A critical discourse analysis of how public participants and their evidence are presented in Health Impact Assessment reports in Wales

Problem

Health Impact Assessment (HIA) involves evaluating how projects affect the health of particular populations. In many countries HIA has become central to attempts to better integrate both health and public participation into policy and decision making. In 2017 HIA gained statutory status in Wales. This study considers how the public and their evidence are presented within HIA reports and what insights this offers into how public participation is constructed within public health.

Approach

Critical Discourse Analysis (CDA), specifically as described by Fairclough (2003), was used to analyse seven HIA reports produced in Wales.

Findings

Four themes were identified. ‘Consensus and polyphony’ addresses the tendency of the reports to produce consensus, with competing or distinctive voices progressively elided. ‘Authors and authority’ describes how participants and their evidence are shaped by different authorial stances. ‘Discussions, decisions and planes of action’ considers how decision makers are (or are not) brought into contact with evidence in the texts. ‘Evidence: fragmentation and compression’ analyses strategies of abstracting and re-ordered participant evidence in the text and the implications of this.

Consequences

This analysis suggests that participants and their evidence are presented in a number of specific ways in HIA reports and that these are particularly shaped by genre, authorial stances and approaches to abstracting and re-ordering texts. Acknowledging these issues and developing reflexivity may create opportunities to develop HIA in new directions. Further research would allow these conclusions to be tested and would contribute to development of a wider ‘sociology of public health documents’.