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Bottom-Up Policy Risk Assessment

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Assessment of Population Health Risks of Policies

Abstract

The top-down risk assessment that fits the classical HIA method and its application on policy was in depth presented in the previous chapter. Many public health experts find large policies difficult to assess as for their impact on health. People knowing health outcome and its societal burden well may find it easier to find proper policies starting from the bottom line—from health outcome. The use of complex causal process diagrams for analyzing health impacts of policy interventions was already described. The RAPID guidance based on bottom-up approach might be helpful to act more efficiently in reducing prevalence of health outcomes by identification and selection of proper policies for structural intervention. The health outcome was taken as a starting point and assessment through levels of risk factors and determinants of health lead to identification of policies needed to reduce burden of health outcome.

The present chapter illustrates through eight case studies conducted in seven different countries a bottom-up policy risk assessment model aiming to describe casual pathways upstream, from a single health outcome (effect) up through risk factors and health determinants leading to a list of policies. The purpose of this approach is to emphasize that results in health outcomes are related to many different policies at the same time, bringing up the need to adopt proactive inter-sectoral negotiations and putting health in the agenda of non-health sectors. Special interest was put on identifying the type of information needed for the description of the full-chain, possible discrepancies in defining health outcomes, risk factors or health determinants, the availability of data, the designation of possible scenarios related to political options, and the characterization of uncertainties.

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Authors and Affiliations

  1. National Institute of Public Health, Trubarjeva 2, SI 1000, Ljubljana, Slovenia

    Peter Otorepec

  2. Escuela Andaluza de Salud Pública, Cuesta del Observatorio 4, 18080, Granada, Spain

    Piedad Martin-Olmedo & Julia Bolivar

  3. Unit Innovation in Health, NRW Centre for Health (LZG.NRW), Bielefeld, 33611, Germany

    Odile Mekel

  4. NRW Centre for Health (LZG.NRW), Bielefeld, 33611, Germany

    Jutta Grohmann

  5. Trnava University, Univerzitne namestie 1, 91701, Trnava, Slovakia

    Daniela Kállayova & Mária Kvaková

  6. Regional Public Health Authority, Ipelska 1, 04011, Kosice, Slovakia

    Jana Kollárová

  7. Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St., Rm. 3-26.22, Toronto, ON, M5B 1C6, Canada

    Ágnes Molnár

  8. University of Debrecen, Kassai 26, 4028, Debrecen, Hungary

    Ágnes Molnár & Balázs Ádám

  9. University of Southern Denmark, Niels Bohrsvej 10, 6700, Esbjerg, Denmark

    Balázs Ádám & Stella R. J. Kræmer

  10. Medical University of Silesia, 18 Medykow Street, 40-752, Katowice, Poland

    Mariusz Geremek & Joanna Kobza

  11. University of Bielefeld, Universitätsstraße 25, 33615, Bielefeld, Germany

    Rainer Fehr

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  1. Peter Otorepec
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  14. Rainer Fehr
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Correspondence to Peter Otorepec .

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Editors and Affiliations

  1. Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark

    Gabriel Guliš

  2. Unit Innovation in Health, NRW Centre for Health, Bielefeld, Germany

    Odile Mekel

  3. University of Southern Denmark, Esbjerg, Denmark, and University of Debrecen, Debrecen, Hungary

    Balázs Ádám

  4. Institute of Clinical Physiology, National Research Council, Rome, Italy

    Liliana Cori

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Otorepec, P. et al. (2014). Bottom-Up Policy Risk Assessment. In: Guliš, G., Mekel, O., Ádám, B., Cori, L. (eds) Assessment of Population Health Risks of Policies. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8597-1_4

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