Background: The validity of health impact assessment (HIA) predictions has not been
accurately assessed to date. In recent years, legislative attempts to promote decentralization
have been progressing in Japan, and Kurume was designated as a core city in April
2008. An HIA into the transition of Kurume to a core city was conducted before the event,
but the recommendations were not accepted by city officials.
Objective: The aim of this study was to examine the validity of predictions made in the HIA
on Kurume by conducting a monitoring review into the accuracy of the predictions.
Method: Before Kurume was designated as a core city, the residents completed an online
questionnaire and city officials were interviewed. The findings and recommendations were
presented to the city administration. One year after the transition, a monitoring review
was performed to clarify the accuracy of the HIA predictions by evaluating the correlation
between the predictions and reality.
Results: Many of the HIA predictions were found to conflict with reality in Kurume.
Prediction validity was evaluated for two groups: residents of Kurume and city officials. For
the residents, 17% (2/12 items) of the predictions were found to be compatible, 58% (7/12)
were incompatible and 25% (3/12) were difficult to evaluate. For city officials, the analysis
was divided into those whose department was directly involved in tasks transferred to
them (transfer tasks) and those whose department was not. For the city officials in
departments responsible for conducting core city transfer tasks, 33% (3/9 items) of the
predictions were found to be compatible, 33% (3/9) were incompatible and 33% (3/9) were
difficult to evaluate. However, for the city officials whose responsibilities were unrelated to
core city transfer tasks, 11% (1/9) of predictions were found to be compatible, 78% (7/9) were
incompatible and 11% (1/9) were difficult to evaluate.
Conclusion: Although it was possible to validate some of the HIA predictions, the results of
this monitoring review found substantial discrepancies between the predictions and reality
1 year after the transition of Kurume to a core city. This suggests that the accuracy of HIA
predictions may be called into question. However, it should be noted that the review was
conducted very soon after the transition and the steering group was very small, which may