Health Impact Assessment (HIA) is a structured and innovative process for prospectively assessing the potential impacts of a project, program or policy on the health and well-being of populations. In order to support capacity building in the field of HIA, the National Collaborating Centre for Healthy Public Policy (NCCHPP) has developed an online course on HIA. This 5-hour course is available free of charge in English and French and can be accessed at any time upon registration. It aims to familiarize participants with the process of conducting health impact assessments of projects, programs, and policies in collaboration with relevant stakeholders.
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Online Course on Health Impact Assessment (HIA): A Tool for Developing Healthy Public Policies (February 2020)
1. Online Course on Health Impact
Assessment (HIA): A Tool for Developing
Healthy Public Policies
February 13, 2020
2:00-3:00pm
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
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7.
8. The National Collaborating Centre for Methods
and Tools (NCCMT)
88
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Local Health
Issues and
Context
Public
Health
Expertise
Community
and Political
Preferences
and Actions
Research Resources
9. 9
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
National Collaborating Centre for
Healthy Public Policy (NCCHPP)
Our mandate
– Support public health actors in their efforts to promote healthy
public policies
Our areas of expertise
– The effects of public policies on health
– Generating and using knowledge about policies
– Intersectoral actors and mechanisms
– Strategies to influence policy making
10. 10
Online Course: Health
Impact Assessment, step
by step
http://www.ncchpp.ca/274/Online_Course.ccnpps
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
11. 11
Presenters
Thierno Diallo, PhD
Scientific Advisor, National Collaborating
Centre for Health Public Policy
thiernoamadou.diallo@inspq.qc.ca
Gabrielle Manseau, MUP
Planning and Research Officer, Montérégie
Region’s Public Health Department (QC)
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
13. Outline
• HIA of a policy, program or project
• Online course on HIA
13
14. What is the origin of HIA?
• Environmental impact assessment
– Methodology
• Health promotion
– Values and objectives
14
15. What is HIA?
• “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” (WHO, 1999).
• “HIA identifies appropriate actions
to manage those effects” (Quigley
et al. 2006).
15
16. What is the purpose of HIA?
As a decision support tool, HIA is used to:
• better inform decisions and assist policy makers
• promote healthy public policy
• promote better cooperation between different authorities and
maintain social equity
• help address health inequalities
• improve the health and well-being of populations
16
17. What are the values of HIA?
17
Democracy Equity
Sustainable
development
Ethical use of
evidence
Gothenburg Consensus Paper WHO, 1999)
18. What are the main characteristics of HIA?
• Based on a holistic view of health
• Focused on policy, program or project outside the health sector
• Conducted before the implementation of the proposal: propective
evaluation
• Interested in both positive and negative impacts
• Used quantitative and qualitative approach
• Concerned with the involvement of all the sectors affected by the
proposal under consideration: Intersectorality
18
19. When should an HIA be conducted?
19
Emergence
Agenda
setting
Formulation
Decision-
making
Implementa
-tion
Assessmen
t
Public
Policy
HIA
Howlett and Ramesh, 2003
21. A development plan for a park and golf course, Madison, USA.
A social development policy in Pincourt, QC.
Shared space model – Community service agencies in Sudbury, ON.
Expansion of the Billy Bishop Toronto City Airport, ON.
A tourism development project in rural Switzerland.
A public market in New Jersey, USA.
An urban redevelopment project around a transit station in Paris, France
Examples
A regional housing strategy in Scotland
St-Pierre, 2016
24. Free Online Course – HIA step by step
Learning objectives
• Recognize the fundamentals of the HIA of public policies
• Explain the steps of a high-quality HIA
• Know the favourable conditions for successful HIA
implementation
24
25. Target audience
• Practitioners, professionals and decision makers active in
public health and in other related sectors, from
governmental or non-governmental organizations
• Any person interested in public policies and their impacts
on population health
25
26. General information
• 9 online modules, including: videos featuring experts
from the field; different learning activities including
quizzes and a case study; and various practical tools
for performing HIAs
• Accessible to you 24/7 upon registration
• Available in English and French
• Opportunity to request a certificate of completion
26
28. Supporting HIA practice in Canada
28
Free Online Course on HIA
Foster the HIA
application to
public policies
Promote the
development
of healthy
public policies
Catalyze the
practice of HIA
in the country
Offer the
opportunity for
capacity
building
30. To learn more about HIA
• NCCHPP’s HIA webpage
http://www.ncchpp.ca/54/health-impact-assessment.ccnpps
• Resources from the Society of Practitioners of Health
Impact Assessment (SOPHIA)
https://hiasociety.org/
• Human Impact Partners:
https://humanimpact.org/products-resources/issue-area/?filter=iss1-145
30
31. References
• Howlett, M. & Ramesh, M. (2003). Studying public policy: policy cycles and policy subsystems.
Oxford : Oxford University Press.
• Quigley, R., den Broeder, L., Furu, P., Bond, A., Cave, B., & Bos, R. (2006). Health Impact
Assessment International Best Practice Principles. Special Publication Series No. 5. Fargo, USA:
International Association for Impact Assessment.
• St-Pierre, L. (2016). Foundations of HIA – A look at over 15 years of practice. Presentation offered
in the context of the Journées annuelles de santé publique (JASP - Québec's Annual Public Health
Days) on November 22, 2016. [PowerPoint slides]. Retrieved from:
http://www.ncchpp.ca/134/Presentations.ccnpps?id_article=1602
• WHO Regional Office for Europe, European Centre for Health Policy. (1999). Health impact
assessment: main concepts and suggested approach. Gothenburg Consensus paper. Brussels:
European Centre for Health Policy. Retrieved from:
http://www.impactsante.ch/pdf/HIA_Gothenburg_consensus_paper_1999
31
32. Online Course on Health
Impact Assessment
(HIA): A Tool for
Developing Healthy
Public Policies
Gabrielle Manseau
Planning and Research Officer at the
Montérégie Region’s Public Health
Department (QC)
February 13, 2020
33. Strategic transit development plan
• Regional transit vision for the next 30
years.
• Objectives: Plan, organize, finance
and promote transit services for the
Montreal region.
• In accordance with governmental and
metropolitan orientations.
• In consultation with regional
departments, municipalities and
public transit organizations.
The Authority’s territory
34. Regional Transit Authority
Strategic transit development plan
Montreal Metropolitan Region
Planning and development plan
Provincial Government
Planning governmental orientations, sustainable mobility policy
Operational program, transit services
Public transit organizations
Strategic transit development plan
35. • Begun in February 2019… and still
not finished
• Establishment of 3 committees:
• With the Authority’s team
• With the 5 Public Health Departments
• With colleagues in Montérégie
(leadership)
• Collaboration at various levels
1. Feedback and comments on 3 ARTM
deliverables (during the year)
2. ARTM’s specific requests
• Rationale concerning effects of transport
on health, addressed to population
• Develop a chapter on mobility inequities:
new field of research
3. The HIA report
HIA: step by step
36. HIA: logic model
Elements of the Plan analyzed Health
determinants
Impacts on health and quality of
life
Physical health
↓injuries
↓obesity
↓ cardiovascular and respiratory
illnesses
↓ diabetes
Mental and social health
↑sense of community belonging
↓stress
↓ psychological distress
↓anxio-depressive disorders
• Health burden on the
population and vehicle-
kilometres travelled (VKT)
• Multimodality, other transit modes
and shared mobility
• Mobility inequities
• Access to employment for
vulnerable populations
• Accessibility barriers
• Development of healthy and
sustainable living environment
• Density, capacity, diversity and
connectivity
• Infrastructures for pedestrians,
cyclists and
persons with disabilities and
reduced mobility
• Incentive parking (park & ride)
Physical activity
Safety
Social inclusion
and equity
Socio-economic
conditions
Noise
Air quality
37. • Some evidence used:
• Scientific literature
• Inequities
• Employment access
• Health impacts of road transport
• Built environment (best practices)
• …
• Main data used
• StatCan database (vulnerability index)
• Origin-Destination survey (trips, destinations, mode of transport,
distance)
• Road safety records (traffic accidents)
HIA: Evidence
38. • Transport vulnerability index
• Recommendation: Prioritize the
increase of transit services between
vulnerable neighbourhoods and
employment zones
• Non-specific recommendations
• pedestrian and cyclist infrastructures
near the transit access points
• rethinking the design of Park and Ride
lots for transit access points
• Prioritize the increase of transit services
along dense, mixed corridors (living
environment).
HIA: Results and recommendations
39. • A plan (not a project)
• Besides having a report to write, had other involvement during the process
• Constant adaptation to schedule changes
• On a metropolitan scale: involves 4 other Public health Departments
• Coordination of 3 committees:
• With the Authority’s team
• With the 5 Public Health Departments
• With colleagues in Montérégie (leadership)
HIA: challenges
40. • Work organization
• The use of tools for the scoping phase and for developing the logic
model
• Appropriate recommendations
HIA course: What has helped me?
41. Thank you!
Gabrielle Manseau
Planning and Research Officer at the
Montérégie Region’s Public Health Department
(QC)
gabrielle.manseau.agence16@ssss.gouv.qc.ca
42. 42
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Next Webinar
Cours en ligne sur l'évaluation de
l'impact sur la santé (EIS) : un outil pour
l'élaboration de politiques publiques
favorables à la santé
20 février 2020 14 h à 15 h (HNE)
https://www.nccmt.ca/fr/developpement-des-
capacites/webinaires
Quality Assessment of Community
Evidence (QACE) Tools
March 9, 2020 1:30 pm – 2:30 pm EDT
https://www.nccmt.ca/capacity-development/webinars
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45. For more information about the
National Collaborating Centre
for Methods and Tools:
• NCCMT website www.nccmt.ca
• Contact: nccmt@mcmaster.ca
For more information about the
National Collaborating Centre
for Healthy Public Policy:
• NCCHPP website http://www.ncchpp.ca/en/
• Contact: ncchpp@inspq.qc.ca
SPOTLIGHT ON METHODS AND TOOLS WEBINAR
Editor's Notes
Hello and welcome to the next installmaent of our Spotlight on Methods and Tools webinar series
My name is Kristin Read and I am a research coordinator at the NCCMT
Today we will be talking about HIAs and featuring NCCHPPs online course on HIA as a tool to support HIA capacity building
We will also have the pleasure of hearing from a colleague involved in the HIA process. They will be sharing some of the benefits and challenges they have encountered as well as their own experience going through the NCCHPP’s online course
Thank you and a warm welcome to those who have joined us this afternoon
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Heads up will also be a few short evaluation questions at the end of the webinar; important to get your feedback so stay tuned
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First question
Like to get a sense of how many people are joining us today
Please let us know if you are joining by yourself, with a small group of colleagues or as a larger group
[Share high-level summary of responses]
Next q = wondering if your familiar with the NCCs…
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For those of you who are unfamiliar
NCCs are funded by the PHAC and each hosted in different academic (and non-academic) institutions across the country
Part of why the NCCs exist in the KT field = to reduce duplication, share learning across jurisdictions, and help identify gaps in knowledge and practice
ALSO a large part of what we all do is act as a resource for training, professional development, and capacity building for knowledge translation & EIDM for PH in Canada
Each NCC works in a different domain of PH
6 NCCs located across the country (state full name + acronym)
NCCIH – Prince George, UNBC
NCCEH – Vancouver, BCCDC
NCCID – Winnipeg, University of Manitoba
NCCMT – Hamilton, McMaster University
NCCHPP – Montreal, INSPQ
NCCDH – Antigonish, StFX
The NCCMT champions the use of different types of evidence in public health decision making
We compile the latest research and evidence for what works in public health
We work with practitioners to develop knowledge and skills for using different types of evidence when making decisions in their own work
Diagram on the left is what we use to guide our thinking around EIDM in PH
Model on the right outlines the steps involved and illustrates the process we use to incorporate evidence into the decision making process
Our goal is to help build confidence in the public health workforce so that practitioners know they are making informed decisions about the programs and policies that affect the health of both individuals and communities
Like to officially welcome everyone to the Spotlight on Methods and Tool webinar series
As mentioned, today featuring the HIA process and highlighting NCCHPP’s course to support HIA capacity building
Introduce presenters
Thierno Diallo, Scientific Advisor at the NCCHPP
Expertise in the use of HIA to assess the health co-benefits of climate change mitigation policies and experience integrating HIA into Quebec City’s urban planning process
Gabrielle Manseau, Planning and Research Officer at Montérégie Region’s Public Health Department (QC)
Sharing her experience with HIA for the regional transit authority’s strategic transit development initiative
Thank you so much for joining us today to share your experience
HIA aims to advance the values of :
Democracy: which means citizen participation in the decision-making process; allowing people to participate in the development and implementation of policies, programs or projects that may impact their lives.
- Equity: taking into account the distribution of the effects on health, particularly among vulnerable groups; Also interested in the distribution of the impact within the population – HIA assesses the distribution of impacts from a proposal on the whole population, with particular attention to how the proposal will affect vulnerable people (in terms of age, gender, ethnic background and socio-economic status).
Sustainable development: taking into account the short- and long-term effects; Consideration of both short-term and long-term, direct and indirect impacts.
Ethical use of evidence: which means rigorous use of quantitative and qualitative evidence; a wide variety of evidence should be collected using the best possible methods.
Secondly HIA is a prospective evaluation. To influence the decision-making process, HIA recommendations must reach the decision-makers before the decision about the proposal will be made.
So, it is not a tool to put a new policy at the governmental agenda, neither a retrospective evaluation. HIA is targeted at the stages of policy development when the policy is being formulated, a window of opportunity that the HIA team will need to catch promptly.
An HIA Includes five steps:
Screening is the first step of an HIA. The aim of this step is to decide whether or not a proposal needs an HIA. It is aimed at determining if HIA is useful for specific proposal. This involves deciding if the proposal is likely to affect health directly or indirectly by affecting its determinants.
Scoping: Having decided that an HIA should be done, the next step is scoping, that is planning how the HIA should be done. This is the step where you plan out all the logistics of the subsequent steps in the HIA (scoping of the process) and where you identify all the plausible links between a proposal and health (scoping of the issues).
Appraisal: The objective of this step is to determine, through the collection and analysis of data, the extent to which the proposal will affect health, the nature of these effects and which population groups will be affected by these effects. The Appraisal step is when you actually do the assessment by collecting data (qualitative and quantitative information) and performing analysis.
Recommendations: The objective of this step is to formulate recommendations for minimizing the negative effects and maximizing the positive effects of a proposed project, program or policy. The results of the HIA are presented in a report.
Evaluation / monitoring: The objective of this step is to determine the extent to which the HIA has been successful, both in terms of the process and its effects. You can also set up mechanisms to monitor the actual health impact of the policy once it is put in place. Review of the process and its influence. Monitoring of the effects
The Authority was created in 2017 and its first mandate was to develop the first strategic transit development plan for the Montreal metropolitan region.
The strategic plan is a 30-year vision and its objectives are to plan, organize, finance and promote transit services for the metropolitan region.
The plan has to be in accordance with governmental and metropolitan orientations.
The Authority was also obligated to consult regional departments, municipalities and public transit organizations throughout the process.
To give you an idea of the context and the structure,
The Regional Transit Authority is an entity which must comply with the orientations of the Montreal Metropolitan Region, which are determined by the provincial government. The Authority plans and organizes the Public transit organization’s services.
We officially began in February 2019 and were supposed to finish in December with the adoption of the Plan by the Executive board.
The Authority occasioned several delays during the process, so we are still working with them. The Transit Plan is now planned for May 2020.
The delay was most welcome for us because such collaboration with the Authority was new to us and the way forward was a bit more complicated than is usual.
For example, we established 3 committees. One with the Authority’s team, one with the 5 public health departments concerned (as you can see on the map, the Authority’s territory is very large), another one with my colleagues in my department. The Montérégie team provided leadership and was in charge of the screening and scoping phases. But we worked with the committee comprising the public health departments, and afterwards we validated this work with the Authority’s team.
Besides during the writing of the HIA report, we had the opportunity to collaborate at several points during the year. The Authority asked us to provide feedback on 3 different preliminary versions of the Transit Plan.
Also, they asked us to develop a rationale addressed to the population regarding the effects of transportation on health. And we developed, in collaboration with them, a perspective on mobility inequities for disadvantaged populations, a new field of research.
I wont detail everything on this slide. Briefly, this is our logic model with the elements of the Plan that we analysed. The health determinants affected. And finally, the potential impacts on health and quality of life.
For all the elements analysed, we used evidences (CHANGER LA DIAPO).
We used scientific literature and systematic review on inequities, employment access, healt impacts of road transport, the best practices of an healthy built environment, …
We also used a lot of data.
For example, the data used most frequently was the 2016 Census data (of StatCan) and the Montreal metropolitan region’s household survey (Origin-Destination survey).
Census data:
Proportion of low income persons
Proportion of single-parent families
Unemployment rate (15 years and over)
Proportion of persons with no diploma or degree (25-64 years old)
Proportion of recent immigrants (2011-2016)
Proportion of households that paid more than 30% of income toward shelter (shelter-cost-to-income ratio)
Median total income (15 years and over)
Regarding noise and air quality, we did not do any specific analyses. We mentioned that the modal shift from the car to public transport could have beneficial effects on noise reduction and the improvement of air quality, on a macro scale, based on the literature. We also warned the Authority about the negative impacts that a major increase in public transportation can have on noise and air quality, for the residents who live near the transit lines.
One of the main analyses carried out concerned the mobility of vulnerable populations toward employment zones. We developed a transport vulnerability index and we were able to map the sectors where a high proportion of vulnerable persons lives and their working sectors. We were also able to evaluate the distance and the time travelled to go to work. A lot of sectors had no transit options or very poor ones, so a majority of these people were driving to work. The transit services are very well developed to accommodate employment in the downtown area, but a majority of vulnerable populations also work in the industrial or retail sectors, on the outskirts of downtown. As we know, car possession is not cheap and the use of public transportation could reduce the expenses of households in need.
Recommendation: Prioritize the increase of transit service between vulnerable neighbourhoods and their employment zones.
Other non-specific recommendations:
Because the HIA was based on a Plan, not a project, the recommendations are not very specific. We made some recommendations to promote the increase of multimodality (e.g.: pedestrian and cyclist infrastructures near the transit access points, rethinking the design of Park and Ride lots for transit access points to make sure that pedestrians, cyclists and buses have priority over car access).
Prioritize the intensification of the public transport service along a dense, mixed corridor, where there is already a living environment.
As I mentioned before, the HIA was based on a Plan, not a project. So the recommendations were more challenging to make.
We had to write a HIA report, but the Authority also asked us to make other contributions during the year, which took time to organize.
Of course changes in schedules are common during HIA projects, but it’s a real challenge to address these.
The scale of the project was also a challenge because it involved 4 other Public health departments, so a lot more professionals to manage.
And as I mentioned before, I was also responsible for the coordination of 3 committees. A basic HIA project usually involves a maximum of 2 committees.
I had already participated in several HIAs in the past as a contributor. So I was already familiar with the HIA process. The course helped me to organize my work. I used the tools for the scoping phase and for developing the logic model.
The course has also helped me to formulated appropriate recommendations.
Thanks to presenters
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