PowerPoint Template

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?????????/??????? ?????????????????????????? (HIA
procedure)
?????????????? ??. ???????? ?????????? ???????????
???????????????????????? ??????????????????
?????????????????? E-mail uraiwan_at_kku.ac.th
????????????????????? ????????????????????????????
???????????????????????? 2-6 ?????? 2552
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???????????????

• ???????? ?????? ?????????
• DPSEEA Model
• ????????????/??????? ??????????? ??????
  ??????????????
• Health determinants
• Health hazards
• Health risks
• ?????????/?????????????????????????????????

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Impact Assessment
The process of identifying, predicting,
evaluating and mitigating the biophysical, social
and other relevant effects of development
proposals prior to major decisions being taken
and commitments made.
Impact Assessment
Source IAIA, 1998.
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Health Impact Assessment

• Gothenburg Consensus Paper on HIA (WHO Regional
  Office for Europe, 1999)
• A combination of procedures, methods and tools
  by which a policy, program or project may be
  judged as to its potential effects on the health
  of a population, and the distribution of those
  effects within the population
• ????????? ??????? ?????????????
  ??????????????????????? ?????? ??????? ?????????
  ?????????????????????????????????????????????

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Health Impact Assessment

• International Association for Impact Assessment
  IAIA (Quigley et al., 2006)
• A combination of procedures, methods and tools
  that systematically judges the potential, and
  sometimes unintended, effects of a policy, plan,
  program or project on the health of a population
  and the distribution of those effects within the
  population. HIA identifies appropriate actions
  to manage those effects.

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Health Impact Assessment

• ????????? (2551)
• ?????????????????????????????? ??????
  ??????????? ??????????????????????????????????????
  ????????????????????????????????????
  ??????????????????????????????????????????????????
  ???
• ???????????????????????? (2546)
• ???????????????????????????????
  ?????????????????????????????????????????????????
  ???????? ?????????????????????????????????????????
  ??????????????????????????????????????????
  ????????????????????????????? ?????? ???????
  ???????????????????????????? ?????????????????????
  ??????????????????????????????????????????????????
  ???????????????????????????

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DPSEEA Model

• DPSEEA (WHO Regional Office for Europe, 1997)
• A model for development, environment and health
  interrelationship
• ????????????????????????????/??????? ???????????
  ??????????? ?????????

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The DPSEEA model
Development
Driving forces
Environmental pressure

Environmental state
Furu
Human exposure

Furu

Health effect
Action
Source Furu, 2007.
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The DPSEEA model
Driving Forces
Population growth
Economic development
Technology
Environmental Pressure
Consumption patterns
Production manufacturing
Waste release
Environmental State
Natural hazards
Resource availability
Pollution levels
Source Furu, 2007.
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The DPSEEA model
Human Exposure
Level of external exposure to hazards
Level of hazards absorbed
Target organ dose
Health Effect
Well-being
Morbidity
Mortality
Action
(Mod. from WHO, 1997)
Source Furu, 2007.
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The impact of health policies and development
policies on health status
Source (Hassan et al., 2005)
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????????
?????? ?????? ???????
???????????????????? ??????????????
???????????????????? ????????
????????????????? ????????????????
???????????????????????
?????????????????????? ???????????????????
?????????????????????????????????????????????
?????????????? ???????????????????
????????????????/ ????????/?????
(????? ??????????? Furu, 2007)
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Health hazards, Health promoter

• Health hazards An agent with a potential to
  create ill health
• Agents of communicable diseases
• Agents/causes of non-communicable diseases
• Causes of malnutrition
• Causes of injury
• Causes of psychosocial disorders
• Health promoter An agent with a potential to
  enhance health status (e.g., anti-oxidants,
  constituents of medicinal plants).

Source Quigley et al., 2006
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Health determinants
The range of personal, social, economic and
environmental factors which determine the health
status of individuals or populations
Health determinants
Risk factor
negative for health
Health opportunity
If positive for health
Source WHO, 1998.
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Health Determinants
(Source Dahlgren and Whitehead, 1991.)
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??????????????
(????? ??????????? Minister of Public
Works and Government Services Canada, 1999)
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Health outcome
A change in the health status of an individual,
group or population which is attributable to a
planned intervention or series of interventions,
regardless of whether such an intervention was
intended to change health status
Health outcome
Source WHO, 1998.
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Vulnerable groups
??????????????????????????????????????????????????
?????????????
Vulnerable groups
Source WHO, 1998.
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????????? ???????????? HIA (Value governing
HIA)

• HIA ???????????????
• Democracy ???????????????????????????????????????
  ??????????? ???????????? ??????????????????
  ????????????????? ???????????????????????
• Equity ??????????????????????????????????????????
  ?????????????
• Sustainable development ?????????????????????????
  ?????????????????
• Ethical use of evidence ?????????????????????????
  ?????????????????????????????????????
  ?????????????????? ?????????????
  ???????????????????????????????????
• Comprehensive approach to health
  ????????????????????? ??? ?????
  ??????????????????????????????????

????? WHO Regional Office for Europe, 1999.
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???????????????????????????????????

• ????????????????????????????????
• Prospective HIA ??????????????????????????
  ?????? ??????? ??????????? ????????????????????
  ??????????????????????? ?????????
  ??????????????????????????
• Retrospective HIA ???????????????????????
  ??????????????????????????????????????????????????
  ????????? ?????????????????????????????????????
  
• Concurrent HIA ???????????????????????
  ?????????????????? ???????????????????????????????
  ???????????????????

????? WHO, 2005 The Health Promotion Division,
National Assembly for Wales, 1999.
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???????????????????????????????????

• ?????????????????????????????????????
• Rapid HIA ?????????????????????
  ????????????????????????????????????
  ????????????????????????????????????????
• Intermediate HIA ????????????????????
  ???????????????????????????? ?????????????????????
  
• Comprehensive or Full-scale HIA
  ??????????????????????? ??????????????????????????
  ? ????????????????????????????????????????????????
  ??????

????? WHO, 2005.
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??????????????????????????????????

• HIA ?????????????? ????????? ????????
  ??????????????????????????????????????????????????
  ??????????????????????????????
• ?????????? ??????????????????????????????????????
  ??? ??????
• ??????????? ?????????????????????????????????????
  ???

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????????????????????????????????????

• ??????????????? ??? ????????????????????????????
  ??????? ???????????????????????????????????????
  ???????? ???????????????????????????
  ????? ?????????????????????????????????????????
  ??????????????????????????? ?????? ??????????
  ?????
• Health safeguards ???????????????????????
  ???????????????????
• Health risk mitigating measures
  ??????????????????????????????????????
• Health promotional measures ??????????????????????
  ????

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3. ????????????????? (Appraisal)
4. ??????????????????????????? (Reporting and
Recommendation)
1. ???????????? (Screening) 2. ??????????????
(Scoping)
????????? ?????????
?????????????????? ?????????
????????? ???????????
??????????? ?????????
????????? ?????????? ????????? ?????????
???????????? ??????????????
????????????????
HIA ??? ?????????????? (HIA in EIA)
5. ??????????????????
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HIA, EIA, SIA, SEA - links
In principle
In practice
Environmental Impact Assessment (EIA)
SEA
EIA
SIA
Social Impact Assessment (SIA)
HIA
HIA
ESHIA
Source Furu, 2007.
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?????????/????????????????????????????????? (HIA
procedure)
5 ???????????
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????????? HIA ????????????????????????

• The Health Promotion Division,
• National Assembly for Wales, 1999
• Health Development, NHS Executive
• London, 2000
• (3) Scott-Samuel et al., 2001
• Commonwealth Department of Health
• and Aged Care, Australia, 2001
• (5) Quigley et al., 2006

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An approach to HIA
Source WHO, 1999.
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1
SCREENING
Output A project category
Effects known and considered
-B- NO
Serious health effects
-A- YES
Negligible effects
-C- NO
2
SCOPING
OutputTerms of Reference for appraisal
Source Adapted from Furu, 2007.
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3
Output Health Impact Statement (HIA report) with
recommendations for Health Risk Management (HRM)
APPRAISAL
4
OutputImproved HIA report Final choice of
options for HRM
REPORTING AND RECOMMENDATION
5
OutputResults made available to inform similar
processes and comparison between expected and
actual impacts
MONITORING AND EVALUATION
Source Adapted from Furu, 2007.
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?????? HIA ???????? EIA ????????????
????????????????????????????????,
2551 ???? 16-29
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??????????????????????????????????????????????????
?
??????????????
?????????????????????
??????????????
?????? EIA
??????????????????????
???????/ ?????????????????????
??????????????
?????????
?????/?????????????
????????/?????????????
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????? ??????? ?????????????????????????? ?????????
?? HIA ???? HIA ?? EIA
?????????????????????? (Project proponent)
- ????????? ?????????????????????????
??????????????? ?????????????????????? ????????
HIA (Consultants) - ??????????? HIA
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????? ??????? ?????????????????????????? ?????????
?? HIA ???? HIA ?? EIA
????????????????? - ???????? TOR
???????????????? ????????? HIA -
???????????????????????????????? ????????? -
?????????????????????????????????
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??????????????????????????????????????????????????
????
HIA
????? ????????????????????????????????, 2551.
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?????????