Quantitative health impact assessment: taking stock and moving forward

Abstract

Over the past years, application of health impact assessment has increased substantially, and there has been a strong growth of tools that allow quantification of health impacts for a range of health relevant policies. We review these developments, and conclude that further tool development is no longer a main priority, although several aspects need to be further developed, such as methods to assess impacts on health inequalities and to assess uncertainties. The main new challenges are, first, to conduct a comparative evaluation of different tools, and, second, to ensure the maintenance and continued availability of the toolkits including their data contents.

Disease modeling for public health: added value, challenges, and institutional constraints

“…In the field of HIV prevention, modeling work by Granich and colleagues [14] has paved the way for UNAIDS to introduce the testand-treat strategy with the long-term goal of elimination of HIV [15]. In the area of chronic diseases, models are used to generate projections of population health given demographic changes, distributions, and trends of risk factors in a population and possible effects of intervention programs [16][17][18][19].…”

Picturing inequities for health impact assessment: linked electronic records, mortality and regional disparities in Portugal

“…Generally, two different approaches to HIA quantification have been followed, one based on health economic evaluation and another on risk assessment (Fehr et al 2012). Quantified HIA based on health economic evaluation relies on health technology assessment methods, estimating indirect costs and health-related quality of life indicators (Brodin and Hodge 2008) and dealing with equity for instance by applying weights to account for inequalities when calculating health gains or by estimating health benefits separately by relevant population subgroups (Glover and Henderson 2010).…”

“…Quantified HIA based on health economic evaluation relies on health technology assessment methods, estimating indirect costs and health-related quality of life indicators (Brodin and Hodge 2008) and dealing with equity for instance by applying weights to account for inequalities when calculating health gains or by estimating health benefits separately by relevant population subgroups (Glover and Henderson 2010). The HIA quantification based on risk assessment is grounded in environmental and public health research experience of estimating risk exposure, frequently relying on epidemiology modeling (Fehr et al 2012;Kemm 2013). Other HIA-related quantification experiences include profiling individuals, screening policies, (Bacelar-Nicolau et al 2008, 2015a, 2015b and evaluating HIA effectiveness (Harris-Roxas et al 2012Haigh et al 2015).…”

“…An assortment of computational tools for HIA quantification has been made available: some more generic, others more specific to certain determinants or diseases; some more related to environmental health risk assessments, others more in tune with public health risk factor-outcome modeling; most not very user-friendly without support from the original developers. Further tool development is no longer considered a priority, but improvements are needed regarding two aspects: its application in various real-life contexts and especially in 'whether and how they estimate impacts on health inequalities' (Fehr et al 2012(Fehr et al , 2016.…”

“…Among the difficulties, a major one is to find available and reliable data to model interrelations, explicitly between health determinants, health impacts, policies and related costs (Fehr et al 2012(Fehr et al , 2016Harris-Roxas et al 2012). Another barrier is that complex statistical methodologies used frequently generate results difficult to understand by non-statisticians, including decision-makers (Fehr et al 2012).…”