Standard Tool for Quantification in Health Impact Assessment. A Review

Background: The health impact assessment (HIA) of policy proposals is becoming common practice. HIA represents a broad approach with quantification of the impact of policy options at its core. However, no standard tool is available and it remains unclear whether any current model can serve as a standard for the field. Purpose: The aim of this study is to assess whether already existing models can be used as a standard tool for the quantification step in an HIA. Methods: A search in 2008 identified 20 models for HIA, of which six are sufficiently generic to allow for various and multiple diseases and different risk factors: Age-Related Morbidity and Death Analysis, Global Burden of Disease, Population Health Modeling, PREVENT, Proportional Life Table Method, and the National Institute for Public Health and the Environment (the Netherlands) Chronic Disease Model. These were evaluated along three proposed model structure criteria (real-life population, dynamic projection, explicit risk-factor states) and three usability criteria (modest data requirements, rich model output, generally accessible) developed to address the needs and requirements of the HIA framework. Results: Of the six generic models investigated, none fulfills all the proposed criteria as a standard HIA tool. The models are either technically advanced with no or limited accessibility, or they are accessible but oversimplified. Conclusions: Further work on models for HIA with equal emphasis on technical appropriateness, availability of data, and end-user-friendly implementation is warranted if the field is to move forward.

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