Factors that facilitated and challenged the development of health goals and targets: the British Columbia experience.

Health promotion research and practice reveal that goal setting and monitoring have gained increased acceptance at international, national, provincial/state, regional and local levels. The global adoption of health goals as a strategy for population health promotion has occurred even though few protocols or guidelines to support the health goals development process have been published. Limited study has occurred on the variation in approach to health goals planning, or on the complex, multiple forces that influence the development process. This paper describes conclusions drawn from an exploratory and descriptive case study that tracked the pathways to health goals in British Columbia (BC) and uncovered nearly 100 factors that influenced the final version of health goals adopted by the government of BC. Influencing factors included: (a) positive perceptions of the benefits of health goals, (b) the role of a trusted health goals champion, (c) positioning of the goals as government rather than health ministry goals, (d) the format and agenda of the health goals consulting process, and (e) political reluctance toward highly specific or measurable goals with targets.

Setting the stage for health impact assessment.

Defining health impact assessment as any combination of procedures or methods by which a proposed policy or program may be judged as to the effect(s) it may have on the health of a population, we make recommendations about how to evaluate the health impact of all government-initiated policies. Such health impact cannot be assessed in the absence of a conceptual or organizing framework that provides the requisite guideposts--population health goals and targets. Health impact assessment offers an approach to ensuring that governments' program and policy initiatives align, or are congruent with, the agreed-upon health goals. It suggests that proposed national policies should be supported or resisted on the basis of their probable influence on the health of populations. In the current Canadian national policy framework, however, there are no underpinnings on which to situate such a process. The specification of consensus goals and objectives with measurable targets can provide the requisite guideposts and benchmarks for health impact assessment. Such an undertaking can set the stage and provide the necessary foundation for an effective health impact assessment process.