Workshop 4
Chair: Mary Mahoney
Health Impact Assessment: Making the Difference
Ashley GouldPolicy Officer (Health Improvement)
Applying HIA in Local Government:
Exploring the Reality
Grace BlauResearch Fellow
School of Health & Social Development
31
Introduction - WLGA
• Represents the interests of local government and promotes local democracy in Wales.
• Promote better local government & support authorities in the development of policies and practices which will improve public services.
• Policy development and representative roles plus improvement and development, procurement, employment issues and health improvement.
• Dedicated Health & Well-being Team
• Local HSCWB Strategies (employing HIA!)
• Recognise, maximise, promote – LA’s as Health Improvement agencies
• Briefings, networks, events & sessions
• Launched HIA guidance with WHIASU in ‘04
• The Route to Health Improvement
Health Improvement Context
HIA in ‘The Route toHealth Improvement’
• Policy Development (1 of the 5 key features)– Setting the vision
▪A Council that develops policy that maximises the positive health impact of services will have the following features:
“Health Impact Assessment…is used on a regular basis as part of
policy and decision making processes”
• Deakin University, School of Health & Social Development, Melbourne (Australia)– Strategic promotion of HIA– Teaching– Research
▪HIA in local government project– Application of HIA
Introduction - HIA Unit
Focus of my role
• Since October 2004– Research– Capacity building– Teaching– Application
• Past experience– Health care services– Local government public health planning
So, does local government ‘do’ health ?
Local government is best placed to change life circumstances and improve health
50%
Social & economic environment
15%
Genetic endowment
10%
Physical Environment
25%
Illness Care System
Source: Canadian Institute for a Advanced Research
Estimated Health Impact of ‘Determinants Of Health’ on Population Health Status
An individuals life circumstances contribute more to health
improvement than health care services
…Absolutely!
Four aspects of the reality of HIA in local government
Why HIA at the local level
How HIA at the local level
Drivers/broader agenda
Organisational context
That’s us – who are you?
AND
Why do you think local government should use HIA?
1.Social networks and the scale of operations within communities are such that the ties between policy makers and those affected are stronger
2.Policy makers live where they work so are identifiable and affected by their own policies
3.The bureaucracies of communities are relatively small and there is a greater chance of inter-sectoral cooperation
Hancock’s rationale for using HIA in LG
The Workshop Bit – sharing your experiences
Drivers/broader agenda
Organisational context
Workshop Task 1
• From your experience in your organisation identify CONTEXTUAL FEATURES IN YOUR ORGANISATION that could – create barriers to positioning or applying HIA – enable the positioning or application of HIA
• As a group, decide if there are there any generic features that are common to many organisations. Rank the features…
Workshop Task 2
• From your experience in your local region or your country identify EXTERNAL DRIVERS or AGENDAS that could – create barriers to positioning or applying HIA – enable the positioning or application of HIA
• Write these on sticky note paper and place on wall – clearly label BARRIER or ENABLER
Examples of ‘how’ in Welsh LG
• School Health Review - Pembrokeshire
• Screening linked to LA ‘Quality of Life’ checklist
– against a proposal of NO school health service
• Two ‘rapid assessment’ workshops
– against 11 aims for a reshaped service
• Systematic gathering of evidence to inform decision on reshaping service
Examples of ‘how’ in Welsh LG
• Highways Maintenance Policy Wrexham CBC– Policy being re-drafting/HIA profile raiser– Police, community reps, disability groups and insurers– driven monthly > walked weekly– More sharing of data to inform policy
• Maesincla Integrated Children’s Centre– Community engagement ‘vehicle’ – Parents, consultants, LA officers and community reps – Renamed by community and daily timetable changed– Report on www.WHIASU.cf.ac.uk
Examples from Victoria
• HIA of Family Violence Strategy– HIA identified increased perceptions of fear
amongst community because strategy raised awareness of incidence of family violence
• HIA of Drought Social Recovery Strategy– Currently impact identification stage– Consecutive short term funding for rural
counselling services may have increased mental health problems
Examples from you!
???
So, what’s changed as a result of the HIA?
Workshop Task 3
• When you leave this workshop today what action do YOU plan to take that will
– reduce the barriers to the positioning or application of HIA in your organisation?
– take advantage of the enablers?
Whys & Hows Drivers &
Contexts
Ashley [email protected]
Applying HIA in Local Government:
Exploring the Reality
Grace [email protected]
Inclusive decisions > ownership
Exploration of what’s
already known
Focuses on the ‘better life’ contribution
Achieve ‘healthier’ results
Structured yet flexible
Community development
Evaluation & shared learning
Open process > justifiable results
cynicism = resistanceraising unrealistic expectationsresource (time & £) constraints
“used” to support controversial issues
A Few disadvantages or weaknesses:
7th International Health Impact Assessment
Conference
Health Impact Assessment: Making the Difference
Supported by: