Data Sheet 1_Exploring methods to assess environmental health inequalities in health impact assessments of local interventions: a systematic review within the JA PreventNCD project.docx

BackgroundHealth Impact Assessment (HIA) procedures can include the assessment of inequalities and inequities associated with the distribution of environmental health risks and benefits, aimed at attenuating the exacerbation of environmental health disparities. This systematic review, conducted as part of the Joint Action Prevent Non-Communicable Diseases initiative, explores methods for assessing health inequalities and equity within HIA frameworks, particularly in local projects affecting the distribution of environmental risks and benefits.
MethodsAdhering to the PRISMA guidelines, a systematic review of the scientific literature was conducted using the MEDLINE/PubMed, Scopus, and Embase databases, searching until March 8, 2024. Furthermore, a grey literature analysis encompassed the Institutional Repository for Information Sharing (IRIS) of the World Health Organization, to identify guidelines and recommendations addressing equity considerations in HIAs. Studies were included based on predefined eligibility criteria if they explored issues related to inequalities, inequities, and vulnerabilities within the context of HIAs. Data extraction focused on methodologies that incorporated equity considerations within the HIA framework, particularly concerning local urban planning initiatives, transport infrastructure, and industrial settings.
ResultsA total of 33 studies met the inclusion criteria. Among these, eight documents from the grey literature, identified as guidelines and guidance, underscored the importance of prioritizing equity to ensure that health impacts are addressed fairly across diverse population groups. The remaining 25 peer-reviewed studies employed a combination of quantitative and qualitative methodologies. Quantitative approaches, including exposure-response modeling and Geographic Information System (GIS) mapping, were utilized to evaluate spatial and demographic health disparities. Qualitative methods, such as focus groups, interviews, and participatory tools, provided insights into the lived experiences of vulnerable populations affected by local interventions. Studies addressing urban and transportation planning predominantly emphasized socioeconomic stratification, whereas those focused on industrial settings highlighted occupational hazards and community vulnerabilities.
ConclusionThis review highlights the diverse and fragmented approaches used to address health inequalities and equity in HIA. It underscores the need for interdisciplinary and systematic methodologies that integrate quantitative and qualitative perspectives, ensuring equity remains a central consideration in policymaking and project implementation. Finally, it proposes a practical framework for integrating equity into HIA.

背景：健康影响评估（Health Impact Assessment, HIA）流程可涵盖与环境健康风险及收益分布相关的不平等与不公平性评估，旨在缓解环境健康差异的进一步扩大。本系统综述作为"联合行动：预防非传染性疾病"倡议的组成部分，探究了在HIA框架内评估健康不平等与公平性的方法，尤其聚焦于影响环境健康风险与收益分布的地方项目。
方法：本研究遵循系统综述与荟萃分析报告规范（PRISMA），利用MEDLINE/PubMed、Scopus及Embase数据库对科学文献开展系统综述，检索时限截至2024年3月8日。此外，本研究还针对世界卫生组织信息共享机构知识库（Institutional Repository for Information Sharing, IRIS）开展灰色文献分析，以识别涉及HIA中公平性考量的指南与建议。研究纳入符合预设纳入标准的文献，前提为其探讨了HIA场景下与不平等、不公平性及脆弱性相关的议题。数据提取工作聚焦于在HIA框架内融入公平性考量的研究方法，尤其涵盖城市地方规划、交通基础设施及工业场景相关研究。
结果：共计33项研究符合纳入标准。其中8份灰色文献（均为指南与指导文件）强调了优先考量公平性的重要性，以确保不同人群均能得到公平的健康影响应对。其余25项同行评议研究结合使用了定量与定性研究方法。定量方法包括暴露-反应模型与地理信息系统（Geographic Information System, GIS）制图，用于评估空间及人口统计学层面的健康差异。定性方法如焦点小组访谈、访谈及参与式工具，则为受地方干预措施影响的脆弱群体的切身经历提供了洞察。针对城市与交通规划的研究多聚焦于社会经济分层，而聚焦工业场景的研究则重点关注职业危害与社区脆弱性。
结论：本综述凸显了当前在HIA中应对健康不平等与公平性问题所采用的方法多样且分散。研究强调了整合定量与定性视角的跨学科系统方法的必要性，以确保公平性始终是政策制定与项目实施的核心考量因素。最后，本研究提出了一套将公平性融入HIA的实用框架。