Health Impact Assessments in Spain: Have They Been Effective?

Maite Morteruel, Amaia Bacigalupe, Elena Aldasoro, Isabel Larrañaga and Elena Serrano
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Maite Morteruel: Department of Nursing, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
Amaia Bacigalupe: OPIK-Research Group for Social Determinants of Health and Demographic Change, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
Elena Aldasoro: Department of Health, Basque Government, 01010 Vitoria-Gasteiz, Spain
Isabel Larrañaga: Department of Health, Basque Government, 20013 Donostia-San Sebastian, Spain
Elena Serrano: Department of Health, Basque Government, 20013 Donostia-San Sebastian, Spain

IJERPH, 2020, vol. 17, issue 8, 1-18

Abstract: Background: Health impact assessment (HIA) has scarcely been developed in Spain, in comparison with other European countries. Moreover, little is known about the effectiveness of HIA, taking into account direct impacts—changes on the decision-making process—as well as indirect impacts or those related to the process outcomes. From this broad perspective of HIA usefulness, the purpose was to assess the effectiveness of five HIAs carried out in Spain at the local level, and the role played by context and process factors on these impacts. Methods: We carried out a qualitative study based on 14 interviews to HIAs participants from different sectors. A documentary review and nonparticipant observation techniques were implemented for an in depth understanding. Results: The direct effectiveness of the HIAs was partial, but they had indirect effectiveness in all cases. The institutional and socio-political context, however, was not favorable to effectiveness. The elements of the process were largely determined by the context, although their influence, mediated by the role of proactive individuals, favored the effectiveness of the HIAs. Conclusions: When assessing HIA effectiveness, it is important to take into account a broad perspective on the nature of impacts and those factors influencing direct and indirect effectiveness. In Spain, the institutional and sociopolitical context was less favorable to HIA effectiveness than process-related factors. In order to implement the Health in All Policies strategy, will be necessary to improve context-related factors, such as institutional facilitators for HIA and democratic quality.

Keywords: health impact assessment; effectiveness; intersectoral action for health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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