Health Impact Assessment – what is it and why do one? : Earth Matters

Health impact assessment is a systematic process that evaluates the potential positive and negative impacts that a proposal may have on a community and examines who is most likely to be affected (equity aspect). An HIA can be done during proposal development (prospective) or used to assess the implementation of an existing initiative or concern (retrospective). It can be used to review an initiative (policy, procedure, process, program, project) or to address a concern.

Why do an HIA?

There are many reasons to do an HIA. When done well, an HIA builds trust among the different parties affected and increases acceptance of a proposal by the community and people who are affected. An HIA:

Identifies community concerns and generates a dialogue about how the proposal benefits the community
Helps people affected understand the trade-offs between community health and wellbeing and other economic, environmental and social objectives
Helps overcome community resistance and speed up approval process and reduce costs
Contributes to employee morale, project sustainability and the social licence to operate

What is involved?

There is no one approach to conducting an HIA. Many frameworks have been developed which identify the following stages:

Screening: An initial rapid review to decide if a health impact assessment is needed.
Scoping: A review of environmental, social and other factors that might have an impact on health and the selection of factors of most concern to be studied in more detail.
Assessment: A detailed assessment of the factors identified in the scoping phase.
Reporting: A report of the findings, including recommendations to reduce negative impacts and enhance positive ones.
Monitoring and evaluation: This involves an assessment of the HIA process itself as well as monitoring the implementation of the proposal and HIA recommendations over a longer term.

Assessments come in all sizes and degree of complexity. For example:

Desktop: An assessment that is based on the available published literature. Typically, a desktop assessment will not include stakeholder or public engagement, though it may include an external review and/or key informant interviews.
Rapid: Done in a short period of time – usually less than a month – it can be a desktop assessment, a workshop that involves stakeholders and/or experts, or a mix of the two.
In-depth or comprehensive: Such assessments are usually undertaken only for major proposals or proposals that may have large unanticipated impacts on the community. They often involve collecting project-specific data, modelling, data analysis and include stakeholder and public engagement in the scoping, assessment and recommendation phase.
Integrated: An HIA that is part of an environmental assessment provides a health lens or perspective on its findings.

Do I need to do an HIA?

If the answer to any of the questions below is yes, an HIA is a useful tool to identify ways your proposal could be improved and to increase community and stakeholder acceptance.

Will the proposal create a major change in the community?
Has the community voiced concern about impacts of the proposal on their health?
Is the proposal likely to have a disproportionate impact on a vulnerable population?
Is there strong opposition to the proposal in the community?
Are there divergent views in the community about the benefits of the proposal?
Will the proposal require an environmental assessment or approval?
Does the proposal include a new or unfamiliar technology or process?