A Consolidated Report for Six Workshops - April-June 2000

An Overview of the Report (continued)

• 7. Suggestions made by participants for the improvement of handbook

All suggestions made by participants in all workshops for the improvement of handbook are grouped to-gather under 17 different aspects of HIA as in Chapter-6 and summarized next:

7.1 The First Most Common Suggestion Group

The first most common suggestion group was on "The Format of the Handbook and the Presentation of Specific Contents in the Handbook" and this group includes specific suggestions such as; reassess the need for different volumes of the handbook, reorganize the volumes of the handbook, provide definitions of different terms used in the handbook, improve the presentation of tables, figures & charts, provide a summary handbook (A Quick Reference Guide), must match titles and contents in different chapters of the handbook, improve the type of language used in the handbook, follow the EA process in the layout of chapters in the handbook, update the outdated information in the handbook, provide a detailed Table of Contents and make provisions for the downloading of individual chapters from the website. Please see Section - 6.13 for more information.

7.2 The Second Most Common Suggestion Group

The second most common suggestion group as in section 6.8 was "Establish a Clear Detailed Process in the Handbook for HIA in EIA" and the specific suggestions in this group includes; provide operational information in the handbook, present a decision tree diagram, connect social issues with HIA, include a tool for HIA in the handbook, provide a process to use determinants of health, incorporate a clear assessment framework for HIA, provide a checklist for do s & don't s, furnish a template that leads us through the entire HIA process, incorporate a set of questions for the process so that answers in lay language could be obtained, provide a process for the integration of HIA with development of policies and programs, supply clear and complete answers in the handbook on 'how to do health impact assessment', incorporate a road map to identify issues / expertise and the process to link EA with HIA, provide information on how to monitor and evaluate HIA process, supply information in the handbook on how to assess the resource requirements and the costs of doing HIA, provide information in the handbook on when to use volume-3 and include information in the handbook on where the decision is finally made.

7.3 The Third Most Common Suggestion Group

As in Section 6.6, the third most common response group was on the need for Public Involvement / Community Involvement Guidelines and the specific responses in this group include suggestions such as; incorporate information on where does community fit into the HIA process, provide pathways for communications with communities, supply information on how governments can learn from communities, incorporate information on how to carry-out public consultation, provide information on how to incorporate all sectors of the public including those without a voice who fall through the cracks, include information on how to get cooperation from all sectors of the public agencies and governments at different levels and discuss a general model for public participation in the handbook.

7.4 Suggestions Made on The Need to Establish The Required Relationships Between Health and Environment

As given in Section 6.2, "Establish the Required Relationship between health and Environmental Assessment" was another suggestion group which includes specific suggestions such as; write a definition in the handbook that includes human beings, incorporate HIA linkages with EA, specify HIA requirements relevant to EA process, provide a Tool Box for health professionals regarding the health aspects of EA and make very clear in the handbook that HIA should be a part of environmental assessment and therefore HIA should not appear to stand alone in the handbook.

7.5 Suggestion Made on the Human Resources Information

As presented in Section 6.10, all suggestions pertaining to human resources are grouped together and this group includes specific suggestions such as; provide information in the handbook on the roles and responsibilities of health professionals, incorporate information in the handbook on the development and implementation of training courses for health professionals, provide information on the roles and responsibilities of health authorities, supply information on 'who starts the HIA process?', provide information on who is responsible for what? when? and how? and provide information in the handbook on expectation of all participants of health impact assessment.

7.6 Suggestions Made on the Need to Identify Target Audience

Participants in all six workshops made suggestions on the need to identify the Target Audience and the suggestions made by participants on Target Audience are grouped together in Section 6.1. The specific suggestions in this group includes suggestions such as the need to include wide audience, provide all necessary information in the handbook to clearly identify the target audience, incorporate information in the handbook to describe the Target Audience, incorporate variety of groups like town councils and other groups with Target Audience, emphasis all Target Audience in the handbook in addition to health professional, incorporate adequate information on Health Impact Assessment Specialists instead or project managers, expand Target Audience to include EA practitioners, provide definition for the Target Audience in the handbook, provide information to identify the clientele targeted by the handbook and a suggestion by a participant to identify Target Audience at the beginning of each volume.

7.7 Suggestions Made on the Need for Information on Cost Analysis and Resource Requirements

All suggestions about the need for cost analysis information are grouped together in one group as presented in Section 6.7 and the specific comments in this group include suggestions such as; must provide information in the handbook on the need for cost effectiveness, provide information on the cost of implementation and add details in the handbook on time and resources needed to carry-out health impact assessment along with the availability of such resources.

7.8 Suggestions Made on the Need to Incorporate Mitigation Information

There were some suggestions in four workshops on the need to incorporate Mitigation Information and all suggestions related to mitigation are grouped together Section 6.9. Specific suggestions in this group include suggestions such as; incorporate Follow-up Procedures needed to minimize the negative effects of projects / programs on human health, provide more information on mitigation aspects in the handbook and furnish information in the handbook on how to make mitigation proposals

7.9 Suggestions Made on the Determinants of Health

In three workshops, suggestion were made on the Determinants of Health and all suggestions related to Determinants of Health are grouped together in Section 6.16. Specific suggestions in this group include statements such as; incorporate information on roles & responsibilities of many different professionals in the handbook since Determinants of Health are in different sectors, add two new Determinants of Health namely Gender & Culture and provide information in the handbook on 'How to Prioritize the Determinants of Health'.

7.10 Suggestions Made on the Improvement of Database in the Handbook Database for Health Impact Assessment

is another suggestion group in Section 6.11 and this group includes specific suggestions such as; must group the relevant information in the handbook under technical, social, economic etc, provide more information on trade-offs, incorporate a detail list of relevant data sources in the handbook, provide information in the handbook for predictions, make provisions in the handbook to update information & references in an on-going basis, incorporate information from different regions of Canada, add information in the handbook on how to avoid bias in relation to HIA Officers and the last suggestion was to establish a process for centralized database.

7.11 Suggestions Made on the Need Analysis for Health Impact Assessment

There were suggestions from Ottawa and Regina workshops on the need to incorporate information on the Need Analysis for Health Impact Assessment and the specific suggestions made by the participants include; add information in the handbook on 'when HIA tool should be used and when should not be used?', furnish a Method in the handbook so that it is possible to use that method to decide 'when to do HIA?', and the last suggestion was to provide a trigger mechanism in the handbook for HIA in EA. Please see Section-6.15 for more information.

7.12 Suggestions Made on the Linkages of HIA with Legislation and Regulations

At Regina and Ottawa workshops, some participants made suggestions to establish clear linkages between HIA and legislation & regulations as in Section 6.4. Specific suggestions in this group include statements of facts such as: supply HIA linkages with health related legislation (Regina), provide health legislation from different levels of government could be clearly stated (Regina) and the last statement of fact was to include all required information regarding regulations, legislation and directives (Ottawa).

7.13 Suggestions Made on the Linkages of HIA with SIA and other Processes

Some participants at Toronto, Ottawa and Vancouver workshops indicated the need to clearly link HIA with SIA and the specific suggestions (section 6.5) include statements of facts such as; the handbook is not clear on whether SIA is separate from HIA and therefore it is important to establish clear linkages between SIA and HIA (Toronto), if SIA is part of HIA then it is important to show that specific linkage (Toronto), provide the links between volume-2 of the handbook and environmental assessment (Ottawa), incorporate linkages of all three volumes (Ottawa) and the last statement of fact was on the need to link HIA with Occupational Health and Safety (Vancouver).

7.14 Need for Information on the Environmental Health Concerns

There were suggestions from Toronto and Ottawa participants that the handbook should provide information on the environmental health concerns in Canada (Section 6.3) and the specific suggestions in this group include statements of facts such as; provide information on the common environmental health concerns in Canada (Toronto) and the second statement was on the need to avoid separation of man from his environment in the handbook (Ottawa).

7.15 Reassessment of the Need for Different Volumes of the Handbook

Participants at the Toronto workshop clearly indicated that volume-3 should be reassessed. The specific suggestions by participants include statements such as; it is imperative to assess whether volume-3 is helpful or not, the particular need for volume-3 is questionable, need for volume-3 of the handbook should be assessed and the last statement in this group was that the volume-3 could be titled as 'back grounder' for health professionals. Please see Section - 6.12 for more detail.

7.16 General Suggestions for the Whole Handbook

An effort is made under "General Suggestions' to bring to-gather all suggestions which were in relation to overall handbook and the overall HIA process. Important statements of facts in this suggestion group include statements such as; amount of information in the handbook may cause "paralysis", the handbook is very long and daunting, language used in the handbook should be improved, titles for chapters and volumes should be made to match the contents, need to link different volumes of the handbook and a suggestion to rewrite the handbook. Please see Section-6.14 for all statements by participants in all workshops.

7.17 Suggestions for the Promotion of HIA Handbook

Once all the above suggestions are included in the handbook, the new improved handbook should be promoted (please see Section 6.17) to realize the adoption of handbook and towards this goal, participants at Quebec City workshop made suggestions such as; promote the handbook more and present them more to health and environmental assessment practitioners and to make the PowerPoint presentation (Appendix-C) available on an official website.

• 8. Suggestions made on the sectoral presentations in the handbook
  In all workshops except Ottawa, suggestions were made by participants pertaining to information in the handbook on Sectors and the specific comments include suggestions such as; provide more references for information on sectors, include information on collaborative works with other Departments such as Natural Resources Canada for information on different sectors, provide complete analysis of all sectors in the handbook, add new sectors in the handbook such as Nuclear Sector and Infra Structural Sector, provide more analysis of each sector by integrating Determinants of Health, include health related database for different sectors, provide all acts and regulations for all sectors, establish all standards and specifications for all sectors and include social impacts for different sectors. Further suggestions on different sectors are provided in Chapter-7 and these sectors include Agriculture, Forestry, Mining, Energy, Transportation / Communication, Waste Management / Waste Disposal, Sewage / Sludge Management and Manufacturing.
  
  
• 9. Suggestions made by participants on improving the presentation of examples
  Finally, the chapter-8 brings together suggestions by participants in all workshops on improving the presentations of examples in handbook and the specific suggestions include; provide more information for each example by using a specific method to conduct health impact assessment, add more information for examples on the application of Determinants of health, add examples on Uranium Mines and Potash Mines, increase the number of examples in all sectors, include information on international examples, municipal examples & household examples, adopt a consistent format for all examples, include information on Social Impact Assessments for all examples, provide information for examples on Benefit / Cost analysis to facilitate decision making and add information for examples on the monitoring and evaluation activities to improve Health Impact Assessment in Environmental Assessment.
  
  Additional suggestions made by participants in all workshops include the need for more analysis on the Loss of Culture and Social Values due to projects & programs, analysis of impacts of off reserve projects on reserve and vice-versa, add information on the use of this handbook by First Nations, add information on acts & regulations and present all available information on standards and specification for hazards on the website.
  
  
• 10. Conclusion
  Most participants expected a clear answer for their fundamental question on "How to Do Health Impact Assessment as a Component of Environmental Assessment". Although, the participants liked many aspects of the handbook as presented in Chapter-4, they did not like fourteen different but related aspects of HIA in the handbook. As presented in Chapter-6, participants at all workshops provided valuable suggestions for the improvements of all fourteen aspects which they disliked plus three more aspects of HIA in the handbook. Hence, improvements should be made on all seventeen aspects of HIA in the handbook by using the valuable suggestions provided by the participants at all workshops. Making improvements on all seventeen aspects will undoubtedly involve a complete redesign and rewrite of the handbook.
  
  Participants further provided valuable suggestions for the improvements of sectors and examples in the handbook as presented in Chapter-7 and Chapter-8 respectively. Making improvements on sectors, examples and HIA through a complete redesign and rewrite of the handbook, would enhance the adoption of handbook and minimize the negative effects of projects, programs and policies on human health.