Theoretical framework for health impact assessment in urban planning
Health impact assessment can elucidate the potential health impacts of changes in the urban built environment,providing a framework for predicting the health benefits of urban development,planning schemes,and projects.Health impact assessment can be incorporated into the compilation and review processes of urban planning to assess and forecast the potential health benefits of these plans and projects.This paper systematically analyzes the challenges and difficulties faced by the theory,methods,and practice of health impact assessment in China.In conjunction with the characteristics of urban planning in China,it constructs a theoretical framework for health impact assessment oriented towards urban planning.This framework clarifies the content system,technical process,model system,and working methods of health impact assessment to provide theoretical,methodological,and mechanistic guidance for the comprehensive integration of health impact assessment into urban planning.Currently,health impact assessment in urban planning faces challenges such as unclear content systems,ambiguous technical processes,unestablished model systems,and lack of working methods,which hinder the full integration of health impact assessment into urban planning.Specifically,urban planning involves the coordinated arrangement of multiple spatial scales and elements,but the content system for conducting health impact assessment in this context has yet to be established,and the assessment elements and their pathways need to be clarified.Although existing health impact assessment projects generally follow the WHO's"screening,scoping,impact assessment,and recommendations"process,the choice of assessment models is often based on project characteristics,data availability,and budget constraints.This reduces the generality of assessment models,the standardization of the assessment process,and the comparability of assessment results.Moreover,key technical aspects of"scoping"and"conducting the assessment"in this process remain vague,limiting their practical guidance.Internationally,the models used in health impact assessment are dispersed across urban planning,environmental science,and medicine,showing strong heterogeneity.Due to the lack of a unified model system,the principles for selecting health impact assessment models and directions for future optimization are unclear.Lastly,although health impact assessment is advocated as part of urban planning scheme formulation,its high demands for objectivity and professionalism mean it is mostly conducted by independent teams and often intervenes only after the planning scheme is formed,serving primarily to verify the planning scheme.In response to these issues and challenges,this paper constructs a theoretical framework for health impact assessment in urban planning,systematically clarifying the content system,technical process,model system,and working methods for health impact assessment.The content system aims to clarify the elements and pathways of health impact assessment and can be carried out from three aspects:health risk control impact assessment,health resource support guarantee assessment,and health behavior promotion benefit assessment.The technical process aims to clarify the specific steps and technical points for conducting a health impact assessment from a practical perspective,including five steps:determining the reference object,defining the assessment scope,constructing the assessment framework,selecting the assessment methods,and conducting the assessment.The model system aims to clarify the models that can be used in health impact assessment and the relationships between models.It consists of core models,related models,and peripheral models,which can be used to calculate the changes in health risk factors or health outcome indicators corresponding to changes in each planning element indicator.The working methods aim to clarify the mechanism for integrating health impact assessment into planning compilation,where planning compilation teams and health impact assessment teams can collaboratively promote the"whole process"integration of health impact assessment into planning.The relationships between these parts are as follows:the content system is determined based on existing healthy urban planning theoretical models;the technical process and model system are determined based on the content system,with health impact assessment models being the most critical part of the technical process;the working methods clarify the implementation path for integrating health impact assessment into urban planning from a mechanistic perspective.To enhance the reliability of health impact assessments in the future and to expand their application in urban planning,there are three key points to consider.First,it continues to deepen empirical research on the effects of the built environment on health outcomes,providing a stronger evidence base for healthy city planning interventions and health impact assessments.Second,it continuously develops and optimizes models to improve the suitability and usability of health impact assessment models within China's planning system.Finally,it promotes the legalization of health impact assessments,establishing them as a mandatory component within the planning and development process at the institutional level.
health impact assessmenthealthy urban planningtheoretical frameworkmodel methodsintegration mechanism
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