scholarly journals The Public Health Implications of Brexit: A Health Impact Assessment Approach

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Green
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Health Impact ◽  
Complex Nature ◽  
The Public ◽  
Wide Range ◽  
The Impact ◽  
The Eu ◽  
Public Bodies

Abstract On March 29th 2019, the United Kingdom (UK) was due to exit the EU in a process known informally as ’Brexit’. This exit and entry into a 2-year transition is a period of unprecedented political and social upheaval - with many unknowns and much uncertainty attached to the outcomes and future impact. In preparation for Brexit, Public Health Wales commissioned the Wales HIA Support Unit to carry out a health impact assessment of Brexit in Wales to support and inform its and other public bodies planning and future work. This paper examines the unique HIA carried out between July and December 2018 on the impact of the UK withdrawal from the EU in Wales. It discusses the robust, participatory process undertaken, the stakeholders involved and the benefits reaped from this. It highlights the evidence gathered and analysed including the collection methods, the complex nature of the work and disseminates the main findings from the HIA including the potential determinants of health and population groups identified. Finally, it describes the challenges faced, how these were overcome, and the huge benefits, impact and influence it has had to date across a wide range of UK and Welsh organisations and public bodies. This work demonstrates continued leadership in the field of impact assessment and spearheads the requirement for public bodies to carry out HIAs as part of the forthcoming statutory requirements of the Public Health (Wales) Act 2017 an can inform practice at a global level. Key messages HIA can inform and influence action in response to important strategic decisions. The Brexit HIA is a unique example which can inform international HIA practice.

scholarly journals Process, Practice and Progress: A Case Study of the Health Impact Assessment (HIA) of Brexit in Wales

2020 ◽  
Vol 17 (18) ◽  
pp. 6652
Author(s):  
Liz Green ◽  
Kathryn Ashton ◽  
Nerys Edmonds ◽  
Sumina Azam
Keyword(s):  
Impact Assessment ◽  
Health Impact Assessment ◽  
Well Being ◽  
Health Impact ◽  
World Health ◽  
Flexible Tool ◽  
Support Unit ◽  
Wide Range ◽  
The Impact ◽  
Health And Well Being

Health impact assessment (HIA) is a systematic and flexible tool, which is advocated by the World Health Organisation as a method through which to consider the impact of policies on the health and well-being of a population, and the inequalities that may arise because of it. In 2018, the HIA support unit in Wales carried out a comprehensive and unique HIA on the impact of Brexit in Wales. The aims were to understand the differential impacts that Brexit would have on the health and well-being of the population and to provide evidence to inform decision makers across a range of public bodies. It followed a five-step process for HIA and utilised a wide range of evidence sources and health intelligence including both quantitative and qualitative evidence. This paper reflects on the process of carrying out the HIA and the methods used. It discusses the stages of the HIA, and shares the findings and reflections of implementation which will be beneficial to other HIA practitioners and policy makers. It does not concentrate on the findings of the HIA in detail, but focusses on what worked and any challenges encountered. It has been used to progress the practice of HIA in Wales and demonstrates the value of HIA as a method to inform and influence complex decisions.

scholarly journals Using health impact assessment (HIA) to understand the wider health and well-being implications of policy decisions: the COVID-19 ‘staying at home and social distancing policy’ in Wales

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liz Green ◽  
Kathryn Ashton ◽  
Sumina Azam ◽  
Mariana Dyakova ◽  
Timo Clemens ◽  
...  
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Well Being ◽  
Health Impact ◽  
Policy Decisions ◽  
Social Distancing ◽  
The Impact ◽  
Health And Well Being ◽  
Staying At Home

Abstract Background Health Impact Assessment (HIA) is promoted as a decision-informing tool by public health and governmental agencies. HIA is beneficial when carried out as part of policy development but is also valuable as a methodology when a policy is being implemented to identify and understand the wider health and well-being impacts of policy decisions, particularly when a decision needs to be taken rapidly to protect the population. This paper focusses on a HIA of the ‘Staying at Home and Social Distancing Policy’ or ‘lockdown’ in response to the COVID-19 pandemic in Wales conducted by the Welsh national public health institute. It describes the process and findings, captures the learning and discusses how the process has been used to better understand the wider health and well-being impacts of policy decisions beyond direct health harm. It also examines the role of public health institutes in promoting and using HIA. Methods A HIA was conducted following a standard HIA five step process. A literature review was undertaken alongside 15 qualitative semi-structured interviews with key stakeholders, and relevant health and demographic data were collated. The results were triangulated and analysed to form a holistic assessment of the policy decision and its impacts. Results A wide range of major health and well-being impacts of the lockdown in Wales were identified across the determinants of health, which included positive and negative social, economic, environmental and mental well-being impacts beyond the impact on direct health. Populations affected included children and young people, those on low incomes and women as well as those whose health has been directly impacted by COVID-19 such as older people. The work highlighted the benefit that HIA can bring in emphasizing impacts which can inform policy and shared learning with others. Conclusion HIA is a largely underused tool to understand the impact of policy and political decisions, particularly when a decision has been taken at speed. This case study highlights how HIA provide evidence and information for advocacy and further work by public health institutes, health agencies and policy makers.

scholarly journals “Health in All Policies” Approach and Health Impact Assessment in Russia and the world

Public Health ◽  
2022 ◽  
Vol 1 (4) ◽  
pp. 15-33
Author(s):  
D. A. Khalturina ◽  
V. A. Zykov ◽  
T. S. Zubkova
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Current System ◽  
Health Impact ◽  
Health In All Policies ◽  
The World ◽  
Regulatory Impact ◽  
The Impact ◽  
Made In

This study presents analysis of the international and Russian experience of implementation of “health in all policies” approach into legislation, as well as of health impact assessment. Certain steps towards the implementation of this approach have already been made in Russia, however, in general, there is still a lot to be done. It was revealed that the current system regulatory impact assessment (RIA) in Russia has a narrow focus and is focused on protecting the interests of business, which does not correspond to the well-established world practice, which presupposes complex RIA, including the impact of regulation on public health. Recommendations for strengthening the principle of “health by all policies” in Russian legislation and the introduction of the practice of assessing the regulatory impact on public health in Russia are presented.

scholarly journals Looking Ahead: Health Impact Assessment of Front-of-Pack Nutrition Labelling Schema as a Public Health Measure

2021 ◽  
Vol 18 (4) ◽  
pp. 1422
Author(s):  
Rodrigo Feteira-Santos ◽  
Violeta Alarcão ◽  
Osvaldo Santos ◽  
Ana Virgolino ◽  
João Fernandes ◽  
...  
Keyword(s):  
Public Health ◽  
Impact Assessment ◽  
Health Impact Assessment ◽  
Health Impact ◽  
Vulnerable Groups ◽  
Controlled Study ◽  
Open Label ◽  
Promotion Policy ◽  
Nutrition Labelling ◽  
The Impact

This study aimed to describe the underlying process, used methods and major recommendations emerging from a comprehensive and prospective health impact assessment of the endorsement of a front-of-pack nutrition labelling (FOP-NL) system by the Portuguese health authorities. A mixed-methods approach was used to gather information on the impact of four FOP-NL schemes on consumers’ selection of food products according to the perception of their nutritional quality, combining a systematic literature review, focus groups (FG), in-depth individual interviews, and an open-label crossover randomized controlled study. The relevance of FOP-NL as a public health promotion policy has emerged as a consensual idea among either FGs’ participants (i.e., consumers and experts), or interviewed stakeholders. Although all of the evaluated FOP-NLs result better than no system on promoting the choice of the healthiest product, the effectiveness of easy-to-interpret FOP-NL among vulnerable groups raised concerns related to the need of integrating specific nutritional information to promote a better self-management of chronic diseases, and related to the level of literacy of consumers, which could impair the usage of FOP-NL. Educational campaigns addressing skills to use FOP-NL is recommended. Furthermore, a monitoring strategy should be considered to evaluate the long-term effectiveness of this policy in promoting healthier food choices, and in reducing diet-related non-communicable diseases burden.

scholarly journals Adding value to the use of Health Impact Assessment and social return on investment technologies

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Green ◽  
K Ashton ◽  
M Dyakova ◽  
L Parry-Williams
Keyword(s):  
Impact Assessment ◽  
Return On Investment ◽  
Health Impact Assessment ◽  
Grey Literature ◽  
Health Impact ◽  
Social Value ◽  
Decision Makers ◽  
Structured Interviews ◽  
Social Return On Investment ◽  
The Impact

Abstract Health Impact Assessment (HIA) and Social Return on Investment (SROI) are beneficial public health methodologies that assess potential effects on health including social, economic and environmental factors and have synergies in their approaches. This paper explores how HIA and SROI can complement each other to capture and account for the impact and social value of an assessed intervention or policy. A scoping review of academic and grey literature was undertaken to identify case studies published between January 1996 and April 2019 where HIA and SROI methods have been used to complement each other. Semi-structured interviews were carried out with nine international experts from a range of regulatory/legislative contexts to gain a better understanding of past experiences and expertise of both HIA and SROI. A thematic analysis was undertaken on the data collected. The review identified two published reports which outline when HIA and SROI have both been used to assess the same intervention. Interview results suggest that both methods have strengths as standalone processes i.e. HIAs are well-structured in their approach, assessing health in its broadest context and SROI can add value by monetizing social value as well as capturing social/environmental impact. Similarities of the two methods were identified i.e. a strong emphasis on stakeholder engagement and common shared principles. When questioned how the two methods could complement each other in practice, the results indicate the benefits of using HIA to explore initial impact, and as a platform on which to build SROI to monetarize social value. HIA and SROI methodologies have cross-over. The research suggests potential benefits when used in tandem or combining the methods to assess impact and account for health and social value. Innovative work is now being carried out in Wales to understand the implications of this in practice and to understand how the results of the two methods could be used by decision-makers. Key messages HIA and SROI methods can be used in tandem to capture both the health impact and social value of policies and proposed interventions. HIA and SROI when used together can provide valuable information to inform decision makers around the health impact and social value of proposed policies and interventions.

scholarly journals Snus and snus-like nicotine products moving across Nordic borders: Can laws protect young people?

2021 ◽  
pp. 145507252199570
Author(s):  
Marjut Salokannel ◽  
Eeva Ollila
Keyword(s):  
Public Health ◽  
Young People ◽  
Health Impact ◽  
The Public ◽  
European Court ◽  
Wide Availability ◽  
Personal Use ◽  
Health Studies ◽  
High Level ◽  
The Eu

Background: Use of snus and snus-like nicotine products is increasing, in particular among young people, in several Nordic countries and Estonia, while snus is legally on the market only in Sweden and Norway. Snus is available in a great variety of tastes and packaging particularly catering for young users. Recently, strong snus-resembling nicotine pouches have emerged on the market. This research investigates the regulatory means to counteract this development. Methods: European Union (EU) and national tobacco control legislation, case law of the European Court of Justice (CJEU) and relevant public health studies are analysed. Results: The research finds that the judgement of the CJEU relating to the sale of snus on Finnish ferries has not been enforced. Permitted large traveller imports for personal use have contributed to wide availability of snus in Finland. Even if the legislation in Sweden is in conformity with the exemption it obtained in the Accession Treaty, the public health impact of snus use for young people in its neighbouring countries has become considerable. Nicotine pouches, -which are not regarded as medical products in terms of medicine legislation, lack harmonised EU-wide regulation. Controlling smuggling across open borders is challenging. Conclusions: The legislation at the EU and national levels should be able to protect young people from new tobacco and nicotine products. It is urgent to harmonise regulation relating to new tobacco and nicotine products taking as a base a high level of protection of health as required in the Treaty on the Functioning of the EU.

scholarly journals Impact of the Affordable Care Act’s Dependent Coverage Expansion on the Health Care and Health Status of Young Adults: What Do We Know So Far?

2017 ◽  
Vol 75 (2) ◽  
pp. 131-152 ◽  
Author(s):  
Joshua Breslau ◽  
Bradley D. Stein ◽  
Bing Han ◽  
Shoshanna Shelton ◽  
Hao Yu
Keyword(s):  
Public Health ◽  
Health Status ◽  
Insurance Coverage ◽  
Health Impact ◽  
Care Utilization ◽  
The Public ◽  
Behavioral Health Treatment ◽  
Coverage Expansion ◽  
Dependent Coverage ◽  
The Impact

The dependent coverage expansion (DCE), a component of the Affordable Care Act, required private health insurance policies that cover dependents to offer coverage for policyholders’ children through age 25. This review summarizes peer-reviewed research on the impact of the DCE on the chain of consequences through which it could affect public health. Specifically, we examine the impact of the DCE on insurance coverage, access to care, utilization of care, and health status. All studies find that the DCE increased insurance coverage, but evidence regarding downstream impacts is inconsistent. There is evidence that the DCE reduced high out-of-pocket expenditures and frequent emergency room visits and increased behavioral health treatment. Evidence regarding the impact of the DCE on health is sparse but suggestive of positive impacts on self-rated health and health behavior. Inferences regarding the public health impact of the DCE await studies with greater methodological diversity and longer follow-up periods.

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