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Enhancing the evidence base for health impact assessment
  1. J Mindell1,
  2. A Boaz2,
  3. M Joffe3,
  4. S Curtis4,
  5. M Birley5
  1. 1London Health Observatory, UK
  2. 2ESRC Centre for Evidence-based Policy and Practice, Queen Mary, University of London, UK
  3. 3Department of Epidemiology and Public Health, Imperial College London, UK
  4. 4Department of Geography, Queen Mary, University of London
  5. 5Liverpool University, UK
  1. Correspondence to:
 Dr J Mindell
 London Health Observatory, 11-13 Cavendish Square, London W1G 0AN, UK;


Health impact assessment differs from other purposes for which evidence is collated in a number of ways, including:

  • the focus on complex interventions or policy and their diverse effects on determinants of health;

  • the need for evidence on the reversibility of adverse factors damaging to health;

  • the diversity of the evidence in terms of relevant disciplines, study designs, quality criteria and sources of information;

  • the broad range of stakeholders involved;

  • the short timescale and limited resources generally available;

  • the pragmatic need to inform decision makers regardless of the quality of the evidence.

These have implications for commissioning and conducting reviews. Methods must be developed to: facilitate comprehensive searching across a broad range of disciplines and information sources; collate appropriate quality criteria to assess a range of study designs; synthesise different kinds of evidence; and facilitate timely stakeholder involvement. Good practice standards for reviews are needed to reduce the risk of poor quality recommendations. Advice to decision makers must make explicit limitations resulting from absent, conflicting, or poor quality evidence.

  • guidelines
  • health impact assessment
  • systematic review
  • methodology

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  • Funding: none.

  • Conflicts of interest: none declared.

  • An earlier draft of this paper was discussed at a workshop held by the London Health Observatory in London on 23 September 2002. Participants are listed above.

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