用好健康影响评估这件“利器”

<正>健康影响评估(Health Impact Assessment,HIA)是实施将健康融入所有政策的重要工具。在全国卫生与健康大会上,习近平总书记明确要求,"要全面建立健康影响评价评估制度,系统评估各项经济社会发展规划和政策、重大工程项目对健康的影响"。健康影响评估在中国怎么推进?借鉴国际先进经验根据世界卫生组织《哥德堡健康影响评估共识》,健康影响评估"是对不同部门政策、规划和项目进行决策的一种     

构建“健康湖北”评估体系的目的、意义及评估框架

在《"健康中国2030"规划纲要》和《"健康湖北2030"行动纲要》中,分别要求建立常态化、经常化的督查考核机制,强化激励和问责。建立健全监测评价机制,并对实施进度和效果进行年度监测和评估。要建立对市县的评价机制、考核机制,完善部门联动机制,形成党政齐抓共管、部门通力协作的工作格局。显然,构建"健康湖北"评估体系是落实"健康中国"和"健康湖北"政策的战略任务,推进健康湖北各项工作落实,协调湖北经济发展与湖北居民健康之间关系的制度保障。因此,进一步构建具有操作意义的健康湖北评估框架,评估流程和评估机制,整合健康影响评价、疾控机构服务的社会经济影响评价等理念和评估体系,为今后开展健康湖北或健康城市评估提供重要经验和决策依据。     

健康影响评价(HIA)在医疗建筑中的运用--以澳大利亚利物浦医院重建项目为例

对国内外现行的医疗建筑评价体系的优缺点进行概述;以澳大利亚利物浦医院重建项目的健康影响评价实践为例,探讨HIA对医疗建筑的评价原则、程序、机制等;结合现有医疗建筑评价体系及我国国情,总结出引入HIA对医疗建筑进行评价的价值及优点。     

应用改良德尔菲法确定湖北省健康城市建设评估指标体系权重

目的建立科学、系统、实用的湖北省健康城市建设评估指标体系,为湖北省健康城市建设评估提供依据。方法应用改良德尔菲法确定湖北省健康城市建设评估指标体系权重。结果湖北省健康城市建设效果评估体系,包含健康城市建设效果评估体系、建设过程评估体系和建设居民满意度评估体系3个维度。研究2轮咨询的专家积极系数均为100.00%,权威系数平均为0.79,协调系数均值第1轮为0.309,第二轮为0.563。结论专家咨询结果代表性好、权威程度高、协调性好,应用改良德尔菲法确定的健康城市建设评估指标体系及其权重结果较为理想,可为健康城市建设评估提供参考。     

上海高校学生网络健康素养指标体系开发研究

目的设计适合上海市高校学生的网络健康素养指标体系。方法通过文献分析法、德尔菲法和认知性修正对高校学生网络健康素养指标体系进行开发。结果通过文献分析法,全面分析现有健康素养理论的相关文献,以相关政府部门颁发的《大学生健康教育基本要求》《上海市高校学生健康教育指导纲要》等文件为指导,初步设计出适合上海高校学生网络健康素养评估体系;通过两轮德尔菲专家咨询,对该体系进行修订,确认我国大学生健康素养评估指标体系。结论本研究开发了上海高校学生网络健康素养评估体系,从健康相关信息处理的角度出发涵盖了高校学生在网络行为各个环节的健康素养水平。     

成人健康、亚健康临床诊断标准的探讨

目的 研究制定一套结合体检资料的成人健康、亚健康临床定量评估诊断标准。方法 采用德尔非法筛选确立评估项目40项并确立分值．建立《成人健康、亚健康评估表》；选取200例无疾病成人，应用评估表进行定量打分并与现有成人健康亚健康症状诊断结果对比．确立健康、亚健康定量标准；应用Spearman法对上述两种方法按健康状况排序结果进行相关分析。结果 两种诊断方法排序结果有显著的相关性。结论 此临床诊断法有一定可行性。     

《健康评估》实验教学方法改革的思考

本文针对《健康评估》实验教学方法改革的思考课题,说明了《健康评估》课程内涵及要求;指出了《健康评估》实验教学状况;阐明了《健康评估》学科发展过程中出现问题;论述了《健康评估》实验教学改革的必要性.     

浙江省杭州市健康城市建设评估

目的：评估浙江省杭州市2015—2018年健康城市建设情况,对健康杭州建设工作提出建议。方法：通过定量定性资料的收集,运用回归模型预测并对比《“健康杭州2030”规划纲要》中的目标值,了解健康杭州建设指标的达标情况和影响因素。结果：《纲要》共29条指标,16项指标预测可达到杭州市2020年目标值,6项指标达标难度较大,7项指标因数据缺失等问题尚无法预测。影响达标的主要原因有大健康理念认识不足、健康城市指导中心办公室职能定位模糊、跨部门合作困难、评估指标体系设计不够合理。结论：健康杭州建设成效显著,突出表现在健康人群、健康服务和健康产业建设上,但健康环境建设稍显不足。建议发挥健康中国战略优势,完善健康杭州建设评估体系与考核方案,引进优秀人才,开展分层分类的健康活动。     

国际旅行者健康评估体系构建探索

目的探索建立国际旅行人员健康评估体系。方法查询国内外健康评估理论和实践,探寻国际旅行人员健康评估的必要性和可行性。结果国际旅行人员传染病监测体检显示传染病检出率4.68%,非传染病疾病和异常指标检出率为22.94%;现代健康管理体系、旅行医学科学体系和疾病监测体检实践为构建国际旅行人员健康评估体系提供了可能。结论旅行者健康评估体系包括健康信息采集、临床检查、实验室检测、健康结论、健康处方5个部分,各模块相对独立又相互关联,支持数据共享,能保存、查询、统计和分析被检者健康信息。     

结构方程模型在健康素养分析中的应用

目的 探索结构方程模型在健康素养分析中的应用,为建立符合理论和实际的健康素养评价体系提供依据.方法 采用武汉市居民健康素养调查数据,构建结构方程模型,评估在健康素养分析中应用价值.结果 结构方程模型拟合良好,测量模型诠释了潜在变量与测量变量之间的关系,结构模型反映了潜在变量间的关系,模型选择的测量变量是健康素养的核心组...     

Health Impact Assessment in a Network of European Cities

The methodology of health impact assessment (HIA) was introduced as one of four core themes for Phase IV (2003–2008) of the World Health Organization European Healthy Cities Network (WHO-EHCN). Four objectives for HIA were set at the beginning of the phase. We report on the results of the evaluation of introducing and implementing this methodology in cities from countries across Europe with widely differing economies and sociopolitical contexts. Two main sources of data were used: a general questionnaire designed for the Phase IV evaluation and the annual reporting template for 2007–2008. Sources of bias included the proportion of non-responders and the requirement to communicate in English. Main barriers to the introduction and implementation of HIA were a lack of skill, knowledge and experience of HIA, the newness of the concept, the lack of a legal basis for implementation and a lack of political support. Main facilitating factors were political support, training in HIA, collaboration with an academic/public health institution or local health agency, a pre-existing culture of intersectoral working, a supportive national policy context, access to WHO materials about or expertise in HIA and membership of the WHO-EHCN, HIA Sub-Network or a National Network. The majority of respondents did not feel that they had had the resources, knowledge or experience to achieve all of the objectives set for HIA in Phase IV. The cities that appear to have been most successful at introducing and implementing HIA had pre-existing experience of HIA, came from a country with a history of applying HIA, were HIA Sub-Network members or had made a commitment to implementing HIA during successive years of Phase IV. Although HIA was recognised as an important component of Healthy Cities’ work, the experience in the WHO-EHCN underscores the need for political buy-in, capacity building and adequate resourcing for the introduction and implementation of HIA to be successful.     

中美国家健康战略比较分析及启示

本研究从战略目标、战略内容和主要指标等三方面,比较分析了美国"健康公民计划"与"健康中国2030"的异同,结合我国社会经济环境,提出了注重健康战略的针对性、动态性和持续性;在全覆盖的基础上有重点地保障人群;确定阶段实施重心,并重视信息监测系统的建设;制定可操作的监督和评价体系及适宜的指标值等建议,以期为"健康中国"战略的推行和进一步完善提供启示。     

Introduction of health impact assessment and healthy cities as a tool for tackling health inequality]

In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.     

La institucionalización de la evaluación del impacto en la salud en Quebec: ¿un modelo factible en España?

Objectives

In Canada, the province of Quebec has institutionalized Health Impact Assessment (HIA) by including it in its Public Health Act (PHA). In Spain, the Ministry of Health, Social Policy and Equality is in the process of reforming its PHA, and plans to include HIA in this legislation. This study reviews the factors that have led to the effective implementation of HIA in Quebec and discusses the possible applications of the Quebec model in the Spanish context.

Methods

Information was gathered through interviews conducted in various public health institutions in Quebec. The Quebec model was compared to the Spanish situation, to identify potential needs associated with the practice of HIA in Spain.

Results

In Quebec, public health institutions have developed a strategy for effective implementation of HIA. This strategy is based on several measures: creation of a network of ministerial representatives, development of an internal procedure at the Ministry of Health and Social Services to respond to requests, preparation of methodological guidelines, establishment of a research program, strengthening of knowledge transfer mechanisms, and establishment of communication and participation tools.

Conclusions

HIA legislation does not guarantee its successful implementation. The institutionalization of HIA requires establishing a well-designed structure, as well as the allocation of adequate resources. The Quebec experience offers one model of HIA implementation that could be adapted to our country, taking into account elements of Spanish idiosyncrasies.     

健康影响评估制度的理论演进、评价方法与实现路径

健康影响评估是判断政策、规划、计划和项目对人群健康潜在影响及其影响分布的程序、方法和工具.许多国家将其作为推动"健康融入所有政策"的有效治理工具.新型冠状病毒肺炎(COVID-19)疫情对我国政府治理体系和治理能力提出巨大挑战,突显卫生健康对国民经济的重要影响,突显构建健康优先治理体系的紧迫要求.我国《基本医疗卫生与健...     

Implementing the legal provisions for HIA in Slovakia: An exploration of practitioner perspectives

Background

Health Impact Assessment (HIA) is an instrument used in many countries across the world to assess and report on negative and positive health impacts of projects, programmes and policies. It was included in the Protection, Support and Development of Public Health Act (355/2007) of the Slovak Republic in 2007, thus legislating for HIA. Due to this novel move to legislate for HIA, exploratory research was conducted in order to inquire into the perceptions of key informants and practitioners of the upcoming enforcement of the HIA part of legislation (to take place from January 2011). This paper presents results from the survey of practitioners in the Slovak Regional Public Health Authorities.

Methods

A postal questionnaire was administered to the Heads of Environmental Health Departments of the 37 Regional Public Health Authorities. Open-ended questions were contained in the survey. The response rate was 38%.

Results

Results show that a number of respondents are uncertain as to how HIA would be implemented in practice, with varying views on the technical and institutional barriers to comprehensive implementation of HIA.

Conclusion

Although the public hygiene and sanitation networks in the public health system in Slovakia operate smoothly, the readiness of the public health infrastructure for HIA, which is based broadly on the social model of health, is dubious. Although HIA is contained within legislation, time will tell whether its implementation in practice will be as comprehensive as is hoped. Recommendations for further integration of HIA into the public health system include further training and education, national HIA resource centres and cross-country support.     

Health impact assessment.

There is growing concern about the environmental, social and health consequences of development projects. Environmental impact assessment (EIA), which aims to address this concern, is often conducted with little input from the health sector. Quantifying the health benefits and risks of a project or policy requires an innovative synthesis of socio-demographic, environmental health, epidemiological and health systems data. This article provides a simple framework for health impact assessment (HIA), a method for describing and measuring the impact of a project or policy on health and wellbeing, and designing appropriate interventions. The key components of HIA are: review of available data; research and identification of priority health issues through the use of rapid assessment methods; design of a health action plan with stakeholder consultation; implementation of interventions and the monitoring of long-term health impacts. HIA can assist in ensuring that development and policies are 'health promoting' and that the health sector plays a meaningful role in EIA.     

Health impact assessment of particulate pollution in Tallinn using fine spatial resolution and modeling techniques

Background  

Health impact assessments (HIA) use information on exposure, baseline mortality/morbidity and exposure-response functions from epidemiological studies in order to quantify the health impacts of existing situations and/or alternative scenarios. The aim of this study was to improve HIA methods for air pollution studies in situations where exposures can be estimated using GIS with high spatial resolution and dispersion modeling approaches.     

健康素养型医疗机构评价工具的研究进展

健康素养型医疗机构(health literate health care organization, HLHO)建设是提升居民健康素养的必要途径。《健康中国行动（2019—2030年）》把医疗机构及医务人员在“健康知识普及”行动中发挥重要作用列为行动目标及评价指标。通过回顾国内外文献,从应用目的、评价内容及方法、评价标准、信效度和应用现况对纳入的7项HLHO评价工具进行介绍,并对工具的评价维度、调查对象与应用场景进行比较分析,以期为评价医疗机构在居民健康素养促进中的作用以及为践行《健康中国行动》中的相关内容提供参考。     

Health impact assessment: an introduction to the what,why and how

It is now widely recognised that policies, programs and projects within the health and other public and private sectors can have significant and often unintended negative impacts on health and well‐being . Health Impact Assessment (HIA) is one way of assessing and addressing these impacts prior to implementation. In many countries, including Australia, HIA has traditionally been undertaken as part of environmental impact assessment and translating the HIA process to this broader focus has raised some important issues, particularly whether the ‘value add’ of HIA outweighs the time and resources required. This paper aims to provide an introduction to HIA, a rationale of why you might use HIA in the project, program or policy development cycle, the steps that are generally followed in undertaking a HIA, and identification of some useful websites. We would encourage you to contribute to the knowledge in this field by ‘learning by doing’.