Health impact assessment
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Transcript Health impact assessment
INTERNATIONAL POLICY CONFERENCE
“COMPETITIVENESS & DIVERSIFICATION:
STRATEGIC CHALLENGES IN A PETROLEUMRICH ECONOMY”
Health Challenges in a Petroleum Rich Economy
Daniel Kertesz
1 | Oil, health, and development
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Health Challenges in a Petroleum Rich
Economy
Daniel Kertesz
WHO Representative in Ghana
World Health Organization
Key messages
Health is vital for successful growth of oil and gas
sector and for development of region
Health impacts associated not only with environmental
risk factors
Opportunity through health, to make sure that this oil is
good for development
Health system a key partner
Many tools and good practice examples of how to do
this
3 | Oil, health, and development
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Overview
1. Why is it important for people to be healthy?
2. What are the specific health concerns when
considering the oil and gas industry?
3. Who is affected
4. Why can’t we deal with these?
5. How can stronger health systems mitigate effects
6. Introduce the idea of Health Impact Assessment (HIA)
4 | Oil, health, and development
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Why is it important for people to be
healthy?
Human health is very easy to relate to – intuitively we all
know and appreciate good health and understand the
impact of bad health
Loss of health can have catastrophic consequences for
individuals and for families
Development progress is measured with health indicators
(e.g. MDGs)
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… healthy population is vital for local
economic development…
Labour pool
– Higher costs - non-wage labour
costs
– Reduced performance and
productivity of workers
– Longer term, due to reduced
educational attainment, less
qualified local labour pool
Less attractive
investment climate
Heavy burden of disease
–
–
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–
Tuberculosis
Alcoholism
HIV/AIDs
Malaria
Less competitive
High health insurance costs
Catastrophic costs of disease
for families
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…..also for industry…
Liability for pollution and
environment and health damages
Impact of projects on disease and
impacts of diseases on projects
– Disease transmission
social licence to
operate
cost of doing
business
Disease and well-being affects
linkages with communities
– Perceptions, expectations and
reactions to business
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reputational
risks
Oil and gas extraction: Direct impacts on
health
Pollution:
– Air emissions - NOx, SOx, PM, dust
– Soil and ground water contamination
– Vibration and noise pollution
Degradation:
– Change in soil quality
– land use changes, damage to ecosystems, loss of biodiversity
8 | Oil, health, and development
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Direct impacts on health
Operation of equipment and machinery
– Road traffic accidents
– Construction
– Fires, explosions
Exposure to hazardous substances
– Chemicals,
– heavy metals
Heat stress, exposure to UV radiation
Ergonomic injuries
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Indirect impacts on health
Changing patterns of communicable diseases
– Tuberculosis, HIV/AIDS, Malaria
– Respiratory infectious diseases
– Sexually transmitted infections
Food and waterborne illness
– Local service / infrastructure are overwhelmed
Increase in non communicable diseases
– “Boom town” effect: more money, more food of poorer quality, less
exercise, more obesity, more heart disease
– Violence, alcohol abuse, mental health problems
– Stress, anxiety and social tensions
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rapid development
example pathways to health outcomes
Stress, mental
well-being
Diet (quality)
and lifestyle
Alcoholism
Cardiovascular
disease
Nutritional status
Diabetes
Change in
spending patterns
Levels of physical
activity
Access to
motorized
transport
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Road traffic
accidents
Obesity
Respiratory
disorders
Injury or death
Why can’t we deal with these?
Underestimation of health impacts by governments
– Inadequate consideration of all implications, lack of awareness
Institutional barriers dividing sector functions
Weak national/local health systems not equipped to
identify or manage impacts
–
–
–
–
Strain on access to limited services
Procurement and supply of commodities
Inadequate quantity/quality of human resources for health
Poor surveillance, information management
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Who is affected?
Outbreak of mass
poisoning from sodium
bromide - 458 cases in
Luanda, Angola
sodium bromide used
widely in oil and gas
industry
Entered the local market
and was mistaken for
table salt
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What is a health system?
All organizations, people and actions whose primary
interest is to promote, restore or maintain health
Has 6 building blocks:
–
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–
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–
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Service delivery
Health workforce
Information
Medical products, vaccines, technologies
Financing
Leadership and governance
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How good health systems can mitigate
impact
Identification of health risks (and benefits)
– And interventions to address them using simple, low cost public
health interventions
Monitoring, reporting and evaluation
– Epidemiological and health indicators for baseline
– Early warning and monitoring of unintended impacts
– Measuring net "social" benefits or losses generated as a result
of growth of the petroleum industry
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How good health systems can mitigate
impact
Responding to community concerns and
perceptions of risk
– Health sector experienced with risk communication and can
engage in dialogue on community concerns about health risks
Emergency preparedness and response
– Public health response to chemical incidents
– Recognition and accurate diagnosis of chemical exposure
Responding to health issues
– Delivery of medical services to workers and to communities
16 | Oil, health, and development
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Key messages
Health is vital for successful growth of oil and gas
sector and for development of region
Health impacts not only associated with environmental
risk factors
Opportunity through health, to anticipate to make sure
that this oil is good for development
Health system a key partner
Many tools and good practice examples of how to do
this
17 | Oil, health, and development
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Thank you
Daniel Kertesz
World Health Organization Representative
Ghana
[email protected]
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Extra slides
Example: Alberta, CANADA (2010)
"boom town"– virtual doubling of
population in less than a decade
Community health status lower in
oil sands areas than in other
regions - inequity
Individual and family pressures
– Inflation (rent, food prices)
– Housing and labour shortages
Fort McMurry and the Oil Sands, Photo: Gord Mckenna
Infrastructure pressures
– Investment in health infrastructure
not as fast as population growth
Increased crime, alcohol
and drug use, family stress
Source: RSC Expert Panel, Environmental and Health Impacts of Canada's Oil Sands Industry, Dec 2010
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Health impacts of oil and gas
extraction activities
Health impact assessment (HIA)
Health impact assessment
– is a key tool/process/platform to facilitate the integration of
health considerations into development policies, plans, and
projects
The use of HIA can enable the upstream
assessment/identification of
– potential health impacts associated with a particular policy,
plan
– opportunities to address those impacts.
HIA can enable foresight to help ensure that the legacy is positive.
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How does HIA work?
Analysis of activities to determine potential health
impacts
Determination of baseline of health status and
assessment/estimation of potential health impacts
Generates recommendations on intervention options
Framework for monitoring and evaluation
Process and platform for systematically engaging all
stakeholders in decision-making process
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Onshore facilities
The footprint of oil and gas activities is much bigger
than just the well.
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Ancillary facilities and infrastructure
Requires construction of pipelines, transport corridors,
sometimes ports, and power and water infrastructure.
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HIA procedure
Policy, programme , or
project development
phase for prospective
assessments.
Screening
Quickly establishes "health
relevance" of the policy or project.
Is HIA required?
Scoping
Identifies key health issues &
public concerns, establishes ToR,
sets boundaries.
Rapid or in-depth assessment of
health impacts using available
evidence – who will be affected,
baseline, prediction, significance,
mitigation.
Appraisal
Reporting
Policy or project
implementation phase
Monitoring
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Conclusions and recommendations
to remove/mitigate negative
impacts on health or to enhance
positive.
Action, where appropriate, to
monitor actual impacts on health to
enhance existing evidence base.
HIA can be easily integrated into other IAs
Strategic Environmental Assessment
1. Establishing the context for the SEA
Scoping (in dialogue with stakeholders)
Collecting baseline data
Identifying alternatives
Identifying how to enhance opportunities and
mitigate impacts
Quality Assurance
Reporting
3. Informing and influencing decision making
Monitor decisions taken on the proposal
Monitor implementation of the proposal
Evaluation of both the SEA and the proposal
DAC Guidance on SEA in Development Cooperation, OECD 2006
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Scoping – where health relevance exists, identifies
questions to ask and defines boundaries for the
assessment
Appraisal
Reporting – development and communication of
– assessment of health impacts using
available evidence
conclusions and recommendations to remove/mitigate
negative impacts on health or enhance positive impacts
Making recommendations
4. Monitoring and evaluating
Screening – to establish health relevance of the proposal
Screening
Setting objectives
Identifying stakeholders
2. Implementing the SEA
Health impact assessment (HIA)
Monitoring – action, where appropriate to monitor
actual impacts on health to enhance existing evidence
base
WHO, 2003