A Comparative Analysis of Health Impact Assessment Implementation Models in the Regions of Montérégie (Québec, Canada) and Nouvelle-Aquitaine (France)

Abstract

Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level.

Lessons from an International Initiative to Set and Share Good Practice on Human Health in Environmental Impact Assessment

“…Simos et al [ 70 ] also set out the importance of institutional support for health in impact assessment across the Healthy Cities European Network. Commentators frequently note the opportunities that HIA offers [ 36 , 71 , 72 , 73 ] as well as the way that HIA depends for its development upon the health sector at the regional and national [ 74 ] and global [ 75 ] levels. Taking a broader perspective, the case has been made that impact assessment has a capacity for transformative change in support of sustainable development [ 76 ].…”

“…The term ‘political will’ is often used to describe the support needed to justify time and resources for cross sectoral efforts such as HIA [ 53 , 74 , 75 , 86 ] and work towards healthy environments [ 87 , 88 , 89 ]. Commentators from a political science perspective question the analytical validity of ‘political will’ and instead draw attention to the ways that ‘interest groups’ present causes so they become politically acceptable [ 90 ].…”

Knowledge hierarchy and mechanisms of power in environmental impact assessment: Insights from the Muskrat Falls hydroelectric project

“…Over the years, the scope of EIA legislation and practice expanded beyond predicting solely environmental impacts to include other valued components, such as social, economic, and health impacts (Jabot et al 2020). The human health impacts of development projects are explicitly considered under the scope of the new impact assessments, as well as in previous iterations of the legislation (Gamache et al 2020).…”

Leçons des évaluations d’impact sur la santé pour élaborer des politiques favorables à la santé

“…Une telle reconnaissance législative confirme la légitimité des EIS et peut faciliter leur réalisation, mais elle n'est pas suffisante pour assurer leur mise en oeuvre [3,9]. L'engagement partagé des autorités de santé publique et des autorités publiques envers le développement de politiques favorables à la santé et la réalisation d'EIS est une condition du déploiement réussi des EIS [10,11]. Cet engagement politique -de même que la consultation des citoyens et autres acteurs concernés -semble plus facile à concrétiser au niveau local ou régional, en commençant par des démarches volontaires, et notamment dans le domaine des projets de développement urbain [6,12].…”