The future challenges for HIA

Health Impact Assessment has made impressive progress over the past 10 years achieving greater clarity over the nature of HIA, understanding that different methods were appropriate for different contexts and accepting that a variety of types of evidence were needed. However areas remain where further progress is needed. Much progress has been made on how HIA informs decision makers but HIA practitioners still need greater understanding of decision making processes and how HIA should relate to them. Predicting the future consequences of following different options is a key element of HIA but there is still need for more robust methods of prediction and in particular better prediction of the magnitude of impacts. Few HIA reports adequately describe the distribution of impacts between different groups and this is another area where improvement is needed. Considerable progress has been made in clarifying the role of participation in HIA but the practice has often been less impressive than the rhetoric. HIA practitioners also need to become more critical in evaluating their activities. In the future it is likely that commercial organisations and EIA practitioners will become more involved in HIA and quality control of HIA practice will become even more important.