HEALTH IMPACT ASSESSMENT PRACTICES AND THEIR INFLUENCE ON PUBLIC HEALTH IN MONTÉRÉGIE

This study examines the effects of the collaborative Health Impact Assessment (HIA) model implemented in Monteregie, Quebec, on the development, adoption, and implementation of municipal projects incorporating health considerations. Nine HIA processes across nine territories were analyzed, involving 35 participants engaged at various stages. Using a cross-sectional design, data were collected through document analysis, semi-structured interviews, and on-site observations, guided by the six-step Contribution Analysis framework. Each HIA was assessed at least six months post-completion to evaluate its influence. Findings indicate varied outcomes. While participants gained new knowledge, the process had limited success in raising municipal actors’ awareness of health issues. HIAs primarily provided stakeholders with stronger arguments to advocate for health-focused actions within their councils. HIAs were often led by actors already aware of the importance of health promotion. Some recommendations were incorporated into planning documents, but reports more often remained supplementary rather than fully integrated into core planning materials. Nonetheless, many municipal actors continued to consider health implications in future policy and project planning. Key prerequisites for effective HIAs include engaged municipal actors aware of their impact on community health, existing municipal policies incorporating health considerations, and active municipal participation throughout the HIA process. This study highlights the complexity of factors influencing HIA effectiveness and underscores the unique dynamics within each process that shape its impact on municipal decision-making.