Objective: The main aim of this study is to discover and analyse the utilization of health impact assessment (HIA) among HIA certificate holders, and to ascertain their opinions on the current situation in the Czech Republic and on the possible future nationwide implementation of health impact assessment. Methods: The target group of the research was identified as holders of professional competence certificates in the field of public health impact assessment. A structured questionnaire was developed. The first part mapped the recent use of HIA in the Czech Republic, the second addressed the issue of linking HIA to regional policies and to the national strategy, the third aimed to gain information about the preparedness of the Czech Republic for the full implementation of HIA, and the last part focused on quality assessment and capacity building for HIA. Results: The results of the survey point to the inconsistencies in the perception of the whole concept of HIA in the Czech Republic by the professional public, and also to a shortage of experts in this area. There is only a narrow circle of experts, especially in the field of health care. It also lacks an informational base, which assist in the unification of processes in this area. As the results of the questionnaire showed, the problems are the lack of interest in the application of the HIA method and, subsequently, the lack of demand. Conclusion: The collected data showed obstacles and gaps in the implementation of the HIA methodology in the Czech Republic. At the same time it has revealed possible ways to change the current situation, based on the opinions of those who practice this methodology in the Czech Republic.
Plošná implementace hodnocení vlivů na zdraví (Health Impact Assessment) v České republice stojí na rozcestí. Inspirovat a poučit se můžeme z implementačních modelů zemí, které mají tuto výzvu již za sebou. Zde existují dva základní přístupy: zakotvení do legislativy (tzv. Top-down přístup) a právního rámce, anebo skrz úroveň obcí (tzv. Bottom-up přístup). Příkladem první varianty je slovenský model, příkladem druhé je dánský model implementace. Článek analyzuje ukotvení HIA v právních předpisech v České republice a hledá inspiraci, pozitiva a výzvy u dvou výše zmíněných modelů.Klíčová slova: hodnocení vlivů na zdraví, orgán ochrany veřejného zdraví, zákonodárství SUMMARY Nationwide implementation of Health Impact Assessment in the Czech Republic stands at a crossroads. We can learn and find inspiration from HIA implementation models in countries where this challenge has already been successfully addressed. There are two main approaches: anchorage in legislation and legal framework (Top-down approach) and implementation through municipalities and cities (Bottom-up approach). Slovak and Danish models of implementation are quoted as examples of such approaches. The article analyses HIA implementation in Czech legislation and discusses the inspiration, strengths and challenges of the two aforementioned models.
The use of methods of geographic information systems and cartography is common in the processes of spatial planning and Health Impact Assessment. As part of the research team of the Technical University of Liberec (Czech Republic) and in cooperation with the Liberec City Hall and the Regional Hygiene Authority of the Liberec Region, we propose a procedure for the implementation of HIA in spatial planning. The project aims to propose and verify the methodological procedure of comprehensive assessment of health determinants in the area following the method of HIA in the territory of Liberec and the municipalities of the Liberec region. The main area of research and the applicability of results is in spatial and urban planning and public health protection, where the methodology will contribute to the identification of the main impacts on the health of the population, health inequalities and the proposed measures to eliminate or reduce negative or strengthen positive impacts. Multicriterial analysis with outputs in GIS will be used to define impacts. Project activities: the design of the concept of the data model, data analysis, evaluation of the methodology and proposal of measures supporting health. The project includes the design of the concept and logical structure of the data model of health determinants. This is the basis for multicriterial analyzes of health determinants. Its proposal will use methods of health impact assessment (HIA, especially scoping) and qualitative research methods. GIScience and geoinformatics methods will be used to solve the model structure. Last but not least, the methodology for analytical processing is elaborated: the activity will focus on the design and testing of multi-criteria analysis of health determinants. Key messages Geographic information systems enable efficient creation, analysis and communication of data model of health determinants. Spatial planning is a concrete tool for the implementation of health impact assessment objectives into practice.
The methodology of health risk assessment (HRA) is embedded in Czech legislation; the process is clearly set, those doing HRA need to be licensed. Public health authorities (PHA) use HRA as a basis for assessing negative impacts of various activities, and are obliged to evaluate the quality of an HRA and, if in doubt, to examine it or directly call for the authorizing authority to revise it. HIA does not have this support in Czech legislation. HIA has the same potential for PHA as HRA, but its use is much broader, because it identifies positive effects as well. Is there a need for more legislation? It seems that yes, partly. Czechia at least needs a clear definition of the terms (HRA and HIA are used interchangeably). It is necessary to create a HIA assessment framework. What does HIA mean for public PHA? Identification of the health profile of a community, identification of missing data sources, current research of scientific literature on the given impact, identification of problems in the territory, prioritization of health impacts and their reflection in measures and health policies. It gives the opportunity to open the discussion with stakeholders and set up projects focusing on health. HIA opens the door for problem-solving, promoting positive impacts, protecting vulnerable groups and reducing distribution of inequalities in the population. Is it possible to use HIA without a national law? The Liberec Region has been using a unique way of implementing HIA into its regulations, which can be issued by the Regional Council in delegated powers. The reason for initiating this process was the absence of health assessment in regional policies. PHA requires an HIA and to evaluate the quality of the HIA, PHA uses a checklist. But the time has come for the next step of HIA implementation, to put it into urban planning. The first step has already been taken; we have prepared a project with GIS experts and urban planning.
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