The Role of Health Impact Assessment for Shaping Policies and Making Cities Healthier

  • Mark NieuwenhuijsenEmail author
  • Haneen Khreis
  • Ersilia Verlinghieri
  • Natalie Mueller
  • David Rojas-Rueda


Health Impact Assessment (HIA) is an important tools to integrate evidence in the decision-making process, and introduce health in all policies. In urban and transport planning, HIAs have been used generally to assess qualitatively urban interventions rather than offering more useful/powerful estimations to stakeholders through quantitative approaches. HIAs could answer various pressing questions such as: what are the best and most feasible urban and transport planning policy measures to improve public health in cities? Also the process on how to get there is often as important as the actual output of the HIA, as the process may provide answers to important questions as to how different disciplines/sectors can effectively work together and develop a common language, how to best incorporate citizen and stakeholder, how different modelling and measurement methods can be effectively integrated, and whether a public health approach could make changes in urban and transport planning.


  1. Bailey, K., & Grossardt, T. (2010). Toward structured public involvement: Justice, geography and collaborative geospatial/geovisual decision support systems. Annals of the Association of American Geographers, 100, 57–86.CrossRefGoogle Scholar
  2. Bailey, K., et al. (2012). Toward environmental justice in transportation decision making with structured public involvement. Transportation Research Record, 2320(1), 102–110.CrossRefGoogle Scholar
  3. Banister, D. (2008). The sustainable mobility paradigm. Transport Policy, 15(2), 73–80.CrossRefGoogle Scholar
  4. Briggs, D. J. (2008). A framework for integrated environmental health impact assessment of systemic risks. Environmental Health, 7, 61.CrossRefGoogle Scholar
  5. Briggs, D. J., Sabel, C. E., & Lee, K. (2009). Uncertainty in epidemiology and health risk and impact assessment. Environmental Geochemistry and Health, 31(2), 189–203.CrossRefGoogle Scholar
  6. Creutzig, F., Mühlhoff, R., & Römer, J. (2012). Decarbonizing urban transport in European cities: Four cases show possibly high co-benefits. Environmental Research Letters, 7(4), 044042.CrossRefGoogle Scholar
  7. Elvy, J. (2014). Public participation in transport planning amongst the socially excluded: An analysis of 3rd generation local transport plans. Case Studies on Transport Policy, 2(2), 41–49.CrossRefGoogle Scholar
  8. European Centre for Health Policy. (1999). Health impact assessment: Main concepts and suggested approach (Gothenburg Consensus). Brussels: European Centre for Health Policy.Google Scholar
  9. Gascon, M., Triguero-Mas, M., Martínez, D., Dadvand, P., Forns, J., Plasència, A., & Nieuwenhuijsen, M. J. (2016a). Green space and mortality: A systematic review and meta-analysis. Environment International, 2(86), 60–67.CrossRefGoogle Scholar
  10. Gascon, M., Rojas-Rueda, D., Torrico, S., Torrico, F., Manaca, M. N., Plasència, A., & Nieuwenhuijsen, M. J. (2016b). Urban policies and health in developing countries: The case of Maputo (Mozambique) and Cochabamba (Bolivia). Public Health Open Journal, 1(2), 24–31.CrossRefGoogle Scholar
  11. Gerike, R., de Nazelle, A., Nieuwenhuijsen, M., Panis, L. I., Anaya, E., Avila-Palencia, I., Boschetti, F., Brand, C., Cole-Hunter, T., Dons, E., Eriksson, U., Gaupp-Berghausen, M., Kahlmeier, S., Laeremans, M., Mueller, N., Orjuela, J. P., Racioppi, F., Raser, E., Rojas-Rueda, D., Schweizer, C., Standaert, A., Uhlmann, T., Wegener, S., Götschi, T., & PASTA consortium. (2016). Physical Activity through Sustainable Transport Approaches (PASTA): A study protocol for a multicentre project. BMJ Open, 6(1), e009924.CrossRefGoogle Scholar
  12. Gkatzoflias, D., Kouridis, C., Ntziachristos, L., & Samaras, Z. (2007). COPERT 4: Computer programme to calculate emissions from road transport. Copenhagen: European Environment Agency.Google Scholar
  13. Hatzopoulou, M., & Miller, E. J. (2010). Linking an activity-based travel demand model with traffic emission and dispersion models: Transport’s contribution to air pollution in Toronto. Transportation Research Part D: Transport and Environment, 15(6), 315–325.CrossRefGoogle Scholar
  14. Health Effects Institute. (2010). Traffic-related air pollution: A critical review of the literature on emissions, exposure, and health effects, Special Report 17. HEI Panel on the Health Effects of Traffic-Related Air Pollution. Boston, MA: Health Effects Institute.Google Scholar
  15. IFC (International Finance Corporation). (2009). Introduction to health impact assessment. Washington, DC: The World Bank.Google Scholar
  16. Innes, J. E., & Booher, D. E. (2004). Reframing public participation: Strategies for the 21st century. Planning Theory & Practice, 5(4), 419–436.CrossRefGoogle Scholar
  17. Ji, S., Cherry, C. R., Bechle, M. J., Wu, Y., & Marshall, J. D. (2012). Electric vehicles in China: Emissions and health impacts. Environmental Science & Technology, 46(4), 2018–2024.CrossRefGoogle Scholar
  18. Kearney, M. (2004). Walking the walk? Community participation in HIA. A qualitative interview study. Environmental Impact Assessment Review, 24(2004), 217–229.CrossRefGoogle Scholar
  19. Kesby, M. (2005). Retheorizing empowerment-through-participation as a performance in space: Beyond tyranny to transformation. Journal of Women in Culture and Society, 30(4), 2037–2065.CrossRefGoogle Scholar
  20. Khreis, H. 2016. Critical issues in estimating human exposure to traffic-related air pollution: Advancing the assessment of road vehicle emissions estimates. Presented at the World Conference on Transport Research, Transportation Research Procedia, WCTR 2016 Shanghai, 10–15 July 2016.Google Scholar
  21. Khreis, H., Kelly, C., Tate, J., Parslow, R., Lucas, K., & Nieuwenhuijsen, M. (2016b). Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis. Environment International, 100, 1–31.CrossRefGoogle Scholar
  22. Linzalone, N., et al. (2016). Participatory health impact assessment used to support decision-making in waste management planning: A replicable experience from Italy. Waste Management, 59(2017), 557–566.Google Scholar
  23. Lowndes, V., et al. (2001). Trends in public participation: Part 1 - Local government perspectives. Public Administration, 79(1), 205–222.CrossRefGoogle Scholar
  24. Macmillan, A., Connor, J., Witten, K., Kearns, R., Rees, D., & Woodward, A. (2014). The societal costs and benefits of commuter bicycling: Simulating the effects of specific policies using system dynamics modeling. Environmental Health Perspectives, 122, 335–344.Google Scholar
  25. McHugh, C. A., Carruthers, D. J., & Edmunds, H. A. (1997). ADMS–Urban: An air quality management system for traffic, domestic and industrial pollution. International Journal of Environment and Pollution, 8(3–6), 666–674.Google Scholar
  26. McKinley, G., Zuk, M., Höjer, M., Avalos, M., González, I., Iniestra, R., et al. (2005). Quantification of local and global benefits from air pollution control in Mexico City. Environmental Science & Technology, 39(7), 1954–1961.CrossRefGoogle Scholar
  27. Mesa-Frias, M., Chalabi, Z., Vanni, T., & Foss, A. M. (2013). Uncertainty in environmental health impact assessment: Quantitative methods and perspectives. International Journal of Environmental Health Research, 23(1), 16–30.CrossRefGoogle Scholar
  28. Mueller, N., Rojas-Rueda, D., Cole-Hunter, T., de Nazelle, A., Dons, E., Gerike, R., Götschi, T., Panis, L. I., Kahlmeier, S., & Nieuwenhuijsen, M. (2015). Health impact assessment of active transportation: A systematic review. Preventive Medicine, 76, 103–114.CrossRefGoogle Scholar
  29. Mueller, N., Rojas-Rueda, D., Basagaña, X., Cirach, M., Cole-Hunter, T., Dadvand, P., Donaire-Gonzalez, D., Foraster, M., Gascon, M., Martinez, D., Tonne, C., Triguero-Mas, M., Valentín, A., & Nieuwenhuijsen, M. (2017). Urban and transport planning related exposures and mortality: A health impact assessment for cities. Environmental Health Perspectives, 125(1), 89–96.CrossRefGoogle Scholar
  30. Mumpower, J. L. (2001). Selecting and evaluating tools and methods for public participation. International Journal of Technology, Policy and Management, 1(1), 66–77.CrossRefGoogle Scholar
  31. Namdeo, A., Mitchell, G., & Dixon, R. (2002). TEMMS: An integrated package for modelling and mapping urban traffic emissions and air quality. Environmental Modelling & Software, 17(2), 177–188.CrossRefGoogle Scholar
  32. NAS (National Academy of Sciences). (2011). Improving health in the United States: The role of health impact assessment. Washington: National Academy of Sciences.Google Scholar
  33. NHS. (2002). Health impact assessment: A review of reviews. London: Health Development Agency.Google Scholar
  34. Nieuwenhuijsen, M. (2016). Urban and transport planning, environmental exposures and health-new concepts, methods and tools to improve health in cities. Retrieved from
  35. Nieuwenhuijsen, M. J., Khreis, H., Triguero-Mas, M., Gascon, M., & Dadvand, P. (2017). Fifty shades of green: Pathway to healthy urban living. Epidemiology, 28(1), 63–71.CrossRefGoogle Scholar
  36. Palerm, J. R. (2000). An empirical-theoretical analysis framework for public participation in environmental impact assessment. Journal of Environmental Planning and Management, 43(5), 581–600.CrossRefGoogle Scholar
  37. Perez, L., Trüeb, S., Cowie, H., Keuken, M. P., Mudu, P., Ragettli, M. S., Sarigiannis, D. A., Tobollik, M., Tuomisto, J., Vienneau, D., Sabel, C., & Künzli, N. (2015). Transport-related measures to mitigate climate change in Basel, Switzerland: A health-effectiveness comparison study. Environment International, 85, 111–119.CrossRefGoogle Scholar
  38. Reed, M. S. (2006). Unpacking ‘participation’ in the adaptive management of social–ecological systems: A critical review. Ecology and Society, 11(2), 39.CrossRefGoogle Scholar
  39. Reisi, M., Aye, L., Rajabifard, A., & Ngo, T. (2016). Land-use planning: Implications for transport sustainability. Land-Use Policy, 50, 252–261.CrossRefGoogle Scholar
  40. Renn, O., & Webler, T. (1995). Fairness and competence in citizen participation: Evaluating models of environmental discourse. London: Springer.CrossRefGoogle Scholar
  41. Richardson, G. P. (2011). Reflections on the foundations of system dynamics. System Dynamics Review, 27, 219–243.CrossRefGoogle Scholar
  42. Sagaris, L. (2014). Citizen participation for sustainable transport: The case of “Living City”. Journal of Transport Geography, 41, 74–83.CrossRefGoogle Scholar
  43. SATURN Manual. (2015). SATURN Manual, April 2015 Version 11.3.12 [Online]. Retrieved April 10, 2016, from
  44. SDG. (2015). Retrieved November 8, 2016, from
  45. Shafiea, F., Omara, D., & Karuppannanb, S. (2013). Environmental health impact assessment and urban planning. Procedia - Social and Behavioral Sciences, 85, 82–91.CrossRefGoogle Scholar
  46. Ståhl, T., Wismar, M., Ollila, E., Lahtinen, E., & Leppo, E. (2006). Health in all policies: Prospects and potentials. Finland: Ministry of Social Affairs and Health.Google Scholar
  47. Stevenson, M., Thompson, J., de Sá, T. H., Ewing, R., Mohan, D., McClure, R. I., Tiwari, G., Giles-Corti, B., Sun, X., & Wallace, M. (2016). Land-use, transport, and population health: Estimating the health benefits of compact cities. The Lancet. Scholar
  48. Sundvor, I., Castell Balaguer, N., Viana, M., Querol, X., Reche, C., Amato, F., Mellios, G., & Guerreiro, C. (2012). Road traffic’s contribution to air quality in European cities. ETC/ACM Technical Paper 2012/14 November 2012. The European Topic Centre on Air Pollution and Climate Change Mitigation (ETC/ACM) (a consortium of European institutes under contract of the European Environment Agency).Google Scholar
  49. Tainio, M. (2015). Burden of disease caused by local transport in Warsaw, Poland. Journal of Transport and Health, 2, 423–433. Scholar
  50. Tainio, M., de Nazelle, A. J., Götschi, T., Kahlmeier, S., Rojas-Rueda, D., Nieuwenhuijsen, M. J., de Sá, T. H., Kelly, P., & Woodcock, J. (2016). Can air pollution negate the health benefits of cycling and walking? Preventive Medicine, 87, 233–236.CrossRefGoogle Scholar
  51. Tobías, A., Recio, A., Díaz, J., & Linares, C. (2014). Health impact assessment of traffic noise in Madrid (Spain). Environmental Research, 137C, 136–140. Scholar
  52. van de Kerkhof, M. (2006). Making a difference: On the constraints of consensus building and the relevance of deliberation in stakeholder dialogues. Policy Sciences, 39(3), 279–299.CrossRefGoogle Scholar
  53. Van Vliet, D. (1982). SATURN—A modern assignment model. Traffic Engineering and Control, 23(12), 578–581.Google Scholar
  54. Wang, A., Fallah-Shorshani, M., Xu, J., & Hatzopoulou, M. (2016). Characterizing near-road air pollution using local-scale emission and dispersion models and validation against in-situ measurements. Atmospheric Environment, 142, 452–464.CrossRefGoogle Scholar
  55. WHO. (1999). European Centre for Health Policy, WHO Regional Office for Europe. Gothenburg Consensus Paper.Google Scholar
  56. WHO. (2015). Global health Observatory. Retrieved 26 October, 2015, from
  57. Williams, M., Barrowcliffe, R., Laxen, D. & Monks, P. (2011). Review of air quality modelling in DEFRA [Online]. Defra. Retrieved from
  58. Woodcock, J., Edwards, P., Tonne, C., Armstrong, B. G., Ashiru, O., Banister, D., Beevers, S., Chalabi, Z., Chowdhury, Z., Cohen, A., & Franco, O. H. (2009). Public health benefits of strategies to reduce greenhouse-gas emissions: Urban land transport. The Lancet, 374(9705), 1930–1943.CrossRefGoogle Scholar
  59. Xia, T., Nitschke, M., Zhang, Y., Shah, P., Crabb, S., & Hansen, A. (2015). Traffic-related air pollution and health co-benefits of alternative transport in Adelaide, South Australia. Environment International, 74, 281–290.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Mark Nieuwenhuijsen
    • 1
    • 2
    • 3
    Email author
  • Haneen Khreis
    • 1
    • 2
    • 3
    • 4
  • Ersilia Verlinghieri
    • 5
  • Natalie Mueller
    • 1
    • 2
    • 3
  • David Rojas-Rueda
    • 1
    • 2
    • 3
  1. 1.ISGlobal, Centre for Research in Environmental Epidemiology (CREAL)BarcelonaSpain
  2. 2.Universitat Pompeu Fabra (UPF)BarcelonaSpain
  3. 3.CIBER Epidemiologia y Salud Publica (CIBERESP)MadridSpain
  4. 4.Institute for Transport StudiesUniversity of LeedsLeedsUK
  5. 5.Transport Studies UnitUniversity of OxfordOxfordUK

Personalised recommendations