Health Impact Assessment
Encyclopedia
Health Impact Assessment (HIA) is defined as "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."
-based recommendations to inform decision-making . HIA seeks to maximise the positive health
impacts and minimise the negative health impacts of proposed policies, programs or projects.
The procedures of HIA are similar to those used in other forms of impact assessment
, such as environmental impact assessment
or social impact assessment
. HIA is usually described as following the steps listed, though many practitioners break these into sub-steps or label them differently:
The main objective of HIA is to apply existing knowledge and evidence about health impacts, to specific social and community contexts, to develop evidence-based recommendations that inform decision-making in order to protect and improve community health and wellbeing. Because of financial and time constraints, HIAs do not generally involve new research or the generation of original scientific knowledge. However, the findings of HIAs, especially where these have been monitored and evaluated over time, can be used to inform other HIAs in contexts that are similar. An HIA's recommendations may focus on both design
and operational aspects of a proposal.
HIA has also been identified as a mechanism by which potential health inequalities can be identified and redressed prior to the implementation of proposed policy, program or project .
A number of manuals and guidelines for HIA's use have been developed (see further reading).
and social
, so that there are many overlaps with environmental impact assessment
and social impact assessment
.
It has been suggested that HIAs can be prospective (done before a proposal is implemented), concurrent (done while the proposal is being implemented) or retrospective (done after a proposal has been implemented) . This remains controversial, however, with a number of HIA practitioners suggesting that concurrent HIA is better regarded as a monitoring activity and that retrospective HIA is more akin to evaluation
with a health focus, rather than being assessment per se . Prospective HIA is preferred as it allows the maximum practical opportunity to influence decision-making and subsequent health impacts.
The International Association for Impact Assessment has an active health section.
A HIA People Directory can be found on the HIA GATEWAY.
, North America
, Australia
, New Zealand
, Africa
and Thailand
.
The new safeguard policies and standards of the International Finance Corporation
(IFC), part of the World Bank
, were established in 2006. These contain a requirement for health impact assessment in large projects. The standards have been accepted by most of the leading lending banks who are parties to the Equator Principles
. Health impact assessments are becoming routine in many large development projects in both public and private sectors of developing countries. There is also a long history of health impact assessment in the water resource development sector - large dams and irrigation systems.
This page uses Harvard referencing. Further reading categories are sorted alphabetically; citations are sorted by year (newest to oldest), then alphabetically by author surname within years. If citations are included in the references section they are not listed in the further reading section.
This page uses Harvard referencing. External links are sorted alphabetically.
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."
Overview
HIA is intended to produce a set of evidenceEvidence
Evidence in its broadest sense includes everything that is used to determine or demonstrate the truth of an assertion. Giving or procuring evidence is the process of using those things that are either presumed to be true, or were themselves proven via evidence, to demonstrate an assertion's truth...
-based recommendations to inform decision-making . HIA seeks to maximise the positive health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
impacts and minimise the negative health impacts of proposed policies, programs or projects.
The procedures of HIA are similar to those used in other forms of impact assessment
Impact assessment
Impact assessment is "a process aimed at structuring and supporting the development of policies. It identifies and assesses the problem at stake and the objectives pursued. It identifies the main options for achieving the objective and analyses their likely impacts in the economic, environmental...
, such as environmental impact assessment
Environmental impact assessment
An environmental impact assessment is an assessment of the possible positive or negative impact that a proposed project may have on the environment, together consisting of the natural, social and economic aspects....
or social impact assessment
Social impact assessment
Social impact assessment is a methodology to review the social effects of infrastructure projects and other development interventions.-Definition:...
. HIA is usually described as following the steps listed, though many practitioners break these into sub-steps or label them differently:
- Screening - determining if an HIA is warranted/required
- Scoping - determining which impacts will be considered and the plan for the HIA
- Identification and assessment of impacts - determining the magnitude, nature, extent and likelihood of potential health impacts, using a variety of different methods and types of information
- Decision-making and recommendations - making explicit the trade-offs to be made in decision-making and formulating evidence-informed recommendations
- Evaluation, monitoring and follow-up - process and impact evaluationEvaluationEvaluation is systematic determination of merit, worth, and significance of something or someone using criteria against a set of standards.Evaluation often is used to characterize and appraise subjects of interest in a wide range of human enterprises, including the arts, criminal justice,...
of the HIA and the monitoring and management of health impacts
The main objective of HIA is to apply existing knowledge and evidence about health impacts, to specific social and community contexts, to develop evidence-based recommendations that inform decision-making in order to protect and improve community health and wellbeing. Because of financial and time constraints, HIAs do not generally involve new research or the generation of original scientific knowledge. However, the findings of HIAs, especially where these have been monitored and evaluated over time, can be used to inform other HIAs in contexts that are similar. An HIA's recommendations may focus on both design
Design
Design as a noun informally refers to a plan or convention for the construction of an object or a system while “to design” refers to making this plan...
and operational aspects of a proposal.
HIA has also been identified as a mechanism by which potential health inequalities can be identified and redressed prior to the implementation of proposed policy, program or project .
A number of manuals and guidelines for HIA's use have been developed (see further reading).
Determinants of health
The proposition that policies, programs and projects have the potential to change the determinants of health underpins HIA's use. Changes to health determinants then leads to changes in health outcomes or the health status of individuals and communities. The determinants of health are largely environmentalSocial environment
The social environment of an individual, also called social context or milieu, is the culture that s/he was educated or lives in, and the people and institutions with whom the person interacts....
and social
Social
The term social refers to a characteristic of living organisms...
, so that there are many overlaps with environmental impact assessment
Environmental impact assessment
An environmental impact assessment is an assessment of the possible positive or negative impact that a proposed project may have on the environment, together consisting of the natural, social and economic aspects....
and social impact assessment
Social impact assessment
Social impact assessment is a methodology to review the social effects of infrastructure projects and other development interventions.-Definition:...
.
Levels of HIA
Three forms of HIA exist:- Desk-based HIA, which takes 2–6 weeks for one assessor to complete and provides a broad overview of potential health impacts;
- Rapid HIA, which takes approximately 12 weeks for one assessor to complete and provides more detailed information on potential health impacts; and
- Comprehensive HIA, which takes approximately 6 months for one assessor and provides a in-depth assessment of potential health impacts.
It has been suggested that HIAs can be prospective (done before a proposal is implemented), concurrent (done while the proposal is being implemented) or retrospective (done after a proposal has been implemented) . This remains controversial, however, with a number of HIA practitioners suggesting that concurrent HIA is better regarded as a monitoring activity and that retrospective HIA is more akin to evaluation
Evaluation
Evaluation is systematic determination of merit, worth, and significance of something or someone using criteria against a set of standards.Evaluation often is used to characterize and appraise subjects of interest in a wide range of human enterprises, including the arts, criminal justice,...
with a health focus, rather than being assessment per se . Prospective HIA is preferred as it allows the maximum practical opportunity to influence decision-making and subsequent health impacts.
HIA practitioners
HIA practitioners can be found in the private and public sectors, but are relatively few in number. There are no universally accepted competency frameworks or certification processes. It is suggested that a lead practitioner should have extensive education and training in a health related field, experience of participating in HIAs, and have attended an HIA training course. It has been suggested and widely accepted that merely having a medical or health degree should not be regarded as an indication of competency.The International Association for Impact Assessment has an active health section.
A HIA People Directory can be found on the HIA GATEWAY.
HIA worldwide
HIA is currently being used or developed around the world, most notably in EuropeEurope
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
, North America
North America
North America is a continent wholly within the Northern Hemisphere and almost wholly within the Western Hemisphere. It is also considered a northern subcontinent of the Americas...
, Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
, New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, Africa
Africa
Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...
and Thailand
Thailand
Thailand , officially the Kingdom of Thailand , formerly known as Siam , is a country located at the centre of the Indochina peninsula and Southeast Asia. It is bordered to the north by Burma and Laos, to the east by Laos and Cambodia, to the south by the Gulf of Thailand and Malaysia, and to the...
.
The new safeguard policies and standards of the International Finance Corporation
International Finance Corporation
The International Finance Corporation promotes sustainable private sector investment in developing countries.IFC is a member of the World Bank Group and is headquartered in Washington, D.C., United States....
(IFC), part of the World Bank
World Bank
The World Bank is an international financial institution that provides loans to developing countries for capital programmes.The World Bank's official goal is the reduction of poverty...
, were established in 2006. These contain a requirement for health impact assessment in large projects. The standards have been accepted by most of the leading lending banks who are parties to the Equator Principles
Equator Principles
The Equator Principles are a voluntary set of standards for determining, assessing and managing social and environmental risk in project financing....
. Health impact assessments are becoming routine in many large development projects in both public and private sectors of developing countries. There is also a long history of health impact assessment in the water resource development sector - large dams and irrigation systems.
HIA conferences
The 12th International HIA Conference will be held in Québec City, Québec, Canada in 2012.Reports
.This page uses Harvard referencing. Further reading categories are sorted alphabetically; citations are sorted by year (newest to oldest), then alphabetically by author surname within years. If citations are included in the references section they are not listed in the further reading section.
HIA Resource Websites
- Health Impact Project - Funding for HIA and resources
- HIA Community Wiki
- HIA Connect
- HIA Gateway
- IMPACT - International Health Impact Assessment Consortium
- RIVM HIA Database
- World Health Organization HIA Site
Government HIA Websites
- Environmental Health Branch, New South Wales Health (Australia)
- European Centre for Health Policy (Belgium)
- HPP-HIA Program (Thailand)
- Institute for Public Health in Ireland (Ireland)
- Planning for Healthy Places with Health Impact Assessments (United States)
- San Francisco Department of Public Health (United States)
- Centers for Disease Control and Prevention (United States)
University HIA Websites
- Monash University, SHIA@Monash (Melbourne, Australia)
- University of Birmingham, HIA Research Unit (Birmingham, UK)
- University of California, Berkeley, Health Impact Group, School of Public Health (Berkeley, USA)
- University of California, Los Angeles, HIA Project (Los Angeles, USA)
- University of California, Los Angeles, Health Impact Assessment Clearinghouse Learning and Information Center (Los Angeles, USA)
- University of Liverpool, IMPACT - International Health Impact Assessment Consortium (World Health Organization Collaborating Centre for Health Impact Assessment), Division of Public Health (Liverpool, UK)
- University of New South Wales, HIA Connect, Health Inequalities, Health Impact Assessment and Healthy Public Policy Program (CHETRE), Research Centre for Primary Health Care and Equity, Faculty of Medicine (Sydney, Australia)
- University of Otago, Health, Wellbeing and Equity Impact Assessment Unit, Wellington School of Medicine and Health Sciences (Wellington, New Zealand)
Other HIA Websites
This page uses Harvard referencing. External links are sorted alphabetically.
See also
- IAssessment
- Impact AssessmentImpact assessmentImpact assessment is "a process aimed at structuring and supporting the development of policies. It identifies and assesses the problem at stake and the objectives pursued. It identifies the main options for achieving the objective and analyses their likely impacts in the economic, environmental...
- Environmental impact assessmentEnvironmental impact assessmentAn environmental impact assessment is an assessment of the possible positive or negative impact that a proposed project may have on the environment, together consisting of the natural, social and economic aspects....
- Equality Impact AssessmentEquality impact assessmentAn equality impact assessment is a process designed to ensure that a policy, project or scheme does not discriminate against any disadvantaged or vulnerable people.- Definition :...
- Four-Step Impact AssessmentFour-Step Impact AssessmentThe Four-Step Impact Assessment is an academic framework initiated and published by the late Jonathan Mann and colleagues at the Francouis-Xavier Bagnoud Center for Health and Human Rights at the Harvard School of Public Health. The assessment takes into account the negotiation of objectives...
- Healthy development measurement toolHealthy development measurement toolThe Healthy Development Measurement Tool , developed by the San Francisco Department of Public Health, provides an approach for evaluating land use planning and urban development with regards to the achievement of human health needs...
- Risk assessmentRisk assessmentRisk assessment is a step in a risk management procedure. Risk assessment is the determination of quantitative or qualitative value of risk related to a concrete situation and a recognized threat...
- Social impact assessmentSocial impact assessmentSocial impact assessment is a methodology to review the social effects of infrastructure projects and other development interventions.-Definition:...
- Environmental impact assessment
- Health promotionHealth promotionHealth promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"...
- Jakarta DeclarationJakarta DeclarationThe Jakarta Declaration on Leading Health Promotion into the 21st Century is the name of an international agreement that was signed at the World Health Organization's 1997 Fourth International Conference on Health Promotion held in Jakarta...
- Ottawa Charter for Health PromotionOttawa Charter for Health PromotionThe Ottawa Charter for Health Promotion is the name of an international agreement signed at the First International Conference on Health Promotion, organized by the World Health Organization and held in Ottawa, Canada, in November 1986...
- Jakarta Declaration
- Health protection
- Environmental healthEnvironmental healthEnvironmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health...
- List of environmental health hazards
- Precautionary principlePrecautionary principleThe precautionary principle or precautionary approach states that if an action or policy has a suspected risk of causing harm to the public or to the environment, in the absence of scientific consensus that the action or policy is harmful, the burden of proof that it is not harmful falls on those...
- Risk assessmentRisk assessmentRisk assessment is a step in a risk management procedure. Risk assessment is the determination of quantitative or qualitative value of risk related to a concrete situation and a recognized threat...
- Environmental health
- Population healthPopulation healthPopulation health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” It is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health...
- Public healthPublic healthPublic health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
- Social determinants of healthSocial determinants of healthSocial determinants of health are the economic and social conditions under which people live which determine their health. They are "societal risk conditions", rather than individual risk factors that either increase or decrease the risk for a disease, for example for cardiovascular disease and...
- Public health