Liz Green

This chapter explores competence in Health Impact Assessment (HIA), placing it within legal, regulatory and professional contexts. Competency frameworks guide training, quality assurance and accreditation across disciplines, particularly in public health. The chapter presents examples of existing models that define the skills and knowledge required for effective HIA practice. It emphasises the overlap between public health and HIA competencies, showing how expertise in one can enhance the other. The chapter also examines global efforts to develop competency frameworks and identifies opportunities for cross-disciplinary learning. It has a focus on the work of the Wales Health Impact Assessment Support Unit, Public Health Wales and the work in Wales to date as a leading example. It concludes by discussing future challenges and opportunities, encouraging action from a range of stakeholders to strengthen HIA practice through competency development.

Health impact assessment (HIA) is a flexible process which considers the health and equity impacts of a decision, policy, plan or proposal (European Centre for Health Policy 1999). It came to the f...

Microbial biotechnologies could affect health through multiple pathways, including impacts on food, nutrition, and the physical, economic, and social environment. Health in All Policies is an approach to ensure that plans and policies in all sectors maximise health gains and minimise any health risks. This approach often uses health impact assessment as a structured process to identify and assess positive and negative health impacts and make recommendations to improve these. There are very few examples where HIA has been applied to the implementation of microbial biotechnologies. As more biotechnologies are developed and implemented, more routine use of HIA could help to avoid adverse effects and realise their potential to improve health and reduce health inequalities. This will require greater awareness and understanding of the breadth of links to health, research to build the evidence base for these links, and governance mechanisms to oversee the development and implementation of microbial biotechnologies that prioritise health, equity and sustainability.

Background Health Impact Assessment (HIA) is a process for systematically assessing the potential health and wellbeing impacts of a policy, plan, or project, including recommendations on how those impacts may be managed. Increasingly policy is seen as interventions in complex systems. Methodologically guidance for undertaking HIA do not explicitly draw on complex systems approaches. This study explores the potential contribution of systems approaches to HIA, with a view to informing practical guidance on conducting HIA. The study was registered with Research Registry (reference: researchregistry9504). Methods Scoping review, Stakeholder Workshops. Results 25 eligible sources were identified applying systems approaches in IA, mostly quantitative modelling approaches, such as system dynamics, though several advocated for the application of systems thinking more broadly. HIA is inherently seen as systems oriented, given the involvement of multiple stakeholders and the focus on the wider determinants of health. Workshop participants showed a range of reactions towards applying the systems tools. Major concerns were HIA already being under resourced and systems methods potentially adding pressure and reducing stakeholder buy-in for HIA. Whilst broadening perspectives was seen as enriching, the difficulty to apply system tools directly would require adaptation to the HIA process. Participants valued the tools for their capacity to structure discussion or stakeholder engagement, and their capacity to communicate findings. There was concern about adding to the structured HIA process. Conclusions This is the first study systematically assessing potential value and practical implications of applying systems informed tools as part of HIA. Although there is some conceptual overlap between HIA and systems approaches, there are practical challenges in incorporating new systems tools into HIA practice. Systems tools have a potential role in the initial setting of boundaries for a HIA, and as a lens to find opportunities to embed HIA in institutional decision-making processes.