Scoping Health Impact Assessment: ecosystem services as a framing device

Document Type

Book Chapter


Edward Elgar Publishing

Place of Publication

Cheltenham, UK


Geneletti, D.


School of Science




Originally published as: Horwitz, P. & Parkes, M. W. (2016). Scoping Health Impact Assessment: ecosystem services as a framing device. In D. Geneletti (Ed), Handbook on Biodiversity and Ecosystem Services in Impact Assessment, (pp. 62-85). Cheltenham, UK: Edward Elgar Publishing. Available here.


Introduction: Many, indeed probably most, decisions made in societies have intended and unintended health outcomes; this alone provides sufficient reasoning to ensure that health professionals are engaged in these decisions rather than deal with the consequences at a later date. Health Impact Assessment (HIA) provides one approach to ensuring that health outcomes of decisions are taken into account (Harris- Roxas et al., 2012).

Harris- Roxas et al. (2012) show that historically HIA has emerged from three strands: environmental health concerns (where the environment has an effect on human health); the social determinants of health (where the concern is the ‘upstream’ causes of ‘downstream’ health conditions); and a focus on health equity (where interventions can address or promote health equity through planning). When any of these strands are performed effectively, or even more, when the three might be combined, the capacity to produce a powerful analysis of health consequences can be envisaged. HIA has considerable value as a proactive and systematic approach to identifying the health impacts of projects, programmes, plans and policies, including those associated with resource development (Utzinger et al., 2005; Winkler et al., 2012; Parkes, 2016).

An overarching theme in the development of HIA has been the engagement by the public health sector in non- health sector activities (Harris- Roxas et al., 2012; Harris- Roxas and Harris, 2013; Lee et al., 2013), and this intrinsically demands interdisciplinary and multidisciplinary approaches capable of seeking both to minimize negative health effects and to enhance positive health effects (Winkler et al., 2010). In their work on sustainability assessment, Bond et al. (2012) expand on this latter point, outlining a series of reasons why more integrative, deliberative and positive approaches to ‘impacts’ are desirable. They cite the shortfalls of focusing on mitigation and minimizing impacts (as compared to a systems approach), and emphasize the value of going beyond the pillars approach of sustainability (which encourages trade- offs), and working to deliver net sustainability gains (through greater system health and resilience over the long term).