Many countries have introduced health impact assessment (HIA) at the national, regional, or local levels. In France and in Québec, there is increasing interest in using HIA to inform decision-makers and influence policies, programs, and projects. This paper aims to compare HIA implementation models in two regions: Nouvelle-Aquitaine (France) and Montérégie (Québec, Canada) using a case study methodology. The objective is to gain a better understanding of the similarities and differences in the approaches used to achieve the operationalization of HIA. The methodological approach involves four steps: (1) design of an analytical framework based on the literature; (2) exchanges within the research team and review of documents concerning the two implementation strategies under study; (3) development of the case studies based on the proposed framework; and (4) cross-comparison analysis of the case studies. The findings show that the two regions share certain similarities, including the strong commitment and political will of the public health organizations involved and a well-established culture of engaging in intersectoral action with municipal partners. Differences mainly concern their different approaches to implementing HIAs in accordance with the regional policies and the organizational and administrative contexts in place. This study identifies potential avenues for supporting the practice of HIA at the municipal level.

In France, there is increasing interest in health impact assessments (HIAs) and most are performed on urban projects. The field of expertise is still under development and mostly established within the public health sector. To date, in France, all HIAs conducted in urban planning are stand-alone HIAs disconnected from the required environmental impact assessment (EIA). The paper opens with an introduction of the close and complex relationship between health and urban planning, HIA and a description of key elements needed for understanding the French context. Then, the paper analyses the context and the implementation process for four HIAs in progress in order to understand the specific characteristics of urban development, identify the key stages for introducing a health perspective into urban projects, and extract avenues to be explored when adapting HIAs applied to urban planning in France. Using a qualitative multiple case study design, an analysis framework was built to compare several aspects of the four HIAs and made it possible to highlight three pathways for adapting HIA to the urban planning sector: the schedule, links between the EIA and HIA, and the complementarity of the initiatives to involve residents. Legal measures enable a point of contact that brings health institutions and cities closer together. HIA is yet another tool that public authorities now have at their fingertips to work together in strengthening democracy and in reducing social, geographical and environmental health inequalities. More research must be undertaken to develop an understanding of the practice-related context; to judge HIA’s capacity to draw on existing approaches in different fields; and to explore the different avenues leading to increased health, wellbeing and equity.

L’évaluation d’impact sur la santé (EIS) suscite aujourd’hui en France un réel intérêt et la pratique ne cesse de progresser, motivée par une préoccupation commune des villes et des institutions régionales de la santé, de contribuer ensemble à l’amélioration de la santé et à la réduction des inégalités sociales de santé. Cette démarche a pour but d’identifier les conséquences potentielles de politiques ou projets sur la santé des populations afin de proposer des mesures destinées à atténuer les impacts négatifs et renforcer les impacts positifs. L’objectif de cet article est d’apprécier dans quelle mesure et par quels mécanismes l’EIS facilite l’intégration de la dimension santé dans les politiques urbaines.

In 2016, the World Health Organization officially recommended sugar-sweetened beverage (SSB) taxation as a strategy to reduce purchases, stimulate product reformulation and generate revenues for health-related programmes. Four years before, France had been one of the first countries to tax SSBs. However, the design of this tax was not considered optimal: its rate was flat, low, identical for SSBs and artificially-sweetened drinks containing no added sugars, and its initial public health justification was set aside in favour of budgetary concerns. In 2018, a new taxation scheme was enacted. Integrated in the Social Security Finance Bill, the tax on SSBs is now linearly indexed to the quantity of added sugars in the drink. In this article, we summarize the lessons learnt from the 2012 soda tax and offer insights on the potential public health benefits of the new tax enacted in 2018. A multidimensional framework aimed at gathering evidence about SSB taxation for public health drove our rational so that we address: (1) the soda tax policy-change process; (2) its impact on price and purchases; (3) the consumer receptiveness to the tax and; (4) its legal framework. We also discuss the potential application of the tax to other foods/nutrients.

Recent regulatory evolutions gave the opportunity to professionals and academics from the health, urban planning and environment sectors – within a working group – to conduct in-depth research at a national level on health challenges in the field of EIA procedure and urban planning. This work resulted in the publication of a guide aimed at all actors involved in the urban planning decision process, which has now become a national reference document. Among the key findings of this project, three main concrete outputs caught our attention: a reference framework for Healthy Urban Planning (HUP); an all-encompassing tool for analysing urban planning projects ‘with a health lens’; an operational tool aimed at French regional health agencies (ARS) to help them formulate their health statements within the framework of the EIA regulatory procedure applied to urban development projects. This paper reviews the process of co-constructing the guide with special attention paid to the ARS tool, present the key findings and outputs and discuss the potential of the EIA process in promoting HUP in the current French context.

Les méthodes utilisées pour évaluer les interventions en promotion de la santé en Afrique sont-elles adaptées aux spécificités de ce domaine ? Telle est la question à laquelle les auteurs s’efforcent de répondre à partir d’une analyse réflexive de quatre évaluations qu’ils ont conduites au Bénin, Burkina Faso et Mali. Les expériences rapportées témoignent de la volonté d’inscrire la démarche d’évaluation en accord avec les principes de la promotion de la santé mais aussi des difficultés à surmonter les écueils de l’exercice. Il reste encore du chemin à parcourir pour que l’évaluation concilie pleinement les attentes des acteurs et les valeurs de la promotion de la santé : rendre compte de l’ensemble des dynamiques générées par les interventions en promotion en la santé, inscrire l’équité au cœur de la réflexion, soutenir les pratiques innovantes en vue de leur pérennité. Parce qu’elle facilite l’émergence et le partage des visions plurielles de ce concept encore mal cerné, l’évaluation est une voie pour faire progresser la promotion de la santé en Afrique.