessment

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Susan L. Povall1, Fiona A. Haigh2, Debbie Abrahams1 and Alex Scott-Samuel1

1Department of Public Health and Policy, **University** of **Liverpool**, **
**Liverpool**, **UK**** ****

2Centre for Health Equity Training, Research and Evaluation, Part of the
Centre for Primary Health Care and Equity, University of New South Wales, A
Unit of Population Health, Sydney and Sydney South West Local Health
Districts, NSW Health, Sydney, New South Wales, Australia ****


*Health Promot. Int. (2013) doi: 10.1093/heapro/dat012 - February 28, 2013*

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*Website: http://bit.ly/W0djzn

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“…….The World Health Organization's Commission on Social Determinants of
Health has called for ‘*health equity impact assessments'* of all economic
agreements, market regulation and public policies. We carried out an
international study to clarify if existing health impact assessment (HIA)
methods are adequate for the task of global health equity assessments. We
triangulated data from a scoping review of the international literature,
in-depth interviews with health equity and HIA experts and an international
stakeholder workshop.

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 We found that equity is not addressed adequately in HIAs for a variety of
reasons, including inadequate guidance, absence of definitions, poor data
and evidence, perceived lack of methods and tools and practitioner
unwillingness or inability to address values like fairness and social
justice. Current methods can address immediate, ‘downstream’ factors, but
not the root causes of inequity.

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Extending HIAs to cover macro policy and global equity issues will require
new tools to address macroeconomic policies, historical roots of inequities
and upstream causes like power imbalances. More sensitive, participatory
methods are also required. There is, however, no need for the development
of a completely new methodology.

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“…..This paper presents the main findings from a pilot study (Povall et
al., 2010) to determine whether or not a new HEIA methodology is needed to
examine the health equity impacts of global, regional, national and local
financial and public policies.
In order to do this, we need to determine the capacity of existing HIA
methodologies to include a consideration of health equity impacts. We
examined this question through three separate but related qualitative
methods: a scoping review of international literature relating to equity
assessment within impact assessment, interviews with health equity and HIA
experts and two stakeholder workshops……..”

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