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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
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
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.