Aplicación de la metodología de evaluación de impacto en salud. Experiencia en el análisis de la fluoración del agua de consumo en la Comunidad Autónoma del País Vasco

Abstract

Introduction: There is currently a controversy about the appropriateness of the addition of fluoride to drinking water. The Health Impact Assessment (HIA) is a combination of methods and tools by means of which a proposal can be evaluated with respect to its effects on the health of the population and the distribution of such effects on it. Objective: To evaluate the usefulness of applying the HIA methodology in view of the proposal to review the appropriateness of maintaining the fluoridation of drinking water in the Basque Country at current concentrations. Method: We have applied the classic stages of the HIA methodology: screening , design and planning, the evaluation proper, and drafting the report on impacts and recommendations. Results: We have identified positive and negative impacts with regard to maintaining the current oral health policy or chaning it. The negative impacts are primarily related to a lack of care of and information to vulnerable sectors of the population, particularly those living in more deprived areas. The positive impacts are related to personal responsibility and education. We have made recommendations to minimize the negative impacts and inequalities Conclusions: The HIA methodology is a useful tool for assessing the desirability of maintaining health policies that were needed at a given time and especially in those in which the socio-economic inequalities are crucial in their implementation