Health Impact Assessment

Health Impact Assessment ColloquiumBondi, 9th December 2005

Prof Mark Harris

Executive DirectorCentre for Primary Health Care and Equity*

University of New South Wales

Centre for Health EquityTraining, Research & Evaluation

* The Centre for Health Equity Training, Research and Evaluation (CHETRE) is part of the Centre for Primary Health Care and Equity

What are impacts?

Both positive and negative changes in a community that are

attributable to a policy, program or project.

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Where does health come in?

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Source: Dahlgren G, Whitehead M. Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute of Futures Studies, 1991; cited in Acheson D, 1998.

What is HIA?

A combination of procedures, methods and tools by which a policy, program or project may be assessed for its potential, and often unanticipated, effects on the health of the population and the distribution of these impacts within the population.

(ECHP, Mahoney & Morgan)

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When is it used?

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Needs Assessment

Planning DraftProposal

HIA

Revised Proposal

Implementation Monitoring

Evaluation

1 2 3

4b 5 6

7

Screening4a 4

Adapted from: Simpson S, Harris E & Harris-Roxas B (2003)Health Impact Assessment: An introduction to the what, why and how, Health Promotion Journal of Australia, 15(2): 162-167.

Key features of HIA

• Prediction

• Combination of methods

• Policy, program or project

• Positive & negative

• Unintended & intended effects

• Distribution of effects

• Solution focused

• Promote & protect health

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Six steps of HIA

1. Screening

2. Scoping

3. Identification of potential health impacts

4. Assessment of potential health impacts (appraisal)

5. Negotiation & decision-making (recommendations)

6. Monitoring & evaluation chetre.med.unsw.edu.au

Assessment and recommendations

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If you implement

the proposal

These will be the

impacts

If you make these

changes

These will be the gains

Assessment Recommendations

Does it Work?

• What constitutes effectiveness?– Changes to decisions?– Changes to health outcomes?

• Monitoring

• Need for further evaluation

• Examples of effective use:– Finningley Airport HIA– CCDPHA HIA

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• 2 x one day workshops with range of NSW Health staff– Introduction to HIA– Exploring pros & cons of HIA

• Review of literature

• Establishment of HIA eNews

What we’ve doneNSW HIA Project Phase 1

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• 5 Developmental Sites– Undertook HIAs on health

proposals (except one)– CHETRE training & support

• Strategic Engagement

• Communication– HIA E-News ongoing– HIA Connect website

What we’ve doneNSW HIA Project Phase 2

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Related work

• Equity-focused Health Impact Assessment (EFHIA)– Consortium with Deakin and

Newcastle Universities– Framework produced

• Discussion Paper on Impact Assessment for NSW Health Futures Planning

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What we’re doingPhase 3 developmental sites

• We’re supporting 6 developmental sites in 2005– Bigger proposals– Predominantly intersectoral

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What’s next?NSW HIA Project Phase 3

1. 2006 Developmental sites

2. Liaison

3. Manual

4. Masters-level subject

5. Electronic Resources

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More Information

HIA Connecthttp://chetre.med.unsw.edu.au/hia

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Good intentions are not always enough

The road to hell is paved with good intentions

HIA helps identify the health impacts from unintended outcomes of a proposal