A health impact assessment (HIA) is the estimation of the overall effects of a specified action on the health of a defined population. It is an approach that ensures that decision making at all levels consider the potential impacts of policies, programmes or a project on health and health inequalities. It identifies actions that can enhance positive effects and reduce or eliminate negative effects. Examples of HIA include looking at the impact of a new motorway in a city, effects of waste management, economic development, as well as the impacts of noise and air quality from traffic or new housing or commerical ventures. Health impact assessments are gaining popularity both within the UK and internationally. It is a new tool and although there is no single agreed national approach or methodology, there is general consensus on its key elements.
1. To assess the potenial health impacts, both positive and negative of projects.
2. To improve the quality of public policy decisions by making recommendations that are likely to enhance predicted positive health impacts and minimize negative ones.
1. It focuses on social and environmental justice
2. It involves a multi-disciplinary, participatory approach
3. It involves positive encouragement of public participation in the debate about public health issues
4. It can bring public health issues into the foreground when organisations and parties are making decisions and policies
HIA is based on four values:
1. Democracy
2. Equity
3. Sustainable development (i.e. development that meets the needs of the present without damaging the health or environment of future generations)
4. Ethical use of evidence
1. Screening
2. Scoping - with multidisciplinary steering group and negotiating favoured options
3. Appraisal
4. Recommendations
5. Implementation
6. Monitoring and evaluation
Screening
Select and analyse policies, programmes or projects for assessment.
Profile the selected population - who is likely to be affected and their characteristics
Scoping
Identify the potential health impacts by getting the information from the range of people who have an interest in the policy
Appraisal
Evaluate the importance, scale and likelihood of the potential impacts (analysis is similar to decision analysis)
Recommendations
Report on the impacts and make recommendations for managing the impacts
For further reading, see WHO Health Impact Assessment page