The assessment of health risks of policies is an inevitable, although challenging prerequisite for the inclusion
of health considerations in political decision making. The aim of our project was to develop a so far missing
methodological guide for the assessment of the complex impact structure of policies. The guide was developed
in a consensual way based on experiences gathered during the assessment of specific national policies selected
by the partners of an EU project. Methodological considerations were discussed and summarized in workshops
and pilot tested on the EU Health Strategy for finalization. The combined tool, which includes a textual guidance
and a checklist, follows the top-down approach, that is, it guides the analysis of causal chains from the policy
through related health determinants and risk factors to health outcomes. The tool discusses the most important
practical issues of assessment by impact level. It emphasises the transparent identification and prioritisation of
factors, the consideration of the feasibility of exposure and outcome assessmentwith special focus on quantification.
The developed guide provides useful methodological instructions for the comprehensive assessment of
health risks of policies that can be effectively used in the health impact assessment of policy proposals.