Health Impact
Assessment

Andy Pennington,
IMPACT - International Health Impact
Assessment Consortium,
University of Liverpool

Introduction
1. My background
2. Aims of the presentation• What is HIA?
• Purpose of HIA is and why you should do it• Definition of health• Model of health and relationship to the social
determinants of health• A generic model of HIA• HIA and health inequalities

What is HIA?
A combination of procedures, methods andtools by which a policy, programme or
project may be judged as to its’ potential

effects on the health of a population and thedistribution of those effects within thepopulation.
WHO 1999

Purpose of HIA

HIA aims to inform and influence
decision-making to reduce (oreliminate) any negative impacts
and enhance the positive impactsof any decision.

10 reasons for doing HIA (1)1. Core responsibilities of public
sector/government

2. Corporate responsibility and reputation
3. ‘Good business sense’ and ‘added value’

4. Costs of mistakes
5. Sustainable development

10 reasons for doing HIA (2)6. Risk management
7. Legislation/license to operate

8. Public/stakeholder participation
9. A balanced approach

10.Appropriate at different levels(Sources: adapted from Birley, 2004; adapted From Briggs, 2008;
HIA CONNECT, accessed January 2010)

Core Values of HIA• Democracy• Ethical use of evidence• Equity• Sustainable development• Openness and transparency

Definition of Health in HIA‘Health is a state of complete
physical, mental and social wellbeing and not merely the absence ofdisease or infirmity.’
World Health Organization, 1948

Model of HealthDahlgren and Whitehead, 1991. Policies and strategies to promote social equity inhealth. Stockholm: Institute of Future Studies

A Generic Model of HIA
Screening

Scoping

Conduct assessment

Policy analysis
Profiling of communities
Qualitative and quantitative
data collection

Impact analysis

Report on health impacts
and policy options

Establish priority
impacts

Monitoring

Recommendations
developed

Impact and outcome
evaluation

Process evaluation

HIA methods and the social
determinants of health
Structure of the community
health profile

General socioeconomic, cultural andenvironmental factors
Living and working
conditions

Health DeterminantsSocial and community
networks
Individual Lifestylefactors

HIA Community
Health Profile

Biological factors

Health Status &Morbidity

Health Outcomes
Life expectancy &Mortality

HIA and Health Inequalities
1. Two different views - Health Impact
Assessment and Health Equity Impact
Assessment
2. Addressing health equity within HIA:••••••••

HIA steering group and TOR
Scoping
Community profiling
Evidence from the literature
Evidence from stakeholders
Impact analysis
Recommendations
Monitoring and evaluation

Risk based ApproachTrue HIA Approach
Screening

Scoping

Conduct assessment

Policy analysis
Profiling of communities
Qualitative and quantitative
data collection

Impact analysis

Report on health impactsand policy options

Establish priority
impacts

Monitoring

Recommendations
developedImpact and outcome
evaluation

Process evaluation

Sources of further information
The HIA Gateway contains:• HIA screening tools• Guides to conducting HIAs
• Sector and topic specific examples of HIA• Information on the relationships between HIA
and other assessments such as SEA and EIA• Information on HIA conferences and training
See: http://tinyurl.com/yfx7r87
or access through the IMPACT Website????

If time allows

3 Levels of HIA• Desk-top• Rapid• Comprehensive

HIAs of employment policy
For HIAs of employment policy conducted byIMPACT in 2004 see:
• HIA of the European Employment Strategy – EU
• HIA of the European Employment Strategy – UK
• HIA of the European Employment Strategy – Ireland• HIA of the European Employment Strategy – Netherlands• HIA of the European Employment Strategy – Germany@ http://www.liv.ac.uk/ihia/IMPACT_HIA_Reports.htm

Examples of IMPACT HIA work•••••••••••••••••

North West Region HIA capacity building programmeComprehensive HIA of housing and neighbourhood investment programme in Salford
Rapid HIA of housing investment programme in Liverpool
Tower Hamlets regeneration HIA and production of best practice guidance
The Liverpool Local Authority and PCT HIA capacity building programme
Wirral Metropolitan Borough Council HIA capacity building programme
HIA of the Cheshire West and Chester Unitary Authority Core Strategy
European Policy Health Impact Assessment (EPHIA) Guide
Prospective Rapid Health Impact Assessment of the proposed Sports Stadium andRetail Development in Kirkby
Health Impact Assessment of the Health is Wealth Commission’s ‘Big Ideas’
Rapid Health Impact Assessment of the Liverpool Mutual Homes Housing Investment
Programme
Prospective Rapid Health Impact Assessment of an Energy for Waste Facility in theStates of Jersey
Rapid Health Impact Assessment of Oldham Town Centre Integrated Care Centre
Rapid Health Impact Assessment of Birmingham International Airport’s Proposed
Runway Extension
Liverpool CitySafe Anti-Social Behaviour Trailblazer Comprehensive Health Impact
Assessment
Integrated Rapid Health Impact Assessment and Race Impact Assessment of theReconfiguration of Women’s and Children’s Health Services in N.W. England
Desk-Based Health Impact Assessment of the Residential Relocation Core Documentfor Liverpool

Differences between HIA and EA• Backgrounds, perspectives and aims

• Different approaches• Skills & understanding• Overcoming differences