Health Impact Assessment

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Health Impact Assessment

• Health Impact Assessment ColloquiumBondi, 9th
  December 2005
• Prof Mark Harris
• Executive DirectorCentre for Primary Health Care
  and EquityUniversity of New South Wales

The Centre for Health Equity Training, Research
and Evaluation (CHETRE) is part of the Centre for
Primary Health Care and Equity
Centre for Health Equity Training, Research
Evaluation
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What are impacts?

• Both positive and negative changes in a community
  that are attributable to a policy, program or
  project.

chetre.med.unsw.edu.au
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Where does health come in?
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.
chetre.med.unsw.edu.au
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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)

chetre.med.unsw.edu.au
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When is it used?
1
2
3
Needs Assessment
Planning
Draft Proposal
4a
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HIA
Screening
4b
5
6
Revised Proposal
Implementation
Monitoring
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Evaluation
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.
chetre.med.unsw.edu.au
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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

chetre.med.unsw.edu.au
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Six steps of HIA

• Screening
• Scoping
• Identification of potential health impacts
• Assessment of potential health impacts
  (appraisal)
• Negotiation decision-making (recommendations)
• Monitoring evaluation

chetre.med.unsw.edu.au
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Assessment and recommendations
Assessment
Recommendations
If you implement the proposal
These will be the impacts
If you make these changes
These will be the gains
chetre.med.unsw.edu.au
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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

chetre.med.unsw.edu.au
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What weve doneNSW HIA Project Phase 1

• 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

chetre.med.unsw.edu.au
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What weve doneNSW HIA Project Phase 2

• 5 Developmental Sites
• Undertook HIAs on health proposals (except one)
• CHETRE training support
• Strategic Engagement
• Communication
• HIA E-News ongoing
• HIA Connect website

chetre.med.unsw.edu.au
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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

chetre.med.unsw.edu.au
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What were doingPhase 3 developmental sites

• Were supporting 6 developmental sites in 2005
• Bigger proposals
• Predominantly intersectoral

chetre.med.unsw.edu.au
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Whats next?NSW HIA Project Phase 3

• 2006 Developmental sites
• Liaison
• Manual
• Masters-level subject
• Electronic Resources

chetre.med.unsw.edu.au
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More Information

• HIA Connect
• http//chetre.med.unsw.edu.au/hia

chetre.med.unsw.edu.au
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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

chetre.med.unsw.edu.au