What is a health impact assessment?
A health impact assessment (HIA) is a combination of tools that can predict health consequences of a policy, strategy, programme or project (referred to as activities) and identify ways of enhancing the positive impacts whilst reducing the negative ones.
Why do one?
Activities where health care is not the main focus can still have major implications for the health and wellbeing of individuals and communities. Consequently they are conducted to identify and estimate the impact of an activity on the health of a defined population. These impacts can be positive or negative, intended or not, single or cumulative, and they might not be evenly distributed across the population. This potential for uneven differences, or health inequality is often overlooked and HIAs are an effective way of identifying them.
Additionally HIAs help promote public health partnerships and encourage stakeholders to gather evidence that shows how an intervention can improve public health. Direct cause-effect relationships between a particular intervention and a specific health outcome are hard to prove so practitioners tend to rely on qualitative information, along with anecdotal evidence and subjective assessment when conducting a HIA.
Our Tool kit
HIA’s tend to follow a common five step process
- screening
- scoping
- appraisal
- producing a report
- implementing recommendations
As long as these steps are followed, the assessments can be tailored to suit particular needs.
Working with the primary care trust we made use of this flexibility and devised a toolkit for HIA’s. Rather than using one model we opted to pick features from a variety of models to define three types of HIA
- basic – policy reviews, initial thoughts on a new proposal
- advanced – service reviews, particular activities about which there is an existing body of research and readily accessible data
- comprehensive – large schemes where a greater element of original research is required.
The toolkit uses a narrative and a series of worksheets, which guide the user through each of the 5 steps . It is designed to be simple enough to be used by people who have little or no previous experience of HIA’s whilst being robust enough to produce meaningful evidence of an activities impact on health.
Practical application
The toolkit has already been used to under take HIAs of several activities. It is a living document in that we are learning each time we use it and updating the toolkit based on these experiences. The subsequent reports and the toolkit itself are available to download from this page.