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Health impact assessment (HIA) has been seen as a promising tool for integrating health considerations into other policies. Both the scientific community and international expert bodies (eg, World Health Organization) in the field of public health have advocated its implementation given the promising findings of its usefulness. However, ensuring that it is systematically implemented in routine daily decision making has been especially difficult, especially at the local level (see eg, Nilunger Mannheimer et al,1 Wismar et al,2 Collins and Koplan,3 and Metcalfe and Higgins4). Undoubtedly, one reason for the difficulties in implementing and institutionalising HIA is the vast number of competing impact assessments—for example environmental, social, economic, business, sex, sustainability, human rights and child. All these are expected to be implemented by officials preparing proposals for decision makers. As a solution, in the context of the European Union, an integrated EC Impact Assessment was presented in 2002 as a comprehensive assessment procedure, only 1 year after the Directorate General for Health …