Health Impact Assessment & Planning- Sue Wright, RTPI CPD June 2013


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Health Impact Assessment & Planning- Sue Wright, RTPI CPD June 2013

  1. 1. Health Impact Assessment (HIA) & Planning 18th June 2013 RTPI (West Midlands) Sue Wright Knowledge and Evidence Manager (Higher Level) HIA Knowledge and Intelligence Team (West Midlands)
  2. 2. What is HIA? • Combination of procedures, methods & tools • That systematically judges the potential, & sometimes unintended, effects of a policy, programme or project • On both the health of a population, & the distribution of those effects within the population • HIA identifies appropriate actions to manage those effects Quigley, R., L. den Broeder, P. Furu, A. Bond, B. Cave and R. Bos 2006 Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5. Fargo, USA: International Association for Impact Assessment.
  3. 3. What is HIA? Screening Consider whether to perform an HIA Scoping Plan how the HIA is to be done Appraisal Assessment of Health impacts Recommendations Formulates recommendations for decision makers Monitoring and Evaluation Actions to monitor impacts and evaluate HIA Present health profile Factors influencing health How will plan change these Is everyone equally affected? Enhance positive health impacts Reduce negative health impacts/Mitigation Reduce health inequalities
  4. 4. Purpose of HIA The purpose of a HIA is to develop evidence based recommendations which influence the decision making process. The recommendations inform decision makers of the ways in which their proposal needs to be amended to enhance the positive impacts and reduce or eliminate the negative impacts. • Informs a decision and is a decision support tool • Predicts the health consequences of implementing different options But also • Increases awareness of health and health inequalities (better informed) • Participation and engagement of stakeholders (decisions more open) • Fosters interagency working
  5. 5. HIA and Planning • Planning has the potential to support, sustain and improve health • HIA is a tool to assess the health consequences of decisions e.g. plans, projects and programmes • If HIA is considered at the planning and design stage then HIA can contribute to better decision making for health
  6. 6. Key features of HIA • Broad definition of health – More than just absence of disease – More than access to healthcare/services • Wider determinants of health – Understanding of the many factors influence health – E.g.: transport, education, income, social networks, housing, income (see Dahlgren & Whitehead 1991 model) • Addresses health inequalities – Assesses differential impact on population groups
  7. 7. Food Safety What doesSmoking Health mean? Older people Drugs Meningitis Blood Pressure Accidents Family Bad Housing Street Suicide Waiting Lists Diabetes Lighting Parenting Water Fluoridation Feeling good HIV/AIDS Are you healthy? Positive health Exercise What makes you healthy? Health is “… a resource for everyday life, not the objective of living. Health is a Heart Disease Teenage positive concept emphasizing social and personal resources, as well as physical Pregnancy capacities."[ World Health Organization. The Ottawa Charter for Health Promotion. Adopted at the First International Conference on Health Promotion, Ottawa, 21 November 1986 - WHO/HPR/HEP/95.1.
  8. 8. 8 Haglund, Svanström, KI, revision, Beth Hammarström HEALTH & HEALTH INEQUALITIES
  9. 9. Prediction of health impacts HIA makes assumptions explicit. Show how a project may potentially affect the health of people through intermediate variables Proposal/ Project Intermediate Variables Expected Outcomes Assumption that changes in one factor lead to other changes which in turn lead to changes in health. Build new road Increased road speed & traffic Increased road accidents Critical Guide to Health Impact Assessment (West Midlands Public Health Observatory)
  10. 10. Appraisal Stage of HIA The appraisal stage of a HIA involves collecting the evidence and assessing the health impacts. This is done by: Policy Context Community Profile Literature & reports Evidence Analyse & prioritise Stakeholder views Local Data Expert knowledge Modelling Describe impacts Which groups?
  11. 11. Unintended Health Impacts of Health related Policies Increase employment opportunities/reduce emissions Improve accessibility to city centre Cars Emissions “Park & Ride” scheme in outer city Winter and Farthing (1997); Barker (1995) Local bus services not viable in outer city Local Business Social networks
  12. 12. Concerns about HIA Criticism Response Costly Estimated to be 0.01% of master plan development and implementation1; not as costly as treatment of health impacts in the long run Time-consuming Conducting the HIA early will bring issues to the front of the & slows decision-making process, potentially speeding approval decision making processes, and preventing costly litigation that delays projects Stops economic development HIA identifies mitigations and recommendations to enhance health and reduce risks but not to say “don’t do that” HIA not scientific HIA pulls together disparate pieces of the best available evidence to make a broad statement about impacts Health impacts already covered e.g. open space, cycling/walking Unintended impacts and health inequalities not always addressed; additional health enhancing actions could be recommended (see HIA of Herne Bay) 1Cost Benefit Analysis of Health Impact Assessment. University of York Health Economics Consortium (2006).
  13. 13. Does HIA work? Studies Impacts Impacts 16 HIAs in England 2006 Positive influence on decision making Benefits outweighed costs HIA in 19 European countries 2004-07 Increased awareness of potential health impacts across sectors Contributed to specific policy changes 76 HIAs in US 2010 Health successfully incorporated into planning processes
  14. 14. Gateshead 2008-present Stoke –on-Trent 2009-present Wanted to integrate health into Council decision making Integrate health into policies and decision making Established HIA steering group and HIA champions in council departments Research project on how the council makes decisions and where health is taken into account (SoT is a Healthy City) HIA Steering Group 4 Pilot HIAs 4 Pilot HIAs supported by 2year mentoring project HIA events/awareness raising/training. Guide to HIA published HIA events/HIA training, also development of high level IIA tool Partnership with HIA expert Partnership with HIA expert and academic institution Identified health impacts of council decisions Assessed council reports for HIA Introduced “Place making for Health” Supplementary Planning Document Healthy Urban Planning-all development plans (specific size) have to have HIA Integrated HIA into Health and Wellbeing Boards Guide to health proofing master plans published
  15. 15. What does HIA add? Herne Bay Regeneration Sustainability Appraisal (SA) themes SA Focus HIA themes HIA Focus Historic Environment Historic character of buildings and identity Neighbourhood image Reputation and pride of place – impacts on health-related behaviour e.g. relatively high rates of binge drinking and teenage pregnancy. Need for community involvement in shaping the character of the town Employment and the Economy Out-commuting, need for local employment, and diversification of the economy Employment, education and the local economy Out-commuting, need for local employment, and diversification of the economy, protection of those displaced in the regeneration. Promote healthy workplaces in new employment areas Transport Need to reduce congestion and address parking pressures Traffic flow, car parking and travel Congestion and car parking management. Safety of all road users; shared space; active travel Quality of Life Need for investment in business and leisure sectors Participation; healthy lifestyles Integrate healthy lifestyle interventions with community involvement in the regeneration. Focus on healthy settings approach
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  17. 17. What HIA is about and other health related IAs HIA reports from 1996 to present Resources to help do HIA People to contact; training; events; and other websites;
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