Evaluation and Optimization of Municipal-Level Health Impact Assessment Policies in China Based on the PMC Index Model

Ying ZhouLin ChengYanshan ZhuJun YuanYu Ma^*

• Guangzhou Center for Disease Control and Prevention, Guangzhou, China

Abstract Objective:This study aims to develop an integrated framework combining text mining with the Policy Modelling Consistency (PMC) index model to evaluate China's Health Impact Assessment (HIA) policies, thereby advancing the methodological and theoretical framework for policy evaluation in health governance. Methods: This study focuses on health impact assessment policies issued at the municipal level in China since 2019. Using the NVivo 11 plus text mining tool, high-frequency terms from the policies were extracted to construct a Policy Modeling Consistency (PMC) index model for health impact assessment policies. Quantitative analysis was conducted on 30 policies using nine primary variables and 39 secondary variables. Results: The average PMC index score was 6.89. Among the sample policies, 11 were deemed complete and reasonable, and 19 were considered acceptable. The quality of the policies was at an acceptable level or above. The policies scored highly in terms of policy nature, content, and evaluation, but scored lower in policy timeliness, issuing authority, safeguards, and policy tools. The average concavity index was 3.11, indicating a moderate concavity level.The concavity index indicates that existing policies have established a solid foundation, ensuring the orderly advancement of the pilot program. However, the policies' intensity and the balance within their internal structure remain inadequate, suggesting that future efforts should focus on strengthening incentive mechanisms and addressing shortcomings. Conclusion: This study adapts the PMC model and validates its applicability in policy analysis for health impact assessments, providing a replicable framework for evaluating health policies in developing countries. China's municipal-level health impact assessment policies have effectively safeguarded public health security and advanced the implementation of the "Health in All Policies" approach. However, numerous challenges persist, including an inadequate legal framework, weak oversight mechanisms, imbalanced policy tools, and insufficient interregional collaboration. Based on this, it is recommended that future efforts strengthen top-level design, address the aforementioned key aspects, and systematically advance the optimization and improvement of health impact assessment policies to better align with the strategic needs of China's health development in the new era, enhance policy effectiveness, and promote the sustained improvement of public health levels.