Recommendations

Abstract

This chapter discusses the fourth step of health impact assessment (HIA), development of recommendations for how to modify the project or policy under consideration. Recommendations represent a translation of findings from the assessment into actions that may improve the health of the affected population. The chapter begins with a discussion of several key success factors that may influence the extent to which recommendations are likely to be implemented. These are: recommendations should flow from the results of the assessment; they should be based on public health principles of harm avoidance; they should be evidence based; they should both mitigate harms and enhance health benefits; they should be specific and actionable; and they should be useable by those who must implement them. The text also discusses the various advantages and disadvantages of including decision makers in the development of recommendations, as well as possibilities and room for variation in styling the format of the recommendations section. The chapter concludes with examples of recommendations from four HIAs conducted on a diverse set of projects and policies, selected because they represent strong and effective recommendations demonstrating many of the key success factors described earlier.