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Scoping Population Health in Impact Assessment (ScopHIA) Realist Review: Identifying Best Practices for Equity in Scoping of Major Natural Resource and Large-Scale Infrastructure Projects

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  • Canada is an international leader in major natural resource and large-scale infrastructure projects, which substantially contribute to the domestic economy. Notwithstanding, major projects in rural and remote regions can pose significant challenges for population health equity, defined as the absence of avoidable differences in health determinants, status, and outcomes between geographic, socio-economic, or demographic communities and sub-populations. In these regions, a more equitable sharing of risks and benefits with Indigenous peoples and affected communities could help to address the ongoing legacy of colonialism, environmental injustice, and systemic oppression tied to histories of major project development. Consequently, public deliberations and decision-making about the impacts of projects should consider population health equity throughout the exploration, construction, operation, and closure periods.

    Impact assessment is a legislated process in more than half of all countries in the world. Through public deliberation and decision-making about proposed major projects, impact assessments are generally mandated to identify and mitigate potential negative impacts to the biophysical environment. The recent development of a new federal system for impact assessments led by the Impact Assessment Agency of Canada has extended this mandate in the Canadian context to incorporate positive and negative impacts of projects on health, social, and economic conditions. In the new system, a 180-day planning phase has been introduced to engage with Indigenous peoples and affected communities on their issues of concern, in order to develop a more tailored impact assessment structure for each project. By providing increased opportunities for consultation, engagement, and input from the earliest stages, the planning phase can provide critical pathways to promote population health equity through impact assessments, which help to ensure projects make a net contribution to the public interest and sustainability.

    The goal of this knowledge synthesis is to prioritize population health equity within federal impact assessment in Canada. Its objectives are to identify key points of leverage in the planning phase for achieving its goals through the implementation of evidence-based best practice and principles. Knowledge mobilization has the aim of promoting the uptake of findings from this research in impact assessment policy and health system practice; advocating for more public health research and practice to support population health equity in the context of major projects; and raising awareness of these issues among the Canadian public.

    Employing a methodologically rigorous realist review research process, documents were retrieved and screened through an iterative combination of systematically searching two key impact assessment journals, and purposively searching other journals and websites. A total of 185 peer-reviewed and grey literature sources underwent full data extraction, analysis, and synthesis, using a standardized procedure and template. Results include recommendations organized by main themes of findings across five key planning phase processes.

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    Attribution-NonCommercial 4.0 International