HIA Development in the 21 Swedish County Administrative Boards

2009-12-17

The Swedish County Administrative Boards are government authorities with a unique position in the Swedish democratic system. Sweden comprises 21 counties, which are in turn divided into municipal areas. The County Administrative Boards are an important link between the citizens and the municipal authorities on one hand, and the government, parliament, and central authorities on the other.

In 2007 and 2008, the Swedish County Administrative Boards were assigned the task of implementing and developing methodology for health impact assessment (HIA) by the government. The Swedish National Institute of Public Health (SNIPH) has reviewed the 21 County Board reports, and summarized these in a report, focusing on three issues:

1. In what areas have the Swedish County Administrative Boards tried health impact assessment?
   Health impact assessment in physical planning dominates the mission in which 12 County Administrative Boards carried out health impact assessment (HIA) within physical planning.
   • The county administrative boards have a particular responsibility to promote the national public health objective in their work with regional growth, community planning, crisis management and alcohol and tobacco issues. The county administrative boards have tried health impact assessment in all these areas.
2. How has the implementation of HIA worked in the Swedish County Administrative Boards?
   • Decisions at the management level, public health skills, clear project management, and interoperability of various skills and structures are all required for successful implementation of health impact assessments in County Administrative Boards.
   • The SNIPH manual on HIA ought to give a better description of how a health impact assessment is best presented to those with no public health background.
   • Several of the County Administrative Boards feel that they don’t deal with matters suitable for health impact assessment themselves, but that they could provide support to municipalities.
   • Compared to environmental impact assessment, many County Administrative Boards consider HIA more difficult to apply.
3. What obstacles and opportunities have been noted by the Swedish County Administrative Boards in their work with health impact assessment?
   • Health Impact Assessments are useful in general, for many types of cases and decisions.
   • It is not necessary, or desirable, to carry out a full health impact assessment in all types of cases.
   • A majority of County Administrative Boards want to deal with social, economic, and environmental consequences in a comprehensive impact assessment.
   • The government assignment to apply health impact assessments has helped to strengthen and broaden the perception of public health issues in both the local and regional perspectives.