Some facilitators of HIA implementation are: utilizing existing impact assessment knowledge; connecting HIA with the concept of a sustainable social development; and awareness of the time needed to adopt complex information. Obstacles detected are: the lack of a mandatory law for HIA; a lack of funding; and an occasional lack of public health skills. The final conclusion is that the public health policy adopted by the Swedish Riksdag, with its overarching aim of equality in health and its 11 domains of objectives, has had a crucial effect as a framework for HIA in Sweden.
Public health trends have generally been stable or positive, although health inequalities persist. Economic analyses demonstrate that ill-health in Sweden costs 12 billion SEK every year, yet a large amount of this ill-health can be prevented. Sixty-eight recommendations were presented in the report. The government's response to recommendations has been very positive; approximately 60% of the recommendations in the three strategic areas have been adopted less than two years after the Public Health Policy Report 2010 was published.
Background: Health issues are being allocated increasingly higher priority on the political agenda in Sweden, due to initiatives taken by both the Parliament (the Riksdag) and the Government over the last few years. The Riksdag has recently adopted a bill for public health. Methods: The case study was performed in accordance with the framework for the project “The effectiveness of Health Impact Assessment”, which includes a common questionnaire and a model for evaluating effectiveness. During the study, six interviewees representing different actors and stakeholders in the decision-making process were contacted. The analysis of effectiveness of the HIA on Route 73 is based on the “partial HIA”, i.e. the HIA that is incorporated into the EIA, but the case study also illustrates the benefits of performing a complementary HIA in accordance with the new guidelines in Sweden. Results: The case study on Route 73 shows that the partial HIA had general health effectiveness and general or direct community effectiveness. With respect to equity effectiveness, the answers varied. If the complementary HIA had been used as a basis instead of the partial HIA, it would have highlighted equity aspects much more since the complementary HIA focuses on priority groups and gender throughout the assessment and makes them an important part of the assessment. Conclusions: There is a growing awareness of public health in Sweden today due to the policies adopted by the Riksdag and the Government. Public health objectives, the pinpointing of prioritised groups, health determinants and indicators constitute a good framework for conducting HIA in accordance with the new public health policy and represent its prime facilitators.
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