Normalizing an American Right to Health by Christina S. Ho

Author:Christina S. Ho
Language: eng
Format: epub
Publisher: Oxford University Press
Published: 2023-08-15T00:00:00+00:00

HIAs and Their Significance

Use of HIA to call for an accounting of such government policies would not necessarily take the form of a right to affirmative provision, but a claim of freedom from these health-harming measures. The claim contrasts with the approach of some libertarian scholars who conceptualize the negative right to health as a freedom from government restriction of choice in medical treatment.37 Their narrower medical autonomy right would disfavor mandatory vaccination and possibly invalidate FDA premarket drug approval requirements.38 This is a blinkered and not necessarily health-promoting view of the government’s role in health, as Jennifer Prah Ruger and others have deplored.39 But a negative right to health properly conceived in the form of an HIA regime would meaningfully address some of the major health challenges we confront today.

HIA has been defined as “a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.”40 In short, the HIAs I propose would subject federal government action to a routine accounting of its impact on health and the distribution of health.41

HIAs conventionally involves six stages: screening, scoping, assessment, recommendations, reporting, and finally, monitoring and evaluation.42 Sometimes called the Liverpool approach, the sequence of steps has been specified in the literature as follows:

[A]pplying a screening procedure to select policies or projects for assessment; defining the scope of the health impact assessment in terms of depth, duration, spatial and temporal boundaries, methods, outputs, and the like; policy analysis; profiling the areas and communities likely to be affected by the policy; collecting qualitative and quantitative data on potential impacts from stakeholders and key informants, using a predefined model of determining health impact; evaluating the importance, scale, and likelihood (and, if possible, cost) of potential impacts; searching for the evidence to validate data; undertaking option appraisal (i.e., developing and choosing from alternative options) and developing recommendations for action; and monitoring and evaluating results following implementation.43

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