Online Course on Health Impact Assessment (HIA): A Tool for Developing Healthy Public Policies (February 2020)
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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
- 2. 2 Housekeeping Use Chat to post comments and/or questions during the webinar • ‘Send’ questions to All (not privately to ‘Host’) Connection issues • Recommend using a wired Internet connection (vs. wireless), • WebEx 24/7 help line • 1-866-229-3239 Participant Side Panel in WebEx Chat SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 3. 3 After Today The PowerPoint presentation and English audio recording will be made available at: http://www.nccmt.ca/previous-webinars Please note that a French webinar will be offered on February 20, 2020 from 2:00pm to 3:00pm (EST) SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 4. 4 Poll Question #1 How many people are watching today’s session with you? A. Just me B. 2-3 C. 4-5 D. 6-10 E. >10 SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 5. 5 Poll Question #2 Have you visited the any of the NCC’s websites or used their resources before? A. Yes B. No SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 6. 6 Poll Question #3 If you stated YES on the previous question, how many times have you used the NCC’s resources? A. Once B. 2-3 times C. 4-10 times D. 10+ times SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 8. The National Collaborating Centre for Methods and Tools (NCCMT) 88 SPOTLIGHT ON METHODS AND TOOLS WEBINAR 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
- 12. Health impact assessment (HIA) and Online Course on HIA 12
- 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
- 20. What are the steps of an HIA? 20
- 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
- 22. The extent of HIA practice 22 St-Pierre, 2016
- 23. 23
- 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
- 27. 27
- 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 Your Comments/Questions • Use Chat to post comments and/or questions • ‘Send’ questions to All (not privately to ‘Host’) Chat Participant Side Panel in WebEx SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 43. 43 Your Feedback is important! Your responses will be completely anonymous to other Webinar participants. Please indicate your level of agreement with the following: 1. Participating in this webinar increased my knowledge and understanding of this tool. 2. How likely are you to use the tool from today’s webinar in your own practice. 3. Which of the following statements apply to your experience with the webinar today (select all that apply): The webinar was relevant to me and my public health practice. The webinar was effectively facilitated The webinar had opportunities to participate The webinar was easy to follow along The webinar met my expectations 4. Can we contact you in the future to discuss how we can improve its webinar series? Yes No 5. If yes, Please provide your name and email address: Name: ____________________________________________ Strongly agree Agree Undecided Disagree Strongly Disagree Strongly agree Agree Undecided Disagree Strongly Disagree SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 44. 44 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 SPOTLIGHT ON METHODS AND TOOLS WEBINAR
- 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
- A few housekeeping items before we start Please use the chat box on the bottom right of your screen to post any comments/questions throughout the webinar When using chat, please make sure you are sending to all participants If you are having connection or technical issues please contact the WebEx help line. The number is posted on the slide & in the chatbox
- The slides and recording of this webinar will be made available shortly after the presentation. Access them through our webinars page on our website OR on our YouTube and SlideShare accounts
- We will be asking a few polling questions today to get a sense of who is joining us Heads up will also be a few short evaluation questions at the end of the webinar; important to get your feedback so stay tuned Answer these using the panel on the right hand side of your screen Please make sure to press submit after selecting your response 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… [Share high-level summary of responses]
- Next q = if you are familiar, how frequently have you used resources from the NCCs? Rarely, sometimes, often always [Share high-level summary of responses] - We always love to hear about how ppl have been using our resources so please feel free to share with us in the chatbox OR get in touch on email, twitter or of social media
- 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 Open it up for questions/comments Please use the chat box to submit your q’s
- As we wrap up… Please take time to answer evaluation questions Using the polling question panel on the right hand side of your screen You feedback is important to us and will be used to continue to improve our webinar series
- Upcoming spotlight webinars
- Final remarks Sign off