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Abstract: Project-level impact assessment was originally conceived as a snapshot taken in advance of project implementation, contrasting current conditions with a likely future scenario involving a variety of predicted impacts. Current best practice guidance has encouraged a shift towards longitudinal assessments from the pre-project stage through the implementation and operating phases. Experience and study show, however, that assessment of infrastructure-intensive projects rarely endures past the project's construction phase. Negative consequences for environmental, social and health outcomes have been documented. Such consequences clarify the pressing need for longitudinal assessment in each of these domains, with human rights impact assessment (HRIA) as an umbrella over, and critical augmentation of, environmental, social and health assessments. Project impacts on human rights are more closely linked to political, economic and other factors beyond immediate effects of a company's policy and action throughout the project lifecycle. Delineating these processes requires an adequate framework, with strategies for collecting longitudinal data, protocols that provide core information for impact assessment and guidance for adaptive mitigation strategies as project-related effects change over time. This article presents general principles for the design and implementation of sustained, longitudinal HRIA, based on experience assessing and responding to human rights impact in a uranium mining project in Malawi. The case study demonstrates the value of longitudinal assessment both for limiting corporate risk and improving human welfare. [Copyright &y& Elsevier]

Abstract: Human rights impact assessment (HRIA) is a process for systematically identifying, predicting and responding to the potential impact on human rights of a business operation, capital project, government policy or trade agreement. Traditionally, it has been conducted as a desktop exercise to predict the effects of trade agreements and government policies on individuals and communities. In line with a growing call for multinational corporations to ensure they do not violate human rights in their activities, HRIA is increasingly incorporated into the standard suite of corporate development project impact assessments. In this context, the policy world's non-structured, desk-based approaches to HRIA are insufficient. Although a number of corporations have commissioned and conducted HRIA, no broadly accepted and validated assessment tool is currently available. The lack of standardisation has complicated efforts to evaluate the effectiveness of HRIA as a risk mitigation tool, and has caused confusion in the corporate world regarding company duties. Hence, clarification is needed. The objectives of this paper are (i) to describe an HRIA methodology, (ii) to provide a rationale for its components and design, and (iii) to illustrate implementation of HRIA using the methodology in two selected corporate development projects—a uranium mine in Malawi and a tree farm in Tanzania. We found that as a prognostic tool, HRIA could examine potential positive and negative human rights impacts and provide effective recommendations for mitigation. However, longer-term monitoring revealed that recommendations were unevenly implemented, dependent on market conditions and personnel movements. This instability in the approach to human rights suggests a need for on-going monitoring and surveillance. [Copyright &y& Elsevier]

Abstract: The quantitative assessment of health impacts has been identified as a crucial feature for realising the full potential of health impact assessment (HIA). In settings where demographic and health data are notoriously scarce, but there is a broad range of ascertainable ecological, environmental, epidemiological and socioeconomic information, a diverse toolkit of data collection strategies becomes relevant for the mainly small-area impacts of interest. We present a modular, cross-sectional baseline health survey study design, which has been developed for HIA of industrial development projects in the humid tropics. The modular nature of our toolkit allows our methodology to be readily adapted to the prevailing eco-epidemiological characteristics of a given project setting. Central to our design is a broad set of key performance indicators, covering a multiplicity of health outcomes and determinants at different levels and scales. We present experience and key findings from our modular baseline health survey methodology employed in 14 selected sentinel sites within an iron ore mining project in the Republic of Guinea. We argue that our methodology is a generic example of rapid evidence assembly in difficult-to-reach localities, where improvement of the predictive validity of the assessment and establishment of a benchmark for longitudinal monitoring of project impacts and mitigation efforts is needed. [Copyright &y& Elsevier]

Abstract: Natural resources development projects are – and have been for more than 150years – located in remote rural areas in developing countries, where local level data on community health is notoriously scarce. Health impact assessment (HIA) aims at identifying potential negative health consequences of such projects and providing the initial evidence-base for prevention and mitigation of diseases, injuries and risk factors, as well as promotion of positive effects. An important, but under-systematised early phase of the HIA process is scoping. It aims at organising diverse, often fragmentary, evidence and identifying potential project-related health impacts and underlying data gaps. It is also a key element in defining the terms of reference for the entire assessment. We present novel methodological features for the scoping process, emphasising the evaluation of quality of evidence, and illustrate its use in a contemporary HIA of the Simandou iron ore project in the Republic of Guinea. Assessment of data quality is integrated with specific content information via an analytical framework for the systematic identification of health outcomes and determinants of major concern. A subsequent gap analysis is utilised to assess the need for further baseline data collection and to facilitate the specification of a set of potential key performance indicators and strategies to inform the required evidence-base. We argue that scoping also plays a central role in the design of surveillance systems for longitudinal monitoring of health, equity and wellbeing following project implementation. [Copyright &y& Elsevier]

Abstract: In the developing world, large-scale projects in the extractive industry and natural resources sectors are often controversial and associated with long-term adverse health consequences to local communities. In many industrialised countries, health impact assessment (HIA) has been institutionalized for the mitigation of anticipated negative health effects while enhancing the benefits of projects, programmes and policies. However, in developing country settings, relatively few HIAs have been performed. Hence, more HIAs with a focus on low- and middle-income countries are needed to advance and refine tools and methods for impact assessment and subsequent mitigation measures. We present a promising HIA approach, developed within the frame of a large gold-mining project in the Democratic Republic of the Congo. The articulation of environmental health areas, the spatial delineation of potentially affected communities and the use of a diversity of sources to obtain quality baseline health data are utilized for risk profiling. We demonstrate how these tools and data are fed into a risk analysis matrix, which facilitates ranking of potential health impacts for subsequent prioritization of mitigation strategies. The outcomes encapsulate a multitude of environmental and health determinants in a systematic manner, and will assist decision-makers in the development of mitigation measures that minimize potential adverse health effects and enhance positive ones. [Copyright &y& Elsevier]

Objective: The current study examined whether cancer survivors showed impairment, resilience, or growth responses relative to a sociodemographically matched sample in four domains: mental health and mood, psychological well-being, social well-being, and spirituality. The impact of aging on psychosocial adjustment was also investigated. Design: Participants were 398 cancer survivors who were participants in the MIDUS survey (Midlife in the United States) and 796 matched respondents with no cancer history. Psychosocial assessments were completed in 1995-1996 and 2004-2006. Main Outcome Measures: Outcomes including self-report measures of mental health and mood, psychological well-being, social well-being, and spirituality. Results: Findings indicated that cancer survivors demonstrated impairment relative to the comparison group in mental health, mood, and some aspects of psychological well-being. Longitudinal analyses spanning pre- and postdiagnosis clarified that while mental health declined after a cancer diagnosis, poorer functioning in other domains existed prior to diagnosis. However, survivors exhibited resilient social well-being, spirituality, and personal growth. Moreover, age appeared to confer resiliency; older survivors were more likely than younger adults to show psychosocial functioning equivalent to their peers. Conclusion: While younger survivors may be at risk for disturbances in mental health and mood, cancer survivors show resilience in other important domains of psychosocial adjustment. [ABSTRACT FROM AUTHOR]

Abstract: Health impact assessment (HIA), a methodology that aims to facilitate the mitigation of negative and enhancement of positive health effects due to projects, programmes and policies, has been developed over the past 20–30 years. There is an underlying assumption that HIA has become a full fledged critical piece of the impact assessment process with a stature equal to both environmental and social impact assessments. This assumption needs to be supported by evidence however. Within the context of projects in developing country settings, HIA is simply a slogan without a clearly articulated and relevant methodology, offered by academia and having little or no salience in the decision-making process regarding impacts. This harsh assertion is supported by posing a simple question: “Where in the world have HIAs been carried out?” To answer this question, we systematically searched the peer-reviewed literature and online HIA-specific databases. We identified 237 HIA-related publications, but only 6% of these publications had a focus on the developing world. What emerges is, therefore, a huge disparity, which we coin the 6/94 gap in HIA, even worse than the widely known 10/90 gap in health research (10% of health research funding is utilized for diseases causing 90% of the global burden of disease). Implications of this 6/94 gap in HIA are discussed with pointed emphasis on extractive industries (oil/gas and mining) and water resources development. We conclude that there is a pressing need to institutionalize HIA in the developing world, as a consequence of current predictions of major extractive industry and water resources development, with China''s investments in these sectors across Africa being particularly salient. [Copyright &y& Elsevier]

Objective: This study investigated whether different psychosocial factors predicted levels of glycosylated hemoglobin (HbA1c) over time, after adjusting for covariates and baseline level of HbA1c. Design: These questions were investigated with a longitudinal sample (N = 97, age = 61-91) of older women without diabetes. HbA1c levels and psychosocial measures were obtained at baseline and 2-year follow-up. Main Outcome Measures: Coping strategies, positive affect, medical history, and health behaviors were assessed using self-administered questionnaires. HbA1c were obtained during the respondents' overnight stay at the General Clinical Research Center (GCRC) at the University of Wisconsin-Madison. Results and Conclusion: Regression analyses showed that higher levels of problem-focused coping, venting, and positive affect predicted lower levels of HbA1c, after controlling for baseline HbA1c and sociodemographic and health factors. Furthermore, positive affect was found to moderate the effects of problem-focused coping (active, instrumental social support, suppressing competing activities). The pattern of interaction showed that the adverse effects of low problem-focused coping on cross-time changes in HbA1c were amplified among those who also had low levels of positive affect. [ABSTRACT FROM AUTHOR]

Objective: This study tested the hypothesis that psychological well-being would predict lower plasma levels of inflammatory factors in aging women. Design: One hundred thirty-five women ages 61-91 years (M = 74.5 years) participated in this study. After completing self-administered questionnaires in their homes, participants stayed overnight at the General Clinical Research Center (GCRC) at the University of Wisconsin--Madison. Blood samples for cytokine analyses were obtained in participants' homes after the GCRC visit. Main Outcome Measures: Psychological well-being and ill-being, history of health problems, and health behaviors were assessed via self-administered questionnaires. Detailed medical history and concurrent health measures were obtained during the GCRC stay. Enzyme-linked immunosorbent assays were used to determine interleukin-6 (IL-6) and soluble IL-6 receptor (sIL-6R) concentrations in plasma. Results and Conclusion: Regression analyses showed that plasma IL-6 levels were lower in women scoring higher on positive relationships, whereas sIL-6R levels were lower in women scoring higher on purpose in life, even after a variety of sociodemographic and health factors were controlled. These outcomes, combined with the absence of significant links with other measures of well-being and ill-being, suggest selective patterns of association between later life inflammatory processes and psychological factors, particularly those focused on positive ties with others and purposeful engagement. [ABSTRACT FROM AUTHOR]

Health impact assessment (HIA) of projects, programmes and policies is increasingly recognized as a powerful methodology for mitigating negative health impacts and enhancing equitable and sustainable development, yet applications in the developing world are sparse. Here, we focus on a large infrastructure development in sub-Saharan Africa, namely the Chad–Cameroon petroleum development and pipeline project. We adapted a five-step process for HIA, consisting of (1) screening of project documents, (2) profiling of affected communities, (3) identifying priority health areas, predicting potential impacts, and proposing mitigation measures, (4) implementing interventions, and (5) monitoring and evaluation of health impacts. We found that project scoping was broad, including extensive environmental and social assessments. Innovative features of the project include the high degree of public–private partnerships, and the management of oil revenues for purposes of poverty reduction. The project also addressed occupational and public health issues, and developed and implemented measures to prevent or mitigate potential health impacts. However, there was a disproportionate emphasis on workers'' health, particularly on the prevention/mitigation of construction-related injuries, sexually transmitted infections (STIs; mainly HIV/AIDS), and malaria. Health impacts among surrounding communities, and cumulative health impacts in the larger region were not considered in a comprehensive way. Concluding, there is a need for a more systemic approach to HIA and its incorporation within ‘Equator Principles’, which are increasingly adopted by the international financial community. This process would include clarification of corporate social responsibility beyond the project fence line in the mitigation of health problems at regional levels. Finally, we propose the establishment and running of a longitudinal demographic surveillance system, which—coupled with regular household surveys—would facilitate monitoring and evaluation of impacts on health, social wellbeing and equity in the broadest possible manner. [Copyright &y& Elsevier]