This chapter discusses the development of health impact assessment (HIA) in The Netherlands. HIA in The Netherlands began in the early 1990s and developed along two different lines: one shaped by the public health approach and the other stemming from the environmental field. Public health-based HIA evolved according to the paradigm presented by the Lalonde model of health. The HIAs mainly concerned national policies and addressed a variety of policy fields, ranging from tobacco discouragement and health insurance policy to national housing policy and the high-speed rail link. The environmental-based HIA focused on preventing environmentally related health risks and did not consider health in a broader sense. There is no legal obligation for environmental impact assessments to consider health impacts outside an environmental scope. If a first screening of the planned activity points to large health impacts or many concerns about potential health effects, a more detailed quantitative health impact assessment should be carried out.
DOCUMENT
SIA developed alongside EIA in the early 1970s as a mechanism to consider the social impacts of planned interventions. The early understanding tended to limit the practical application of SIA to the project level, usually within the context of regulatory frameworks, and primarily considered only the direct negative impacts. However, like other types of impact assessment, SIA has evolved over time and has diverged considerably from EIA.
MULTIFILE
![Health in SIA [social impact assessment]](https://publinova-harvester-content-prod.s3.amazonaws.com/thumbnails/files/previews/pdf/20250619195352125062.19174651005859.Health_in_Impact_Assessments_final_versio-thumbnail-400x300.png)
Stakeholder engagement in Environmental Impact Assessment (EIA) and Health Impact Assessment (HIA) provides opportunities for inclusive environmental decision-making contributing to the attainment of agreement about the potential environmental and health impacts of a plan. A case evaluation of stakeholder engagement was carried out to assess its effect in terms of consensus-building. The case consisted in two health impact scoping workshops engaging 20 stakeholders: policy-makers, experts and residents. A Participatory Action Research approach was adopted. Methods included observation, semi-structured questionnaires and interviews. Analysis methods consisted of several coding rounds, in-depth reading and discussion of Atlas.ti output reports, as well as studying questionnaire results. Participants reported a broadening of perspectives on health in relation to the environment and attainment of shared perspectives. Still, meaningful differences remained, indicating that joint learning experiences, trust and mutual respect created a ‘sense of consensus’ rather than a joint view on the issues at stake. To avoid disappointment and conflict in later project development, explicit acknowledgment and acceptance of disagreements should be included as a ground rule in future stakeholder engagement processes.
DOCUMENT
