Time for a paradigm change? Tracing the institutionalisation of health impact assessment in the Republic of Ireland across health and environmental sectors

Abstract

a b s t r a c tThis paper presents a critical analysis of health impact assessment (HIA) in the Republic of Ireland (ROI) in the context of institutional policy and practice. It begins with a brief background to the origins and aims of HIA. Core developments in health and environmental sectors pertaining to HIA in the ROI are then considered. A series of significant developments have taken place in these sectors over the past decade that are positively associated with the promotion of HIA in the ROI. However, it is argued that in spite of various institutional facilitators, the practice of implementing HIAs in the ROI is significantly underdeveloped, and it continues to lag behind several of its European Union counterparts. It is contended that a paradigm change is required in order to address the current policy-action gap. An organisation theory framework is used to assess the implementation problem and a number of suggestions are highlighted as potential facilitators of this process.

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

“…In New Zealand, local governments responsible for the delivery of public health services have established strong collaborations with public health for the achievement of HIAs with the support of the Public Health Advisory Committee, a body that is politically and administratively independent [ 23 ]. In Ireland, HIA was boosted by the publication of a proposal for a National Environmental Health Action Plan, followed by the national health strategy [ 25 ]. 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 ].…”

“…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.…”

“…Finally, in Ireland, the Institute of Public Health provides a set of educational resources, facilitates a forum each year and supports a network of stakeholders. It received a mandate to construct an evidence base by publishing reviews of the literature in certain fields (employment, transport, the built environment) [ 25 ]. Québec and France are no exception to countries engaging in these practices.…”

“…Others are linked to the implementation process and, more particularly, to the degree of HIA integration in decision-making processes and to the nature of the pending decision [ 21 , 23 ]. Some authors also point to the overall context, including here the political setting, the prevailing regulatory, administrative and organizational frameworks, the degree of health leadership, and the prevailing evaluation culture, all of which have the potential to become facilitators of or, conversely, barriers to HIA implementation [ 21 , 23 , 24 , 25 ]. With regard to this, the recent work of Linzalone et al [ 19 ] analyzing barriers to and opportunities for HIA implementation in different countries provides interesting insights.…”

“…It places particular importance on two main drivers, political will and legal and administrative frameworks, which activate a “cascade mechanism” triggering other key factors for HIA development, including capacities and expertise, intersectoral coordination, a dedicated structure or an HIA champion, and funding. Finally, other authors have identified the growing interest in integrating health in other forms of impact assessment such as EIAs as a key factor for HIA development [ 24 , 25 , 26 , 27 , 28 , 29 ].…”