This deliverable, produced by the team working on Health in All Policies (WP9) of JA PreventNCD, builds on Deliverable D9.5.1, Identification of impact assessment tools and procedures in place in relevant European countries and at the EU-level. While D9.5.1 mapped the impact assessment tools identified across the participating countries and at EU level, D9.5.2 takes the analysis a step further by examining how health and health equity are reflected in those assessments and by identifying practical entry points for strengthening Health in All Policies implementation.
The report is based on the recognition that many sectors already use prospective impact assessments when developing laws, strategies, plans, programmes and projects. This creates an important opportunity to integrate health, wellbeing and health equity more systematically into decision-making beyond the health sector. Within this context, Task 9.5 focuses on reviewing existing tools and procedures, analysing how health and equity are currently considered, and contributing to stronger capacity and more practical guidance for future assessments.
Across the participating countries and at EU level, the task identified and analysed 60 impact assessments using available written guidance materials. Common assessment types included Regulatory Impact Assessments, Environmental Impact Assessments and Strategic Environmental Assessments, while stand-alone Health Impact Assessments were identified in five countries and at EU level. Most of the impact assessments reviewed were mandatory and applied to laws, policies, projects, plans and strategies. Public involvement was especially visible in environmental assessment processes, although it was often limited to information and consultation.
A key finding of the report is that health is already present in several assessment frameworks, but often in a limited or uneven way. The strongest emphasis tends to be on physical health, particularly in environmental assessments. Health equity is addressed much less consistently. While some tools refer to specific population groups such as children, older people or persons with disabilities, broader and more systematic equity perspectives are often missing. Vulnerable groups are acknowledged in many cases, but intersecting forms of disadvantage are rarely examined in depth.
The report concludes that there is a strong foundation on which to build, but also clear room for improvement. It points to the value of more standardised tools, including comprehensive checklists for health and health equity, stronger and more meaningful participation of affected groups, and better reporting and monitoring mechanisms. These steps could help make impact assessments more effective in supporting fairer policymaking and reducing health inequalities. The full document provides country profiles, an EU-level review, cross-country analysis, and recommendations for future strengthening of impact assessment practice.