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Health Impact Assessment

                Centre for Primary Health Care and Equity




                                                     Ben Harris-Roxas
  Conjoint Lecturer, University of New South Wales, Sydney
Health Section Co-Chair, International Association for Impact
                                                            Assessment
                                Consultant, Harris-Roxas Health
What is HIA?
                       A combination of procedures,
                        methods and tools by which a
                      policy, programme 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 (1999) Gothenburg Consensus Paper on Health Impact Assessment:
      main concepts and suggested approach, WHO Europe: Brussels

UNSW Research Centre for Primary Health Care & Equity
• Identify how the proposals affect
                   health and wellbeing
                 • Who it affects
                 • What can we do about it
                      – Maximise positives
                      – Minimise negatives




UNSW Research Centre for Primary Health Care & Equity
HIA features
          •                                  Prospective
          •                                  Predictive
          •                                  Systematic
          •                                  Transparent process




UNSW Research Centre for Primary Health Care & Equity
HIA features
          • Considers intended and unintended effects

          • Considers distribution of impacts

          • Involves developing recommendations

          • Is an aid to decision making
              (it doesn’t make the decision)


UNSW Research Centre for Primary Health Care & Equity
HIA considers how a proposal impacts on the
                         determinants of health




Dahlgren G, Whitehead M. Policies and Strategies to Promote Social Equity in
Health. Stockholm: Institute of Futures Studies, 1991.
At a minimum HIA should consider
             differential impacts in terms of
                                    Age
                                  Gender
                         Socio-economic status
                                 Location
                          Culture and ethnicity
                       Current levels of health and
                                 disability

UNSW Research Centre for Primary Health Care & Equity
The steps of HIA


                                         Screening
                                          Scoping
                                       Identification
                                        Assessment
                          Decision-making and recommendations
                                  Evaluation & monitoring



Centre for Primary Health Care and Equity
Research that makes a difference
www.cphce.unsw.edu.au
Scoping the scale of the HIA

                                                        Comprehensive HIA
                    High
          Investment and
             capacity
              Level of




                                              Intermediate HIA



                                  Rapid HIA
                     Low
                           Desk-Based
                            Low                                        High
                                    Magnitue of potential health impacts


UNSW Research Centre for Primary Health Care & Equity
Example of an Assessment Matrix
Assessment                              Recommendations

       If you                                    If you make
                          These will be                          These will be
     implement                                       these
                           the impacts                             the gains
    the proposal                                    changes




UNSW Research Centre for Primary Health Care & Equity
These slides are available at

www.slideshare.net/benharrisroxas


  b.harris-roxas@unsw.edu.au

  @ben_hr or @hiablog

  healthimpactassessment.blogspot.com

  linkedin.com/in/benharrisroxas

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Health Impact Assessment

  • 1. Health Impact Assessment Centre for Primary Health Care and Equity Ben Harris-Roxas Conjoint Lecturer, University of New South Wales, Sydney Health Section Co-Chair, International Association for Impact Assessment Consultant, Harris-Roxas Health
  • 2. What is HIA? A combination of procedures, methods and tools by which a policy, programme 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 (1999) Gothenburg Consensus Paper on Health Impact Assessment: main concepts and suggested approach, WHO Europe: Brussels UNSW Research Centre for Primary Health Care & Equity
  • 3. • Identify how the proposals affect health and wellbeing • Who it affects • What can we do about it – Maximise positives – Minimise negatives UNSW Research Centre for Primary Health Care & Equity
  • 4. HIA features • Prospective • Predictive • Systematic • Transparent process UNSW Research Centre for Primary Health Care & Equity
  • 5. HIA features • Considers intended and unintended effects • Considers distribution of impacts • Involves developing recommendations • Is an aid to decision making (it doesn’t make the decision) UNSW Research Centre for Primary Health Care & Equity
  • 6. HIA considers how a proposal impacts on the determinants of health Dahlgren G, Whitehead M. Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute of Futures Studies, 1991.
  • 7. At a minimum HIA should consider differential impacts in terms of Age Gender Socio-economic status Location Culture and ethnicity Current levels of health and disability UNSW Research Centre for Primary Health Care & Equity
  • 8. The steps of HIA Screening Scoping Identification Assessment Decision-making and recommendations Evaluation & monitoring Centre for Primary Health Care and Equity Research that makes a difference www.cphce.unsw.edu.au
  • 9.
  • 10. Scoping the scale of the HIA Comprehensive HIA High Investment and capacity Level of Intermediate HIA Rapid HIA Low Desk-Based Low High Magnitue of potential health impacts UNSW Research Centre for Primary Health Care & Equity
  • 11.
  • 12. Example of an Assessment Matrix
  • 13.
  • 14. Assessment Recommendations If you If you make These will be These will be implement these the impacts the gains the proposal changes UNSW Research Centre for Primary Health Care & Equity
  • 15. These slides are available at www.slideshare.net/benharrisroxas b.harris-roxas@unsw.edu.au @ben_hr or @hiablog healthimpactassessment.blogspot.com linkedin.com/in/benharrisroxas

Editor's Notes

  1. Screening is about asking if a HIA is required: Is the proposal developed enough ? HIA is no substitute for planning – there needs to be a clear proposal that’s being assessed. Is a HIA possible within the time requirements? Are there resources to undertake a HIA? Is there an opportunity to change the proposal ? There’s no point in proceeding if decision-makers aren’t going to listen to you. Are the impacts of sufficient level to warrant a HIA? It’s worth considering the cumulative impact a number of developments may have, as I mentioned previously. The final aspect of screening to consider is the distribution of impacts . Even if the impacts appear minor overall but severe for one group it may still be worth doing a HIA. By the end of screening you should have a clear rationale for why you’re proceeding with the HIA.