Inclusion of Health in Environmental Impact Assessment of Major Transport Infrastructure Projects in Vietnam

Document Type : Original Article


1 Faculty of Science, The University of Sydney, Sydney, NSW, Australia

2 Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia


Infrastructure spending, especially in the transport sector, is expected to increase rapidly in Vietnam. This boost in transportation investment impacts health. Environmental impact assessments (EIAs) are essential tools for decision-making to reduce and mitigate anticipated impacts of development projects, and integration of health assessment as an essential part of the EIA process has been regulated in many high-income countries. There is, however, limited knowledge about how health is evaluated in these environmental assessments in low- and middle-income countries (LMICs) such as Vietnam.

We did an analysis of EIAs of four major transport projects in Vietnam, applying a six-step coding framework previously used to investigate EIAs in the Australian context.

We found that health was inadequately considered in all four EIAs. There was no direct health assessment within the four EIAs due to the lack of formal requirements from either Government or the financing agency, the Asian Development Bank (ADB). Health issues were often identified as risks posed by the projects within the assessment of impacts on environmental conditions. A broader consideration of health was limited. When social outcomes of the projects were present in EIAs, they were often mentioned once without any detailed assessment or linking to health. There was no evidence linking health benefits and shifts towards active travel with the construction of two metro rail projects. Mitigation measures offered in all four EIAs were found to be generic and insubstantial.

The health assessments in the EIAs of four transport projects in Vietnam were significantly less detailed than those in Australia, mainly due to the lack of legislative requirements. The lack of health content indicates the need for involvement of health experts in the environmental assessment process, as well as requirements for the health assessment to be integrated in EIA. Our findings suggest there is the need to build capacity both within and outside of government to fully consider the health impacts of infrastructure in EIA practice.


Supplementary File 1 (Download)

Supplementary File 2 (Download)


Main Subjects

  1. PwC. A Summary of South East Asian Infrastructure Spending: Outlook to 2025 Published 2015.
  2. Jetin B. ‘One Belt-One Road Initiative’ and ASEAN Connectivity: Synergy Issues and Potentialities. In: Deepak BR, ed. China's Global Rebalancing and the New Silk Road. Singapore: Springer; 2018:139-150.
  3. Hayes N. The impact of China’s one belt one road initiative on developing countries. International Development2017.
  4. Kunzli N, Kaiser R, Medina S, et al. Public-health impact of outdoor and traffic-related air pollution: a European assessment. Lancet. 2000;356(9232):795-801. doi:10.1016/s0140-6736(00)02653-2
  5. Dora C. A different route to health: implications of transport policies. BMJ. 1999;318(7199):1686-1689.
  6. Morrison DS, Petticrew M, Thomson H. What are the most effective ways of improving population health through transport interventions? Evidence from systematic reviews. J Epidemiol Community Health. 2003;57(5):327-333. 
  7. Sitlington J. A discussion paper prepared for VicHealth.    Published November 1, 1999.
  8. Thomson H, Jepson R, Hurley F, Douglas M. Assessing the unintended health impacts of road transport policies and interventions: translating research evidence for use in policy and practice. BMC Public Health. 2008;8:339. doi:10.1186/1471-2458-8-339
  9. Hoek G, Brunekreef B, Goldbohm S, Fischer P, van den Brandt PA. Association between mortality and indicators of traffic-related air pollution in the Netherlands: a cohort study. Lancet. 2002;360(9341):1203-1209. doi:10.1016/s0140-6736(02)11280-3
  10. Dhondt S, Le Xuan Q, Vu Van H, Hens L. Environmental health impacts of mobility and transport in Hai Phong, Vietnam. Stoch Environ Res Risk Assess. 2011;25(3):363-376. doi:10.1007/s00477-010-0374-3
  11. George C. Environmental Impact Prediction and Evaluation. Environmental Assessment in Developing and Transitional Countries.2000:85-110.
  12. Morgan RK. Environmental impact assessment: a methodological perspective. Dordrecht: Kluwer Academic; 1998.
  13. Morgan RK. Environmental impact assessment: the state of the art. Impact Assessment and Project Appraisal. 2012;30(1):5-14. doi:10.1080/14615517.2012.661557
  14. Ahmad BS. Integrating health into impact assessment: challenges and opportunities. Taylor & Francis; 2004.
  15. Litman T. Integrating public health objectives in transportation decision-making. Am J Health Promot. 2003;18(1):103-108. doi:10.4278/0890-1171-18.1.103
  16. Bhatia R, Wernham A. Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice. Cien Saude Colet. 2009;14(4):1159-1175. doi:10.1590/S1413-81232009000400022
  17. Barton H, Grant M. Testing time for sustainability and health: striving for inclusive rationality in project appraisal. J R Soc Promot Health. 2008;128(3):130-139.
  18. Carmichael L, Barton H, Gray S, Lease H. Health-integrated planning at the local level in England: Impediments and opportunities. Land Use Policy. 2013;31:259-266. doi:10.1016/j.landusepol.2012.07.008
  19. British Medical Association. Health and environmental impact assessment: an integrated approach. Routledge; 2013.
  20. Van Brusselen D, Arrazola de Onate W, Maiheu B, et al. Health Impact Assessment of a Predicted Air Quality Change by Moving Traffic from an Urban Ring Road into a Tunnel. The Case of Antwerp, Belgium. PLoS One. 2016;11(5):e0154052. doi:10.1371/journal.pone.0154052
  21. Harris-Roxas B, Viliani F, Bond A, et al. Health impact assessment: the state of the art. Impact Assessment and Project Appraisal. 2012;30(1):43-52. doi:10.1080/14615517.2012.666035
  22. Riley E, Harris P, Kent J, Sainsbury P, Lane A, Baum F. Including Health in Environmental Assessments of Major Transport Infrastructure Projects: A Documentary Analysis. Int J Health Policy Manag. 2018;7(2):144-153. doi:10.15171/ijhpm.2017.55
  23. Litman T. Transportation and public health. Annu Rev Public Health. 2013;34:217-233. doi:10.1146/annurev-publhealth-031912-114502
  24. Hartig T, Mitchell R, de Vries S, Frumkin H. Nature and health. Annu Rev Public Health. 2014;35:207-228. doi:10.1146/annurev-publhealth-032013-182443
  25. Cohen-Cline H, Turkheimer E, Duncan GE. Access to green space, physical activity and mental health: a twin study. J Epidemiol Community Health. 2015;69(6):523-529. doi:10.1136/jech-2014-204667
  26. Erlanger TE, Krieger GR, Singer BH, Utzinger J. The 6/94 gap in health impact assessment. Environ Impact Assess Rev. 2008;28(4):349-358. doi:10.1016/j.eiar.2007.07.003
  27. Harris P, Riley E, Sainsbury P, Kent J, Baum F, Lane A. Assessing environmental impacts of major transport infrastructure projects. The Henry Halloran Trust;2015.
  28. Yin RK. Case study research: Design and methods. Sage publications; 2009.
  29. Environmental Assessment Guidelines. ADB websie. 2003.
  30. Centre for Poverty Analysis (CEPA). A Review of the Southern Transport Development Project (STDP) Grievance Redress Mechanisms. Consoliated Final Report (ADM/80-046: RSC No. C80610). Colombo; 2009.
  31. Giles-Corti B, Vernez-Moudon A, Reis R, et al. City planning and population health: a global challenge. Lancet. 2016;388(10062):2912-2924. doi:10.1016/s0140-6736(16)30066-6
  32. Fehr R, Viliani F, Nowacki J, Martuzzi M. Health in Impact Assessments: Opportunities not to be missed. Copenhagen. WHO Regional Officer for Europe; 2014.
  33. Giles-Corti B, Foster S, Shilton T, Falconer R. The co-benefits for health of investing in active transportation. N S W Public Health Bull. 2010;21(5-6):122-127. doi:10.1071/nb10027
  34. Cavill N, Kahlmeier S, Racioppi F. Physical activity and health in Europe: evidence for action. World Health Organization; 2006.
  35. Martin A, Goryakin Y, Suhrcke M. Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey. Prev Med. 2014;69:296-303. doi:10.1016/j.ypmed.2014.08.023
  36. Giles-Corti B, Kelty SF, Zubrick SR, Villanueva KP. Encouraging walking for transport and physical activity in children and adolescents: how important is the built environment? Sports Med. 2009;39(12):995-1009. doi:10.2165/11319620-000000000-00000
  37. Viet Nam: Transport sector assessment, strategy, and road map. Asian Development Bank website. 2012.
  38. Petsko E. Transforming a motorcycle city: the long wait for Hanoi's metro. The Guardian 2016.  Accessed July 17, 2017.
  39. Musil C, Toàn VK. Filling the urban transport infrastrucuture gap: the challenge of building mass rapid transit systems. The Newsletter 73 Spring 2016.
  40. Vo Hai. Hanoi revives plan to ban motorbikes in uphill battle against congestion. Vnexpress International; 2017.
  41. O'Rourke D. Community-Driven Regulation: Balancing Development and the Environment in Vietnam. MIT Press; 2004.
  42. United Nations. Sustainable Development Goals. Published 2015.
  43. Krieger G, Singer B, Winkler M, Divall M, Tanner M, Utzinger J. Health impact assessment in developing countries. In: Kemm J, ed. Health Impact Assessment: Past Achievement, Current Understanding, and Future Progress. Oxford University Press; 2013:265-276.
  44. Winkler MS, Divall MJ, Krieger GR, et al. Assessing health impacts in complex eco-epidemiological settings in the humid tropics: Modular baseline health surveys. Environ Impact Assess Rev. 2012;33(1):15-22. doi:10.1016/j.eiar.2011.10.003
  45. Doberstein B. Environmental capacity-building in a transitional economy: the emergence of EIA capacity in Viet Nam. Impact Assessment and Project Appraisal. 2003;21(1):25-42. doi:10.3152/147154603781766509
  46. Brown AL, Hindmarsh RA, McDonald GT. Environmental assessment procedures and issues in the Pacific Basin-Southeast Asia region. Environ Impact Assess Rev. 1991;11(2):143-156. doi:10.1016/0195-9255(91)90029-J
  • Receive Date: 19 July 2017
  • Revise Date: 16 January 2018
  • Accept Date: 08 April 2018
  • First Publish Date: 01 September 2018