Research Items (49)
Brazil was one of the first countries in Latin America to institutionalize a National Environmental Policy in 1981, including the environmental impact assessment (EIA) process of economic activities with anticipated impacts on the environment. Today, EIA practice in Brazil comes with a number of limitations: it is constrained by its environmental advocacy role; application is strongly oriented towards large capital projects; and social responsibility considerations are only partially included. Consequently, EIA studies mainly address issues connected to localised and direct environmental impacts, largely ignoring any socio-economic and health impacts. This perspective paper highlights limitations of current EIA practice in Brazil with a focus on health considerations in impact assessment. While recognizing the positive impact to municipalities where large capital projects are being developed and operated, adverse impacts on health are a reality with measurable evidence in Brazil. Therefore, we argue that specificities on how to systematically assess and monitor potential health impacts cannot remain invisible in the Brazilian legislation, as currently seen in the reformulation of the licensing process in the country. The process of better integrating the assessment of health impacts in the licensing process of large capital project in Brazil must, however, not be based on the imposition of an external model but should be promoted by internal stakeholders from the environmental and health sector, incorporating the experiences gained in various case studies from all over the country. © 2018 The Author(s); Published by Kerman University of Medical Sciences.
The cross-border association of municipalities in the vicinity of the Geneva international airport (GA) demanded an environmental impact study (EIS) of the airport’s development plan. The Geneva government finally agreed that one should be performed early in the summer of 2015. After an international call for projects, a consortium of experts, coordinated by the Global Health Institute of the University of Geneva and bringing together university, research institutions, private consulting firms, and the associative sector, conducted this EIS between October 2015 and October 2016. Its objective was to quantify the current (reference state 2014) and future (scenario 2030) effects of airport activity. A group of senior canton officials in the relevant departments (environment, health, territorial development, economics) and representatives of the municipalities near the airport supported this EIS and validated its procedure, methodology, and other strategic choices. The results showed that the health impact of air pollution would be greater in 2030 than that of noise; moreover, daytime noise would improve while nocturnal noise would grow worse. A telephone survey concerning quality of life questioned 750 adults living in the study area and corroborated trends similar to those shown by the quantitative analysis of the health risks. The very positive contribution of the airport in terms of the region’s economy and jobs and the health consequences of this contribution were also explained. This study analyzes the effectiveness of the EIS procedure according to the conceptual framework proposed by Harris-Roxas & Harris in 2013. This EIS, performed in a potentially very conflictual context, met the principal criteria for effectiveness of the process. It was also effective in reaching its short-term goals. While it is too early to judge its long-term effects, encouraging signs have been noted.
Introduction Green space in the built environment is an important topic on the health agenda today. Studies have shown that access to green spaces is associated with better mental and physical health, yet green spaces can also be detrimental to health if they are not managed appropriately. Despite the increasing interest in urban green spaces, little research has so far been conducted into the links between green spaces and cancer. Objective The purpose of this scoping review is therefore to map the literature available on the types of relationship between urban green spaces and cancer. Method and analysis We followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 guideline to report the protocol. To conduct this scoping review, we will use a structured search strategy based on controlled vocabulary and relevant key terms related to green space, urban space and cancer. We will search MEDLINE (PubMed), GreenFILE (EBSCOhost), Cumulative Index to Nursing and Allied Health Literature (EBSCOhost) and ScienceDirect as electronic database as well as hand-search publications for grey literature. This review will therefore provide evidence on this current topic, one which could have practical implications for policy-makers involved in choices which are more conducive to healthy living. Ethics and dissemination No primary data will be collected since all data that will be presented in this review are based on published articles and publicly available documents, and therefore ethics committee approval is not a requirement. The findings of this review will be presented at workshops and conferences, and will be submitted for publication in a peer-reviewed journal.
- Jan 2018
The aim of this study is to investigate the integration of the health dimension within existing impact assessments such as environmental impact assessment (EIA), strategic environmental assessment (SEA) and sustainability assessment (SA). This work focuses on the canton of Geneva (Switzerland) and was carried out using the following methodology: a review of the legal texts and the guidelines that underpin the design and methodology of IAs; an analysis of the application of these tools in 37 case studies (11 SEAs and 20 EIAs conducted in Geneva as well as 6 SAs undertaken at national level); and conducting semi-structured interviews with selected professionals who participated in these case studies. Our study reveals serious shortcomings in the consideration of health within the investigated environmental assessments, limited to a simple review of the effects of projects on the determinants of the physical environment as required by the Swiss or local (Geneva) legislations. Regarding SA, our research finds that health is treated superficially and primarily through the analysis of ‘health and safety’ criteria.
Background This paper presents the research protocol of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project funded by the National Institute for Cancer (Subvention N°2017–003-INCA). In France, health inequities have tended to increase since the late 1980s. Numerous studies show the influence of social, economic, geographic and political determinants on health inequities across the life course. Exposure to environmental factors is uneven across the population and may impact on health and health inequities. In cities, green spaces contribute to creating healthy settings which may help tackle health inequities. Health in All Policies (HiAP) represents one of the key strategies for addressing social and environmental determinants of health inequities. The objective of this research is to identify the most promising interventions to operationalize the HiAP approaches at the city level to tackle health inequities through urban green spaces. It is a participatory interventional research to analyze public policy in real life setting (WHO Healthy Cities). Method/design It is a mixed method systemic study with a quantitative approach for the 80 cities and a comparative qualitative multiple case-studies of 6 cities. The research combines 3 different lens: 1/a political analysis of how municipalities apply HiAP to reduce social inequities of health through green space policies and interventions 2/a geographical and topological characterization of green spaces and 3/ on-site observations of the use of green spaces by the inhabitants. Results City profiles will be identified regarding their HiAP approaches and the extent to which these cities address social inequities in health as part of their green space policy action. The analysis of the transferability of the results will inform policy recommendations in the rest of the Health City Network and widely for the French municipalities. Discussion/conclusion The study will help identify factors enabling the implementation of the HiAP approach at a municipal level, promoting the development of green spaces policies in urban areas in order to tackle the social inequities in health. Electronic supplementary material The online version of this article (10.1186/s12889-017-4812-8) contains supplementary material, which is available to authorized users.
Abstract After publication of the article , it has been brought to our attention that in the original publication the third author’s name was spelt incorrectly. The correct spelling is “Emmanuelle Faure”. This was previously spelt as “Emmannuelle Faure”. The original article has been revised to reflect this.
In Switzerland, the federal authorities, the cantons, and the communes share the responsibility of healthcare, disease prevention and health promotion policies. Yet, the cantons are in most health matters independent in their decisions, thus defining as a matter of fact their own health priorities. We examined and analysed the content of the disease prevention and health promotion plans elaborated during the last decade in six French-speaking cantons with different political contexts and resources, but quite similar population health data, in order to identify the set health priorities. The plans appear significantly inhomogeneous in their structure, scope and priorities. Most of the formal documents are short, in the 16 to 40 pages range. Core values such as equity, solidarity and sustainability are explicitly put forward in 2/6 cantonal plans. Priority health issues shared by all 6 cantons are "physical activity/sedentariness" and "nutrition/food." Mental health is explicitly mentioned in 5 cantonal plans, whereas tobacco and alcohol consumptions are mentioned 4 times. Less attention has been given to topics that appear as major public health challenges at present and in the future in Switzerland, eg, ageing of the population, rise of social inequalities, increase of vulnerable populations. Little attention has also been paid to issues like domestic violence or healthy work environments. Despite some heterogeneity, there is a common base that should make inter-cantonal collaborations possible and coordination with national strategies easily feasible.
- May 2017
This study aims to understand how the health dimension is integrated into four impact assessment tools used in Geneva, Switzerland: environmental impact assessment (EIA), strategic environmental assessment (SEA), sustainability assessment (SA) and health impact assessment (HIA). We have chosen as a case study greenhouse gas (GHG) emissions reduction policies chosen by the city of Geneva. The methodological approach consists in analysing EIA, SEA, SA and HIA conducted on three projects in three topic areas: urban planning, heating and transportation. These projects are: a complex urbanisation plan in an urban neighbourhood in Geneva (the Gare des Eaux-Vives project), a sustainable transportation plan for a central district in Geneva (the St-Gervais transportation project) and a strategy to encourage the City's employees to use sustainable transport for local business travel. The results show some shortcomings in the consideration of health in SEA, EIA and SA. This work highlights a narrow vision of health in SEA and EIA, limiting itself to a review of the effects of projects on the determinants of the physical environment as required by the legislation relating to these tools. EIA does not require the integration of the health dimension. As for SA, our research found that health is treated much more superficially than in HIA and primarily through the analysis of 'health and safety' criteria. It appears from this work that HIA is the tool which provides the most elaborate assessment, compared to SA, SEA or EIA, of the consequences for health of the GHG reduction policies chosen by the local decision-makers of a city. However, our study suggests that the HIA community should identify the situations in which HIA should be carried out and in which cases it is better to include health issues within an integrated analysis.
In this chapter we review the first five chapters of the book through the lens of social movement theory and within a gaze of glocal health (the idea that the global and the local have become inextricably connected) development and evidence. We seek a foundation for the case material in Part II of the book in the documented evidence of Healthy Cities, communities, and villages around the world, and in particular in the series of evaluations carried out for the European Region of WHO Healthy Cities networks. As such, the chapter provides a comprehensive update on the empirical evidence for Healthy Cities around the world. It ends with a reading guide for the ‘regional’ case material in Part II of the book and a justification for the material compiled in that section.
HIA has emerged as a privileged tool for the implementation of health in all policies (HiAP). It is a vehicle to help health practitioners inform societal decision-making and can be very effective in the decision-making process as a decision-aid tool.
Europe has played an important role in the global development of Healthy Cities. The Regional WHO Bureau in Copenhagen was the first to implement the Healthy Cities concept, with partners from North America and through an initial network of cities in Europe. The network was then consolidated and expanded through several successive 5-year phases. Facilitating the creation of national WHO Healthy Cities networks ensured further diffusion of the idea. This relatively formal structure has ensured that Healthy Cities is the only programme where WHO liaises not with Member States ministers but with the mayors of cities or conurbations. Working in coordinated by WHO networks has favoured the exchange of information between partners as well as the pursuit of common goals. It has also allowed the production of structured and innovative evaluations, impossible to produce by each participating city in isolation. The European model is therefore a useful way of implementing the Healthy Cities concept. It ensures a certain degree of homogeneity, which does not prevent novel concepts from emerging, such as the Green Fork label, used in catering.
Africa is one of the least urbanized continents. Less than 40 % of the population (413 million of over one billion) lived in urban areas in 2011. This situation is changing rapidly, and in 2050 around 70 % of the continent’s population is expected to be urban. This extremely fast pace means that the gap between Africa and other continents is closing rapidly—the world average was 52.1 % in 2011 (see Fig. 6.1).
In this chapter we attempt to systematically analyse the case studies provided for the different regions in Part II of the book. We argue that a degree of systematizing of Healthy Cities around the world is warranted. However, the evidence generated in Part II shows that each Healthy City is unique, with a unique context and unique set of governance and operational parameters. This is no surprise, and we continue to explain why any effort at collective analysis must first and foremost take into account the matter of glocal values and political choice. The argument is grounded in political philosophy and efforts to frame political cultures across nations and (social and political) environments. We present the statements to come out of pivotal 2016 meetings (the Habitat 3 Quito statement and the WHO Shanghai health promotion declaration) as sharing the value system that is also espoused by the Sustainable Development Goals and the new Global Public Health Charter. (Healthy) Cities have been working towards these value systems for three decades now, and seem well placed to continue to take a lead in the grand challenges of urban health—as presented in Part III of this book.
- Feb 2017
This forward-looking resource recasts the concept of healthy cities as not only a safe, pleasant, and green built environment, but also one that creates and sustains health by addressing social, economic, and political conditions. It describes collaborations between city planning and public health creating a contemporary concept of urban governance-a democratically-informed process that embraces values like equity. Models, critiques, and global examples illustrate institutional change, community input, targeted assessment, and other means of addressing longstanding sources of urban health challenges. In these ambitious pages, healthy cities are rooted firmly in the worldwide movement toward balanced and sustainable urbanization, developed not to disguise or displace entrenched health and social problems, but to encourage and foster solutions. Included in the coverage: Towards healthy urban governance in the century of the city Healthy cities emerge: Toronto, Ottawa, Copenhagen The role of policy coalitions in understanding community participation in healthy cities projects Health impact assessment at the local level The logic of method for evaluating healthy cities Plus: extended reports on healthy cities and communities in North and Latin America, Africa, Europe, Asia, Oceania, and the Middle East Healthy Cities will interest and inspire community leaders, activists, politicians, and entrepreneurs working to improve health and well-being at the local level, as well as public health and urban development scholars and professionals.
While European States insist on the necessity to develop environmental health policies, mainly at the international level, a careful analysis of national policy processes, focused on national environmental health action plans (NEHAPs) and national strategies of sustainable development (NSSDs), tend to show that results obtained are particularly limited. This study investigates the reasons for this surprising “environmental health paradox”. Data used in this study come from interviews of experts in Swiss, German, and Belgian environmental health policies and from survey results provided by the WHO Regional Office for Europe (WHO/Europe) and its Environmental Health Center in Bonn. Findings show that the major obstacles to more ambitious environmental health policies are the lack of political recognition at the national level, notably vis-à-vis the concept of sustainable development, their confinement to measures of scientific research, which limits their ability to reach policy actors situated outside dedicated “epistemic communities”, and the absence of any substantial system of indicators capable of correctly assessing environmental health issues and policy outcomes. These results, also compared to corresponding French and Austrian policies, provide an explanation for the difficulties faced by this relatively new field of public policy and highlight the most common difficulties in developing complex, cross-sector environmental health policies.
- Apr 2016
Urban agriculture plays an important role in the economy of developing countries. In Dakar (Senegal), this activity produces 70 % of the demand in vegetables and also provides thousands of direct and indirect jobs. In spite of this very important social and economic role, the urban agriculture in Dakar is confronted with two major problems : the land insecurity and the limited access to water. To cope with these constraints, growers use methods that have consequences on the environment and human health. The objective of this study is to analyze the health impacts of agricultural practices in a context of continuing urbanization. Following this work, the research reveals that agricultural practices in the Niayes (agricultural region) of Dakar have one hand enormous impacts on the health of farmers and surrounding populations and also in the medium term these impacts will be accentuated by the strong urbanization of the area. Indeed, the current agricultural practices in water management and use of pesticides put in perspective with the changes inherent in the high urbanization may upset the existing spatial synergies in urban production systems.
- Jan 2016
Several cities around the world have taken action to reduce greenhouse gas (GHG) emissions, but how many know to what extent these measures may affect public health? The aim of this study is to assess the effects on health and well-being of GHG emissions reduction policies in the city of Geneva. Three projects related to climate change mitigation were identified, in three topic areas: urban planning, heating and transport. These projects are: a complex urbanisation plan in a neighbourhood of the city of Geneva (urban planning and heating), a sustainable transportation plan for a district in Geneva (transport) and a strategy to encourage City's employees to use sustainable mobility for local business travel (transport). The main issues investigated were physical activity, air quality, noise and energy. The methodological approach consisted in applying the Health Impact Assessment process. Qualitative and quantitative methods were used to assess potential health impacts. For the first project, results show that the energy scenario with the least CO2 emissions is the best for limiting health impacts (and maximising cobenefits). For the second project, results show that the scenario with the most space devolved to pedestrians is the most beneficial for health especially in terms of cardiovascular disease prevention. The analysis of the strategy of the City of Geneva for local business travel revealed that the strengthening of sustainable modes of transportation for this purpose in the city would be favourable in terms of the environment (reduction of CO2, NOx and PM10 emissions) and health. It appears from this case-study in Geneva that cities can play a key role in tackling climate change while bringing co-benefits for health.
The purpose of this article is to review the status of Health Impact Assessment (HIA) in Switzerland and assess whether HIA can be used to implement Health in All Policies (HiAP) in this highly decentralized country. The methods include expert opinion and an extensive literature review, as well as targeted interviews with key informers in the cantons of Geneva, Jura and Ticino. HIA has been implemented successfully since the early 2000s in Switzerland. However, integration has been heterogeneous with only a few cantons taking the lead. Integration of HIA at the federal level was attempted in 2012 but failed due to resistance from a pro-business lobby. HIA in Switzerland has the potential to contribute to HiAP, but success depends on a wider dissemination of HIA and on some form of integration at the national level. In this respect, a 'bottom-up' approach based on inter-cantonal collaborations appears more promising than the 'top-down' federal level approach. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Les relations entre sante, espaces verts, paysages, formes et ambiances urbaines, amenagements et la vie quotidienne est une question ouverte depuis le XIXe siecle. Qu’en est-il a l’heure ou l’humanite habite dans sa majorite (dans son ecrasante majorite au Nord) en milieu urbain ? Quel sens donner, du point de vue de la sante des habitants, a des principes urbanistiques tels que densification, [...]
In this article we reflect on the quality of a realist synthesis paradigm applied to the evaluation of Phase V of the WHO European Healthy Cities Network. The programmatic application of this approach has led to very high response rates and a wealth of important data. All articles in this Supplement report that cities in the network move from small-scale, time-limited projects predominantly focused on health lifestyles to the significant inclusion of policies and programmes on systems and values for good health governance. The evaluation team felt that, due to time and resource limitations, it was unable to fully exploit the potential of realist synthesis. In particular, the synthetic integration of different strategic foci of Phase V designation areas did not come to full fruition. We recommend better and more sustained integration of realist synthesis in the practice of Healthy Cities in future Phases. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: email@example.com.
Health impact assessment (HIA) is a prospective decision-making aid tool that aims to improve the quality of policies, programmes or projects through recommendations that promote health. It identifies how and through which pathways a decision can impact a wide range of health determinants and seeks to define the distribution of effects within populations, thereby raising the issue of equity. HIA was introduced to the WHO European Healthy Cities Network as one of its four core themes during the Phase IV (2004-08). Here we present an evaluation of the use of HIA during Phase V (2009-13), where HIA was linked with the overarching theme of health and health equity in all local policies and a requirement regarding capacity building. The evaluation was based on 10 case studies contributed by 9 Healthy Cities in five countries (France, Hungary, Italy, Spain and the UK). A Realist Evaluation framework was used to collect and aggregate data obtained through three methods: an HIA factors analysis, a case-study template analysis using Nvivo software and a detailed questionnaire. The main conclusion is that HIA significantly helps promote Health in All Policies (HiAP) and sustainability in Healthy Cities. It is recommended that all Healthy City candidates to Phase VI (2014-18) of the WHO Healthy Cities European Network effectively adopt HIA and HiAP. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Promoting physical activity and active transport strategies are among the “best buys” for tackling the risk factors of noncommunicable diseases (WHO Global status report on noncommunicable diseases, 2010). Operationalising such insights requires policies favourable to health in the transport sector. In Switzerland and many other countries, the transport sector has its own agenda which includes increasing walking, cycling and public transport patronage, and reducing car use – or at least limiting it to areas or purposes not easily covered by other transport modes. It is clear to most transport sector professionals that reducing car use and favouring other modes not only alleviates traffic congestion, but also contributes to reducing noise, air pollution, energy consumption and greenhouse gas emission. However, many transport strategies have trouble integrating health into their argumentation plans. Air pollution is sometimes mentioned, however improvements in motor and fuel quality standards have weakened this argument. What remains under-explored is the potential of a reduction in car use and/or an increase in public transport use to increase daily walking. Given the current global epidemic of sedentariness, overweight and obesity, this deserves to be explored further. We used the Swiss transport micro-survey (MTMT2010) – a complex database where 62’868 people describe their transport behaviour on randomly selected reference days – to investigate associations between walking and the use of other transport modes. Linear regression was carried out using kilometres walked as the dependent variable. We found walking to be positively associated with public transport use and negatively associated with the use of a private motorised vehicle. The proportion of variance in walking distances explained is around 3% (p
L'évaluation d'impact sur la santé (EIS) est un courant de pratique qui connaît une popularité croissante partout dans le monde depuis la fin des années 1990. D'abord utilisée dans le cadre des évaluations d'impact environnemental (EIE), elle s'est enrichie des connaissances et des principes portés par le courant des déterminants sociaux de la santé et par celui de l'action sur les inégalités sociales de santé pour être transposée dans le contexte de l'élaboration de politiques publiques et ce, à tous les échelons de prise de décision gouvernementale. Dans les faits, l'EIS poursuit trois objectifs concomitants : estimer les effets potentiels d'un projet de politique sur la santé, favoriser la participation citoyenne et de parties prenantes au processus d'analyse d'impact et informer le processus de décision. L'article définit brièvement ce qu'est l'EIS, sa démarche standardisée en étapes successives, ce qui permet de structurer l'action et d'établir clairement les pas à franchir : dépistage, cadrage, analyse, recommandations, évaluation et contrôle ; et propose trois exemples d'EIS dans trois situations différentes : dans le Canton de Genève en Suisse, à Rennes en France, et en Montérégie au Québec, au Canada. La synthèse de ces illustrations montre que l'EIS est une stratégie intéressante pour influencer les décisions locales et intégrer de la santé dans les projets et politiques du palier local ou régional.
This article offers initial feedback from a field experience on the design and implementation of a Health Impact Assessment (HIA) approach in the context of an urban planning project. This approach aims at minimizing negative impacts and optimizing positive impacts of the project on the health and quality of life of populations. A methodology based on the design of a multi-criteria grid with several health determinants was developed and a list of recommendations was subsequently suggested to decision-makers. The strengths of such a participatory and approach integrating both environmental health and sustainable development are discussed and methodological recommendations are produced in order to facilitate future use of such an approach in similar contexts.
The development of HIA in France may appear slower than elsewhere but its presence at the national, regional and local levels is now undeniable. HIA was introduced in France through two separate and independent levels, national and local community. This chapter analyses the different rationales and demands involved in these approaches. At a national level, the introduction of HIA is part of a wider process of impact assessments in support of legislation. At a local community level, it is more about urban planning and health, mainly linked with the healthy cities framework. For both levels, HIA is promoted as a tool to help reduce health inequalities. The new administrative arrangements with the creation of Regional Health Agencies gives new perspectives and opportunities for HIA implementation at the regional level.
The nature of HIA and how it has been incorporated into Switzerland's administrative structure is strongly linked to the political functioning of the country. In that perspective, this chapter tackles separately the processes at each institutional level (federal state, cantons states), but also the nexus between them, specifically the Swiss HIA Platform whose purpose is to coordinate and to reinforce the efforts made to initiate HIA in Switzerland. Three founding cantons-Geneva, Jura and Ticino-initiated the creation of this Platform, which is strongly supported by Health Promotion Switzerland. The legal status of HIA in Switzerland, l on the federal and cantonal levels, is an important issue for its specific context and will be analysed. Finally, the weaknesses, opportunities and perspectives for HIA in Switzerland will be discussed.
This article is intended to be an initial report on the experiences gained while using HIA. Although it is provisional and pragmatic, it ought to provide useful elements for comparison with other territorial situations, both Swiss and foreign. The large differences between the three cantonal political-institutional contexts probably explain the profound differences in the way that HIA processes were introduced in each canton. Nevertheless, the article - through the concept of institutionalization - seeks to identify supracantonal elements. Finally, by presenting HIA implementation methods in different Cantons, it endeavours to demonstrate the existence of a common matrix in the Swiss context beyond the differences arising from the actual political-institutional situations linked to them.
- Jun 2006
Using the synergies between strategic environmental evaluation and HIA to advance the integration of environmental and health issues in public decision-making processes The Geneva rule was the first one in Switzerland to introduce the concept of Strategic Environmental Assessment (SEA). This assessment constitutes a decision making aid which describes the process set up to allow evaluation of potential environmental impact and comparison of possible variants, recommends the choice for the best option and suggests the precautions to take. It presents much resemblances to HIA. In this case therefore the application of SEA in the urban planning project MICA has been presented. It is in this framework that a first experience of integration HIA to the SEA process was realized. In an additional way to SEA, HIA is focused on the following fields of potential impact: transport and movements, housing, public facilities, water management.
The Geneva rule was the first one in Switzerland to introduce the concept of Strategic Environmental Assessment (SEA). This assessment constitutes a decision making aid which describes the process set up to allow evaluation of potential environmental impact and comparison of possible variants, recommends the choice for the best option and suggests the precautions to take. It presents much resemblances to HIA. In this case therefore the application of SEA in the urban planning project MICA has been presented. It is in this framework that a first experience of integration HIA to the SEA process was realized. In an additional way to SEA, HIA is focused on the following fields of potential impact: transport and movements, housing, public facilities, water management.
- Feb 2005
The Forum Dialogue on national health systems which took place as a satellite meeting of the 2nd International Conference on Local and Regional Health Programmes compared four countries (Brazil, France, Switzerland and Canada) sustain "conditions to integrate prevention and promotion in health systems". Despite the diversity of the four systems presented, several similarities regarding difficulties faced and achievements obtained in the integration process have been extracted, which has allowed highlighting three perspectives of action. It is suggested that prevention and promotion can be integrated into health systems by mobilising the population and health professionals towards prevention, but with the condition that the promotion and prevention sector increase its credibility by developing practices of quality, organisation, discourse, and prevention practices adjusted to the health care context. Finally, exchange between the countries on this subject is the way forward to nourish the thinking and support each other to obtain this desired integration.
- Jan 1996
- Presses polytechniques et universitaires romandes, Lausanne, Suisse