Health promotion goes beyond health care. It puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health. —World Health Organization Ottawa Charter on Health Promotion (1986)

Given that many social, economic and environmental policy decisions are made outside the domain of public health, yet have measurable impacts on health outcomes and disparities, public health practitioners are seeking to increase health considerations in decision-making contexts.  Health impact assessment is a set of tools that can be used to advance the goal.

The simple and common-sense notion—that public and private decisions should account for their consequences to human health—is the fundamental aim of HIA.  While traditional public health science searches for the causes of disease, HIA goes beyond this paradigm by: 1) evaluating how social, economic and environmental decisions can impact health and, 2) by providing recommendations to shape decisions in ways that augment health benefits while avoiding or mitigating harm. 

Health in the United States is heavily influenced by social factors including income and education as well as race and ethnicity.  For example, men and women in the highest-income group are likely to live at least six and a half years longer than poor men and women.  Place-based differences in health often mirror geographic differences in income, education and racial or ethnic composition.  Improving health and reducing health disparities requires a focus on a wide range of factors, including living and working conditions in homes and communities, as well as economic and social opportunities and resources.

Source:  Image prepared for the Robert Wood Johnson Foundation by the Center on Social Disparities in Health at the University of California, San Francisco. More information available at:  www.commissiononhealth.org.