Health impact assessment.

Correspondence to: Dr M Joffe, Department of Epidemiology & Public Health, Imperial College London, St Mary’s Campus, Norfolk Place, London W2 1PF, UK; [email protected] _________________________ A person’s health status is largely determined by factors outside the control of the healthcare sector. While some of these are fixed, such as inheritance, many are environmental in the broadest sense of the term. These operate through such socioeconomic sectors as employment, education, housing and transport, which structure the health risks and opportunities of individuals. Typically the structuring is unequal—sometimes referred to as clustering of disadvantage—so that those who are less well placed socioeconomically also have worse health outcomes, contributing to socioeconomic inequalities in health. The health impacts of these sectors can be influenced by interventions, whether or not these are primarily motivated by health considerations. For example, a policy or other intervention to improve educational status can raise the socioeconomic standard, thereby improving health. Such interventions have the potential to increase or decrease inequalities.