Health impact assessment on urban development projects in France: finding pathways to fit practice to context

Abstract

In France, there is increasing interest in health impact assessments (HIAs) and most are performed on urban projects. The field of expertise is still under development and mostly established within the public health sector. To date, in France, all HIAs conducted in urban planning are stand-alone HIAs disconnected from the required environmental impact assessment (EIA). The paper opens with an introduction of the close and complex relationship between health and urban planning, HIA and a description of key elements needed for understanding the French context. Then, the paper analyses the context and the implementation process for four HIAs in progress in order to understand the specific characteristics of urban development, identify the key stages for introducing a health perspective into urban projects, and extract avenues to be explored when adapting HIAs applied to urban planning in France. Using a qualitative multiple case study design, an analysis framework was built to compare several aspects of the four HIAs and made it possible to highlight three pathways for adapting HIA to the urban planning sector: the schedule, links between the EIA and HIA, and the complementarity of the initiatives to involve residents. Legal measures enable a point of contact that brings health institutions and cities closer together. HIA is yet another tool that public authorities now have at their fingertips to work together in strengthening democracy and in reducing social, geographical and environmental health inequalities. More research must be undertaken to develop an understanding of the practice-related context; to judge HIA's capacity to draw on existing approaches in different fields; and to explore the different avenues leading to increased health, wellbeing and equity.

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

“…Finally, the WHO Healthy Cities network has played a catalytic role in many European countries since WHO included HIA in the fourth phase of the action program for the 2004–2008 period [ 46 ]. Galway in Ireland and Rennes in France were the first cities not only to join the network but also to initiate and promote HIA [ 14 , 25 ]. These experiences show that HIA development greatly depends on the advocacy function of the health sector and its ability to actively seek opportunities to collaborate with local authorities to promote its practice.…”

“…HIA practice in France is more recent but it is rapidly spreading [ 14 ]. The very first instance was an HIA conducted in 2008 at the initiative of a health promotion and sustainable development association closely linked to the WHO European Healthy Cities Network.…”

“…It also funded a series of training courses whose formats varied in terms of content, duration, and audiences (elected officials, professionals, and practitioners), and, in 2015, it launched a call for proposals for funding three intermediate HIAs. Progressively, HIA has been included as a subject of discussion in conferences and colloquiums, and meetings have been organized to share experiences and promote its practice [ 14 ].…”

The Elaboration of an Intersectoral Partnership to Perform Health Impact Assessment in Urban Planning: The Experience of Quebec City (Canada)

“…This tool supporting decision-making is a useful lever to take concrete action on the environmental, economic and social determinants of health in urban planning projects. HIA has been identified as a promising means of integrating health concerns into planning processes [ 41 , 42 , 43 , 44 ]. Urban planning is a good topic for the implementation of the HIA approach.…”

“…In Switzerland, out of 23 HIAs completed between 2001 and 2014, 26% were applied to decisions on urban planning [ 47 ]. In France, most of the HIAs are performed on urban development projects [ 44 ].…”