环境污染健康影响评价规范

按语：近来年环境污染危及公众健康的事件（或事故）时有发生，为了规范和统一评价工作，以期科学、准确、客观、公正地评估环境污染事件（或事故）对人群健康造成的损害，以保障公众的健康效益，卫生部卫生法制与监督司起草了《环境污染健康影响评价规范》（征求意见稿）...     

健康影响评价的国际应用现状及对我国的启示

在梳理健康影响评价在国际上的应用现状基础上,分析健康影响评价在国外相关政策规定、应用领域、实施过程以及存在的挑战,并为推动我国健康影响评价制度的建立和完善提供以下政策建议:在健康融入所有政策的过程中,我国急需建立完善的、政府主导的健康影响评价机制;立法是健康影响评价重要基础,完善的健康影响评价实施机制是健康影响评价发挥政策价值的重要保障。     

危险度评价:从人类健康到生态危害

从20世纪80年代开始，逐渐发展出了健康危险度评价(Health Risk Assessment)的概念和方法。健康危险是指在一定条件下，环境中的有害因素导致暴露群体中出现不良健康反应的概率。健康危险度评价则是从定性和定量两个方面，对这些不良健康反应进行估计和评定的过程，包括4个步骤，即危害认定、剂量．反应关系评价、人类暴露评价和危险表征。     

集成环境健康影响评价研究进展

环境污染健康影响风险评价及风险管理是决策者及公众关注的问题。环境健康风险管理可以分为三个主要阶段,分别为环境风险意识初显阶段、定量健康风险评估阶段和综合环境健康影响评价阶段。现代社会的环境健康风险已转变为嵌入更广泛的社会环境和政治经济体系中对健康的复杂系统性风险,因此综合评价的实质在于建立一个分析复杂环境问题的平台。集成环境健康影响评价(IEHIA)是21世纪越来越受到关注的新概念,该文综述IEHIA的产生背景、框架、工作程序及应用前景,旨在为我国环境健康风险评价的发展提供思路借鉴。     

环境健康影响评价及发展历程

环境健康影响评价（environmental health impact assessment, EHIA）作为环境规划与决策过程,旨在预测、分析和评估拟建项目所带来的人群健康影响。近年来,我国越来越重视环境对人群健康的影响,积极推动环境健康影响评价工作。本文系统概述了EHIA的主要内容及其国内外发展历程和现状,为完善我国EHIA制度提供理论依据和实施策略,进而为环境健康影响评价在实践中解决人类健康问题提供参考。     

国际全科医生制度发展历程:影响因素分析及政策启示

全科医生制度建设的国际经验可以为中国全科医生制度的建立和发展提供借鉴。本文首先梳理了国民健康服务体制、社会医疗保险体制、商业医疗保险体制等部分典型国家的全科医生制度发展历程,重点分析了全科医生制度建设的影响因素。结果发现,建立和发展全科医生制度的主要影响因素有:经济社会因素、卫生保健体制对卫生体系的控制力、医师对卫生体系的控制力、全科医学服务的激励机制、全科医学的发展程度等。最后,结合近年我国全科医生制度建设的实际提出几点政策启示,一要以满足我国公众健康需求为目标,构建中国特色全科医生制度;二要普及全科医学服务核心价值,为建立全科医生制度提供公众民意基础;三要建立健全促进全科医生制度发展的激励机制,提高全科医生地位;四要积极推动全科与专科医学的专业分工,促进全科医学发展。     

2008年北京奥运会对人群健康影响的评价指标体系

该文系统介绍了2008年北京奥运对人群健康影响的评价指标体系。主要涵盖了奥运健康遗产评价中健康理念、行为方式、健康结果3个二级指标部分的内容。介绍了二级指标的含义及所属的三级指标的定义、目的、数据来源、计算方法和测量频率,并介绍了相关指标的计算方法和使用范围。     

患病群体的健康综合评价及其影响因素探讨

健康是一个复杂、多维的生物学和社会学现象 ,具有质和量的双重性 ,它包括生理健康、心理状态和社会功能三个维度 ,每个维度又包含多个范畴的内容。长期以来 ,人们多用发病率、死亡率、期望寿命等传统指标从生命数量角度对人群健康水平进行衡量 ,但一个良好的健康综合测量指标应能综合生命数量和生命质量的双重信息并概括健康的多维度内容 ,在此背景下 ,先后出现了用减寿人年数、无残疾期望寿命、失能调整生命年等指标 ,来评价疾病对人群健康的影响。随着人群对健康需求的提高以及健康观和医学模式的转变 ,人们越来越倾向于对人群健康状况作…     

Supporting health impact assessment in practice

Health impact assessment (HIA) is a process that aims to predict potential positive and negative effects of project, programme or policy proposals on health and health inequalities. It is recommended by national government and internationally. Supporting health impact assessment is one of the roles of English Public Health Observatories. The few centres in England with accredited health impact training centres have inadequate resources to meet demand. Currently, the London Health Observatory is providing the bulk of the training nationally. Some Public Health Observatories are currently investigating the preferences for support of those commissioning or conducting health impact assessment within their regions. The availability of published guidance on how to conduct health impact assessments has increased substantially over the past few years. The Department of Health has funded a research project led by the London Health Observatory to develop advice for reviewing evidence for use in health impact assessment. Completed health impact assessments can be useful resources. Evaluation of the process and impact of health impact assessment is important in order to demonstrate its usefulness and to learn lessons for the future. The focus for Public Health Observatories is to train and support others to conduct health impact assessment according to good practice, rather than undertaking health impact assessments themselves. The aim is to create sufficient skilled capacity around the country to undertake health impact assessments. The London Health Observatory plans to share its support models and to roll out a train the trainer programme nationally to enable effective local delivery of their national health impact assessment programme.     

Mini-symposium — Public Health Observatories: Supporting health impact assessment in practice

Health impact assessment (HIA) is a process that aims to predict potential positive and negative effects of project, programme or policy proposals on health and health inequalities. It is recommended by national government and internationally. Supporting health impact assessment is one of the roles of English Public Health Observatories. The few centres in England with accredited health impact training centres have inadequate resources to meet demand. Currently, the London Health Observatory is providing the bulk of the training nationally. Some Public Health Observatories are currently investigating the preferences for support of those commissioning or conducting health impact assessment within their regions. The availability of published guidance on how to conduct health impact assessments has increased substantially over the past few years. The Department of Health has funded a research project led by the London Health Observatory to develop advice for reviewing evidence for use in health impact assessment. Completed health impact assessments can be useful resources. Evaluation of the process and impact of health impact assessment is important in order to demonstrate its usefulness and to learn lessons for the future. The focus for Public Health Observatories is to train and support others to conduct health impact assessment according to good practice, rather than undertaking health impact assessments themselves. The aim is to create sufficient skilled capacity around the country to undertake health impact assessments. The London Health Observatory plans to share its support models and to roll out a train the trainer programme nationally to enable effective local delivery of their national health impact assessment programme.     

国外健康影响评估的制度化现状及对我国的启示

健康影响评估是将健康影响纳入综合决策的有效工具,是实现"健康融入所有政策"的必然要求,但目前我国的健康影响评估制度建设尚处于起步阶段.本文综述了英国、美国、加拿大、澳大利亚和泰国等国家(地区)的健康影响评估制度化现状,在此基础上对我国健康影响评估制度化进行分析与展望,并提出以下建议:(1)明确健康影响评估对象,逐步制订...     

Transport policy and health inequalities: a health impact assessment of Edinburgh's transport policy

Health impact assessment (HIA) can be used to examine the relationships between inequalities and health. This HIA of Edinburgh's transport policy demonstrates how HIA can examine how different transport policies can affect different population groupings to varying degrees. In this case, Edinburgh's economy is based on tourism, financial services and Government bodies. These need a good transport infrastructure, which maintains a vibrant city centre. A transport policy that promotes walking, cycling and public transport supports this and is also good for health. The HIA suggested that greater spend on public transport and supporting sustainable modes of transport was beneficial to health, and offered scope to reduce inequalities. This message was understood by the City Council and influenced the development of the city's transport and land-use strategies. The paper discusses how HIA can influence public policy.     

Evaluating health impact assessment

Health impact assessment (HIA) is a developing approach that assesses the health impacts of a proposal on a population, and produces a practical set of recommendations to inform the decision-making process of the proposal. The purpose is to influence decision makers to increase positive health impacts of a proposal and decrease negative impacts. Most work within the HIA field to date has focused on methodological development and actually carrying out HIAs. Little attention has been paid to the formal evaluation of the HIA approach and whether or not HIA works (if and how the HIA approach informs the decision-making process and, in particular, if it contributes to improving health and reducing inequalities). With the drive towards evidence-informed policy, HIA also needs to show whether it adds value to the decision-making process, given the significant resources often involved in carrying out an HIA. A suggested approach to evaluating HIAs is presented, as well as its relationship with monitoring, drawing on the significant public health evaluation literature that already exists. Methodologies appropriate for use, and examples of indicators suitable for HIA evaluation, are provided. We suggest that typical HIA evaluations should focus on the process of the HIA and the impact that it has on the decision-making process, rather than attempting to evaluate long-term health outcomes or whether predicted impacts actually occurred.     

Migration and health impact assessment

Government policies, programmes and projects can have a significant impact on health. Health impact assessments (HIAs) seek to estimate this impact, but they often do so by measuring intermediate or proxy indicators and factors that act to determine health. These measures frequently assume a static population. However, regeneration policies can work hard for several years to no apparent effect. One explanation could be migration. Families who have benefited move from the area and other, perhaps more deprived, families move in. Conversely, healthy, prosperous families may move into an improved area, giving the impression that the health of the population has changed, when in fact it is the actual population that has changed. Census data in England and Wales show that a positive correlation exists between migration within wards and deprivation scores. This paper explores the possible implications of migration for HIA. The census, NHS central register, electoral register, labour force survey, central index of the Department of Social Security, council tax database and other data sources are examined to identify what migration data are available at a local level. Factors that determine rates of migration at a local level have been reviewed, with special reference to the differences between population subgroups. The paper concludes with recommendations to take account of residential mobility and changes in migration patterns when carrying out HIAs.     

Engaging communities to tackle anti-social behaviour: a health impact assessment of a citizens' jury

OBJECTIVES: To carry out a health impact assessment (HIA) of the Netherley Valley Citizens' Jury that was set up to develop recommendations for how anti-social behaviour should be addressed in their community. STUDY DESIGN: Concurrent HIA based on the Merseyside Guidelines for HIA and the European Policy HIA Guidelines. METHODS: Literature reviews, community profiling, and interviews and workshops with stakeholders and key informants were undertaken. RESULTS: A wide range of positive and negative impacts were identified, and 20 recommendations were developed to suggest ways of maximizing the potential positive impacts on health and wellbeing and minimizing the negative impacts. CONCLUSIONS: This HIA provided a unique opportunity to compare predicted and actual health impacts, which illustrates the importance of assessing the potential impacts of processes as well as intended outcomes. It also highlighted some of the potential risks involved in engaging with communities, and reinforced the value of assessing the potential impacts on health of policies, programmes and projects that may intuitively appear to be beneficial to all involved.