From health reporting to health impact assessment – modelling for policy advice

Context: Health reporting is a cornerstone of policy advice. Primarily health reporting refers to status quo, but can also proceed towards (i) forecasts of future trends, and (ii) exploring policy options including the consequences of specific policy measures („what – if“). Currently, there are tendencies to transcend the usual health reporting/status quo approaches and to advance health reporting by both forecasts and what-if analyses. Methods and Materials: In a dedicated „comparative“ workshop, different relevant approaches, models, and tools that have been, or are being developed internationally for this purpose were introduced. Based on selected criteria the approaches were compared by way of synopsis. Results: The following modelling approaches were included in the comparative workshop: PREVENT, DYNAMO-HIA, INTARESE/HEIMTSA, Impact Calculation Tool (ICT), MicMac (i.e. 5 models from Europe), and California Health Forecasting tool (USA). These models originated from different contexts, and are in different stages of completion. Some of them are pure „shells“ for calculating effects on health by risk factor (e.g. smoking, obesity, environmental factors) using user's own (national or regional) data, whereas others incorporate data sets from registries, surveys, or individual data for microsimulations. Advantages of quantifying approaches include the comparability of health impacts under varying policy options, provision of a common metric for preventive and treatment results. Disadvantages include lack of comprehensive data. Open questions, e.g., refer to acceptance as well as complexity and interaction of the relevant health, treatment, environmental, and social dimensions. Conclusions: Current efforts to improve the empirical basis for policy-making are supported by a host of quantitative modelling approaches. Up to now, the application of such models for policy-making has been rather limited. Nevertheless, the approach carries the potential of significantly supporting the practice of policy-making. Additional instruments to include questions of equity, participation, and integration are needed.