A Guide to Health Impact Assessment - 2nd Edition

HIA is defined as a formal way to predict the potential effects of policies on health, wellbeing and equity. It is used to help facilitate better policy-making based on evidence, focused on outcomes and encouraging collaboration between sectors and stakeholders. The publication defines “health” using the “Whare Tapa Wha” model which includes physical, mental, spiritual and family/community aspects of health and wellbeing.

HIA is based on the recognition that the health status of people and communities is greatly influenced by factors lying outside the health sector, for example in areas such as housing or transport. For instance, it is noted that if HIA had been applied to the introduction of market rates to state housing rentals in the 1990s, it may have highlighted implications for health resulting from overcrowding, strongly associated with infectious diseases such as meningococcal disease.

However, HIA does not aim to make health and wellbeing paramount considerations over economic or environmental concerns. Rather, it enriches the policy-making process, providing a broader base of information to make trade-offs between objectives where necessary, and makes explicit the health implications of those trade-offs.

A Guide to Health Impact Assessment sets out four stages and two appraisal tools for HIA. Guidance is provided on how to apply the tools. The PHAC intends the publication to be used by policy-makers in central and local governments and encourages users to adapt and refine the tools as they apply them, and to give feedback so it can be enhanced over time.

The four key stages of Health Impact Assessment are identified: (a) screening – the initial selection process to assess a policy’s suitability for HIA; (b) scoping – highlighting the key issues needing to be considered to define and shape the HIA; (c) appraisal and reporting – identifying the relevant determinants of health and using specific tools to identify potential health impacts then assessing the significance of these impacts and drawing out practical changes to the policy; (d) evaluation – assessing how the process was undertaken and the extent to which the recommendations were taken up by the policy-makers.

In addition, the publication is also a practical guide in exactly what HIA is, why it should be carried out and who should carry it out.