Hee Yon Sohng

Abstract:

Aim: Health impact assessments (HIA) are tools that can be used to inform policy makers of the potential health consequences of their decisions. Reviews of HIAs related to housing and transportation have been performed, but little is known about employment-related HIAs. We identify the range of health issues addressed by employment-related HIAs, evaluate the process of conducting a labor-related HIA, and identify knowledge gaps for future HIA work.

Methods: A master list of completed HIAs was used to identify employment-related HIAs. These HIAs were coded for general descriptive statistics such as location, year of completion, depth, type of proposal, and health issues addressed. We also performed a process evaluation using guidelines adapted from existing practice standards.

Results: Reports from twenty-six prospective, employment-related HIAs conducted between 2004 and 2014 were available for review. Half of the HIAs were conducted in the United States, 23% were conducted in the United Kingdom, and 19% were conducted by the European Union (including one HIA from Ireland), 4% were conducted by practitioners in New Zealand and Palau, respectively. The majority (73%) of HIAs was performed in response to a proposed policy and 23% addressed a proposed project (23%). Over half of the HIAs examined how employment conditions such as flexible labor markets (European Union), paid sick leave (U.S.), and job security influenced health. Few HIAs assessed how physical/chemical/biological hazards influenced health.

Conclusion: HIAs were performed for a wide range of employment-related topics. In the US, HIAs are funded primarily through foundation support. Outside the US, governments typically funded HIAs which served more often as decision-support tool rather than an advocacy tool. This could result in greater engagement of decision makers in the HIA process in these countries. Review of the HIA process confirmed that while scoping, assessment, and reporting generally meet practice standards, more work is needed to improve plans to evaluate and monitor the more distal impacts of employment-related HIAs.