The need to address the human health implications of northern development is well founded, and the role of health determinants in environmental impact assessment is increasingly recognised; however, there is limited understanding of the nature of health determinants and current practices in northern project assessment and decision making. This paper reports on a study of the nature and use of health determinants in Canadian northern environmental impact assessment, and discusses the key challenges to, and opportunities for, improved practice. Four themes emerged from this study. First, the consideration of health is limited to physical environments and the physical determinants of health, with limited attention to broader social and cultural health determinants. Second, when health is considered in northern project impact assessments such considerations rarely carry forward to post-project approval monitoring of health determinants and evaluation of health impact management programmes. Third, while there is general consensus that health determinants should be an integral part of northern impact assessment, there exist different expectations of the role of health determinants in project evaluation and decision making due in large part to different understandings and interpretations of health. Finally, a broader conceptualisation of health and health determinants in northern environmental impact assessment is required; one that takes into consideration northern cultures and knowledge systems, and is adaptive to local context, geography and life cycles.
ALTERNATIVES ANALYSIS IN ENVIRONMENTAL IMPACT ASSESSMENT: METHODS OF DECISION MAKING