School of Public Health, University College Cork

Dr Monica O'Mullane
Health Impact Assessment
& Policy Development

Senior Research Fellow & Principal Investigator, HIA-IM Project. Investigating how Health Impact Assessment can be embedded within policy-making to tackle structural health inequalities across the island of Ireland and beyond.

Who Is Dr Monica O'Mullane?

Monica O'Mullane is a Research Fellow at UCC's School of Public Health, where she leads the HRB-funded HIA-IM project (2023–2027). Her doctoral research at UCC investigated how Health Impact Assessments inform public policy in both the Republic of Ireland and Northern Ireland, applying a theoretical framework rooted in new institutionalist theories from political and social science.

She has published two monographs on HIA: Integrating Health Impact Assessment with the Policy Process (Oxford University Press, 2013), an edited volume with 35 international contributors, and Health Impact Assessment and Policy Development: Republic of Ireland and Northern Ireland (Manchester University Press). She is Interim Chair of WHO-designated Cork Healthy Cities and convenor of the ISS21 SHAPE research cluster at UCC.

Her teaching spans health promotion, Health in All Policies, HIA, inequality studies, and qualitative research methods. In January 2025, she launched the first dedicated HIA module (EH3005) in any higher education institution on the island of Ireland.

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Academic Position

Research Fellow, School of Public Health, UCC. BSc Public Health Sciences module coordinator. Supervisor on MPH programme. Member of UCC Academic Council (since 2020).

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Institutional Roles

Interim Chair, Cork Healthy Cities. Convenor, ISS21 SHAPE cluster. Member, UCC University Ethics Committee (from 2025). EUPHA HIA Section & Health Promotion Steering Group member.

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Funding

HRB Emerging Investigator for Health Award (EIA-2022-001), 2023–2027. HRB Knowledge Translation Award (KTA-2024-009), TRANSLATE-HIA, December 2024–April 2026.

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International Experience

Formerly Lecturer at Trnava University, Slovakia (funded by Slovak Ministry of Education). Investigated HIA feasibility in Slovakia. Worked on ECDC surveillance consortia.

The Weltanschauung

O'Mullane's work is grounded in a distinct worldview: that health is socially determined, that policies are interventions in complex systems, and that the gap between evidence and policy action is itself a political and institutional problem. Her theoretical lens draws from new institutionalism, feminist institutionalism, and implementation science.

Social Determinants of Health

Health outcomes are shaped by structural conditions: housing, employment, education, transport, and environmental quality. HIA makes these determinants visible in policy before implementation, not after harm has occurred.

New Institutionalism

Institutions (rules, norms, organisational cultures) shape how evidence is used in policy. O'Mullane's doctoral framework examined how institutional factors determine whether HIA knowledge is taken up, ignored, or left to "gather dust on shelves."

Health in All Policies (HiAP)

HIA is the practical instrument for operationalising HiAP. Rather than health being an afterthought, it should be a structured input at every level of policy development: local, national, and international.

Equity & Democracy

Grounded in the 1999 Gothenburg Consensus, HIA rests on four values: democracy (stakeholder participation), equity (population-wide impact), sustainable development, and ethical use of evidence. Community voice is not optional.

"I am passionate about exploring and problematising the complex and nuanced processes of tackling health and social inequalities through programme and policy implementation."

— Dr Monica O'Mullane, UCC Research Profile

Health Impact Assessment: Scope, Method & Process

Health Impact Assessment is defined by the WHO as "a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population" (European Centre for Health Policy/WHO, 1999). It is a prospective, evidence-based, participatory tool that sits at the intersection of public health, policy science, and democratic engagement.

What makes HIA distinctive?

Unlike environmental or social impact assessments, HIA centres health equity explicitly. It looks forward, not backward, aiming to prevent harm and amplify positive health outcomes before a policy, plan, or project is implemented. It combines quantitative evidence with qualitative community knowledge, treating both as equally valid inputs.

The Six Stages of HIA

The Institute of Public Health (Ireland) 2021 guidance, which underpins O'Mullane's HIA-IM project, structures HIA across six stages:

Screening

Determine whether a proposal could affect health. Apply screening criteria on a case-by-case basis or through adopted HIA policy.

Scoping

Define the parameters: which health determinants to examine, which populations are affected, what evidence and methods to deploy, and who the stakeholders are.

Appraisal

The core analytical stage. Gather and synthesise evidence (literature, data, community input) to identify and estimate the magnitude, likelihood, and distribution of health impacts.

Reporting

Present findings and recommendations to decision-makers and communities in accessible formats. Recommendations must be actionable and evidence-informed.

Decision-Making

Decision-makers consider HIA findings alongside other inputs. The key question: were recommendations adopted, adapted, or rejected, and why?

Monitoring & Evaluation

Track whether recommendations were implemented and whether predicted health impacts materialised. This long-term feedback loop is often the weakest stage in practice.

HIA Types by Depth

Desk-Based HIA

2–6 weeks. Uses existing literature, data, and expert judgement. Provides a broad overview of potential health impacts. Suitable for rapid policy cycles.

Rapid HIA

~12 weeks. More detailed evidence gathering including limited stakeholder engagement. Balances rigour with practical time constraints.

Comprehensive HIA

~6 months or more. Full participatory assessment with extensive community engagement, original data collection, and in-depth analysis. O'Mullane's HIA-IM work operates at this level.

Integrated HIA

Health embedded within SEA or EIA processes. Required under EU Directives for certain plans and projects. The IPH 2021 guidance covers both standalone and integrated forms.

Dove Gardens, Derry/Londonderry

The Dove Gardens HIA is one of the foundational cases in O'Mullane's doctoral research, documented in her monograph Health Impact Assessment and Policy Development (Manchester University Press). It involved a social housing urban redevelopment project on the Dove Gardens estate in Derry/Londonderry's Bogside/Brandywell area.

Dove Gardens Urban Redevelopment HIA

Social housing redevelopment, Bogside/Brandywell, Derry/Londonderry, Northern Ireland

The Dove Gardens estate is located in one of Derry's most historically disadvantaged areas. The HIA was conducted on the urban redevelopment project to assess its potential effects on the health and wellbeing of residents. O'Mullane's research examined not just the HIA process itself, but crucially whether and how its findings were actually used in policy formulation.

This case study formed part of a larger comparative analysis across four HIAs on the island of Ireland, covering traffic and transport, Traveller accommodation (in Donegal), urban redevelopment (Dove Gardens), and air quality (Belfast). The analytical lens drew on new institutionalist theories to understand the institutional factors that enable or obstruct evidence-to-policy translation.

The Dove Gardens case highlighted the critical role of housing as a social determinant of health. Poor housing conditions, overcrowding, damp, and inadequate design directly affect respiratory health, mental wellbeing, community cohesion, and child development. The HIA process enabled residents' lived experience to be formally documented as evidence alongside epidemiological data.

Key Findings from O'Mullane's Analysis

Institutional Gatekeeping

Whether HIA evidence reached decision-makers depended on institutional norms and existing relationships, not just evidence quality.

Community Voice as Evidence

Residents' experiential knowledge carried weight alongside quantitative data, but only when HIA processes were designed to elevate it.

Housing–Health Nexus

The case reinforced the built environment as a primary determinant: housing quality, spatial design, and access to green space directly shape population health outcomes.

Policy Uptake Gap

O'Mullane's longitudinal study tracked whether HIA recommendations actually influenced redevelopment decisions, revealing systemic barriers to evidence use.

Cork City Development Plan HIA & The HIA-IM Model

The HIA-IM project (Developing a Health Impact Assessment Implementation Model) represents the culmination of O'Mullane's decades-long research trajectory. Funded by the HRB Emerging Investigator for Health Award (EIA-2022-001), the project uses action research methodology to conduct two HIAs in Ireland, then build a transferable implementation model.

The first HIA under HIA-IM assessed the Core Strategy of the Cork City Development Plan (2022–2028). This was the first HIA ever conducted on a city development plan in Ireland. Using the Institute of Public Health's 2021 HIA Guidance, the team worked with Cork City Council, the HSE, and community stakeholders.

A public engagement event gathered residents' lived experience as formal evidence. The HIA examined how the plan's spatial strategy, housing allocations, transport provisions, green space access, and economic zoning would differentially affect population health across Cork's communities, with particular attention to vulnerable and disadvantaged groups.

The resulting report and briefing document were published through UCC's CORA repository in 2024, with a journal article published in Impact Assessment and Project Appraisal in 2025.

The second HIA under HIA-IM operates at national scale, assessing the Irish Government's Climate Action Plan (2024). This elevates HIA from local planning to national climate policy, examining how decarbonisation measures, energy transitions, and land-use changes might create or exacerbate health inequalities.

This national-level HIA represents a significant methodological and political challenge: climate policy operates across multiple sectors (energy, transport, agriculture, housing) and affects every community differently. The HIA must account for distributional justice: who benefits and who bears the costs of climate action.

TRANSLATE-HIA is a complementary knowledge translation project funded by the HRB Knowledge Translation Award (KTA-2024-009), running December 2024 to April 2026. Its purpose is to share learnings from HIA-IM and boost the policy and practice impact of findings.

On 6 November 2025, the team hosted the first "Getting Going with Health Impact Assessment" knowledge translation event in Ireland, attracting approximately 60 attendees from HSE, NGOs, local authorities, the private sector, and academia. A World Café method was used to gather practitioner insights for an upcoming HIA informational resource.

O'Mullane's HIA-IM project is distinctive in explicitly applying implementation science frameworks. The team's 2025 scoping review in Health Promotion International used the Consolidated Framework for Implementation Research (CFIR) to map HIA implementation factors.

The key insight: HIA practice fails not because of methodological weakness, but because of implementation barriers. Institutional readiness, intersectoral governance, workforce capacity, and political will are the determining factors. The implementation model being developed aims to address these systemic barriers directly.

2
HIAs Conducted
5
Year Programme
~60
Event Attendees (Nov 2025)
CFIR
Analytical Framework

Cork Healthy Cities & the Broader Ecosystem

O'Mullane co-edited Commitment, Collaboration & Continuity: Celebrating Cork as a Healthy City (2024) with Denise Cahill. This was the first publication of its kind in Ireland and across Europe, documenting Cork's journey as a WHO Healthy City since 2012. It covers projects including Green Spaces for Health (17+ community garden projects since 2018), the Cork Food Policy Council, and community health promotion initiatives.

The WHO Healthy Cities platform provides the governance infrastructure within which HIA can be embedded as a routine practice. Cork's designation creates the institutional conditions: political commitment, intersectoral partnerships, and community engagement mechanisms that make HIA actionable rather than academic.

Aggregates, Boundaries & Scale of O'Mullane's Work

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Scale

Local: City development plans (Cork CDP 2022–2028), estate-level redevelopment (Dove Gardens). National: Climate Action Plan 2024. International: Comparative HIA across 15+ countries in the 2013 OUP volume.

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Methods

Mixed-methods action research. Qualitative longitudinal studies. Scoping reviews (CFIR-informed). Community participatory workshops. World Café. Expert stakeholder interviews. Policy document analysis.

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Boundaries

O'Mullane's scope encompasses all-island Ireland (Republic + Northern Ireland) as the primary research territory. Her work intersects public health, political science, sociology, urban planning, and implementation science.

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Aggregates

Population-level health data (morbidity, deprivation indices, CSO census). Community-generated evidence (public engagement, lived experience). Policy analysis (development plans, climate strategies). Implementation outcomes (CFIR domains).

Key Works & Outputs

Edited Volume
Integrating Health Impact Assessment with the Policy Process: Lessons and Experiences from around the World
O'Mullane, M. (Ed.)
Oxford University Press, 2013. 18 chapters, 35 contributors.
Monograph
Health Impact Assessment and Policy Development: Republic of Ireland and Northern Ireland
O'Mullane, M.
Manchester University Press. Doctoral study on HIA use in policy formulation across both jurisdictions.
Edited Book
Commitment, Collaboration & Continuity: Celebrating Cork as a Healthy City
O'Mullane, M. & Cahill, D. (Eds.)
2024. ISBN: 978-1-9163790-8-4. First publication of its kind in Ireland and Europe.
Journal Article
Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities — A Mixed Methods Study Protocol
O'Mullane, M., Kenny, T., Nash, K., McHugh, S.M., Kavanagh, P., Smith, K. & Archibong, U.
HRB Open Research Platform, 7, 14. (2025)
DOI: 10.12688/hrbopenres.13873.3
Journal Article
Routemap for Health Impact Assessment Implementation: Scoping Review Using the Consolidated Framework for Implementation Research
Kenny, T., Harris-Roxas, B., McHugh, S., Douglas, M., Green, L., Haigh, F., Purdy, J., Kavanagh, P. & O'Mullane, M.
Health Promotion International, 40(3). (2025)
DOI: 10.1093/heapro/daaf080
Journal Article
Undertaking the First Health Impact Assessment on a City Development Plan in Ireland: A Case Study
O'Mullane, M., Kenny, T., Nash, K., Ryan, M., Fitzsimons, J., Connolly, B., Green, L., Purdy, J., Cave, B. & Harris-Roxas, B.
Impact Assessment and Project Appraisal. (2025)
DOI: 10.1080/14615517.2025.2590854
Report
Report of the Health Impact Assessment on the Core Strategy of the Cork City Development Plan (2022–2028)
O'Mullane, M., Kenny, T., Nash, K., Ryan, M., O'Mahony, K. & Fitzsimons, J.
University College Cork, 2024.
hdl.handle.net/10468/16851
Journal Article
Health Impact Assessment and the Role of Local Government in Ireland
O'Mullane, M. & Quinlivan, A.
Environmental Impact Assessment Review, 2012.
Journal Article
Health Impact Assessment for Health Promotion, Education and Learning
Harris-Roxas, B. & O'Mullane, M.
Global Health Promotion, 2017.
Earlier Article
The Case for Health Impact Assessment in Irish Public Policy
O'Mullane, M.
Administration, Vol. 56, No. 4, pp. 87–109, 2009.

Collaborators & Partners

The HIA-IM project and O'Mullane's broader research are deeply collaborative, spanning academic, clinical, governmental, and community sectors.

UCC & Steering Group

Prof. Ivan Perry (UCC) Dr Sheena McHugh (UCC) Dr Ger Mullally (UCC) Prof. Hannah Daly (ERI/UCC) Dr Tara Kenny (Postdoc) Dr Joanna Purdy (IPH Ireland) Prof. Uduak Archibong (Bradford) Dr Lisa Pursell (U. Galway) Prof. Katherine Smith (Strathclyde)

International & National

Dr Ben Harris-Roxas (UNSW, Australia) Dr Liz Green (Public Health Wales) Dr Margaret Douglas (Public Health Scotland) Ben Cave (BCA Insight) Dr Sara Burke (Trinity College Dublin) Tadhg O'Mahony (EPA Ireland)

Government & Practice

Karen O'Mahony (Cork City Council) Dr Ina Kelly (HSE) Dr Paul Kavanagh (HSE) Dr Diarmuid O'Donovan (HSE) Vinnie O'Shea (Slaintecare) Leonora McConville (Sligo CC) Denise Cahill (Cork Healthy Cities) Bernie Connolly (Environmental Forum)

Research Timeline

2005–2009
Doctoral Research, UCC
Investigated HIA use in policy formulation across Northern Ireland and the Republic. Case studies: Dove Gardens (Derry), Traveller Accommodation (Donegal), traffic/transport, air quality (Belfast). Applied new institutionalist framework.
2008–2010
Co-founded Southern HIA Network
Coordinated the Southern HIA Network in Ireland, building regional capacity for health impact assessment practice.
2010–c.2018
Trnava University, Slovakia
Lecturer in Public Health, funded by Slovak Ministry of Education. Investigated HIA feasibility in Slovakia. Worked on ECDC surveillance system consortia.
2013
Oxford University Press Volume
Published Integrating HIA with the Policy Process. 18 chapters, 35 contributors, 7 reviewers. The only book examining HIA–policy relationships from a global perspective.
2023
HIA-IM Project Launch
HRB Emerging Investigator for Health Award (EIA-2022-001). Five-year programme to develop an HIA implementation model through action research on Cork CDP and Climate Action Plan.
2024
Cork Healthy Cities Book & Cork CDP HIA Report
Published Commitment, Collaboration & Continuity with Denise Cahill. Released HIA report on Cork City Development Plan Core Strategy. First HIA on a CDP in Ireland.
2025
First HIA Module & Major Publications
Launched EH3005 (HIA module), first of its kind on the island of Ireland. Published in Health Promotion International, HRB Open Research, and Impact Assessment & Project Appraisal. Hosted first "Getting Going with HIA" event (Nov 2025).
2026–2027
HIA-IM Model Completion
National Climate Action Plan HIA completion. Implementation model development and dissemination. TRANSLATE-HIA knowledge translation outputs.