While extractive industries contribute to the Canadian economy, energy and mineral developments pose many risks and benefits to affected communities. Hundreds of active mines, and thousands of potential sites, are located in rural and remote regions; notably near Indigenous communities facing population health equity challenges. Impact assessment (IA) is the key regulatory review process for identifying and mitigating risks to socio-ecological determinants of health, involving regulators, proponents, public health stakeholders, other government stakeholders, civil society, affected communities, and rights-holders (with constitutionally protected interests). Critical public health perspectives are needed for a system-level framework to advance socio-ecological determinants of health during impact assessments, with direct application to highly contested Canadian contexts.

Realist interviews were conducted with thirty-five government officials, researchers, knowledge brokers, and consultants working in Canada, and internationally. Polycentric regulatory analysis provided a middle-range theory to structure the presentation of research findings across three themes and six subthemes: mechanisms for establishing and maintaining the legitimacy of IA regimes (with subthemes of affirming the socio-ecological determinants of health, and integrating sustainability and population health equity); mechanisms for collaborative accountability in IA processes (with subthemes of mandated and adaptive responsibilities and surveillance and engagement techniques); and mechanisms for communicating legitimacy and accountability in IA practice settings (with subthemes of free, prior, and informed consent and social learning and field building). These themes provide a system-level framework to orient the advancement of socio-ecological outcomes in pluralistic IA processes, supporting more sustainable population health equity improving activities and initiatives in the regulation of extractive industries.

虽然采掘业为加拿大经济做出了贡献，但能源和矿产开发给受影响的社区带来了许多风险和好处。数百个活跃矿场和数千个潜在矿场位于农村和偏远地区；特别是在面临人口健康公平挑战的土著社区附近。影响评估（IA）是识别和减轻健康的社会生态决定因素风险的关键监管审查过程，涉及监管者、支持者、公共卫生利益相关者、其他政府利益相关者、民间社会、受影响社区和权利持有者（宪法规定）受保护的利益）。系统级框架需要关键的公共卫生观点，以在影响评估期间推进健康的社会生态决定因素，并直接应用于竞争激烈的加拿大环境。

对在加拿大和国际上工作的 35 名政府官员、研究人员、知识经纪人和顾问进行了现实主义采访。多中心监管分析提供了一个中层理论来构建跨三个主题和六个子主题的研究结果的呈现：建立和维护IA制度合法性的机制（子主题是肯定健康的社会生态决定因素，以及整合可持续性和可持续发展）。人口健康公平）；内部审计流程中的协作问责机制（分主题为法定责任和适应性责任以及监督和参与技术）；以及在IA实践环境中传达合法性和问责制的机制（以自由、事先和知情同意以及社会学习和领域建设为副主题）。这些主题提供了一个系统级框架，以引导多元化IA进程中社会生态成果的进步，支持采掘业监管中更可持续的人口健康公平改善活动和举措。