HIA introduction - WHO website, www.who.int/hia

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					Health impact assessment

          World Health Organization
Health Impact Assessment

 A combination of procedures, methods
 and tools by which a policy, programme or
 project may be judged as to its potential
 effects on the health of a population, and
 the distribution of those effects within the

 WHO, European Centre for Health Policy. Gothenburg Consensus Paper,
 Health Impact Assessment- main concepts and suggested approach.
 Brussels, 1999.

                                  World Health Organization
          Why use HIA?
We have to think about the effects policies
 have on health, and in particular, how
 they can alter the health of all people in
 the population. Non-health sector
 proposals, where health is not the main
 objective, may have major effects on the
 health and well-being of people,
 particularly vulnerable groups.

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           HIA explained

• HIA is an approach that gets people to think
  about what they are doing, and how it may alter
  people’s health. It promotes health – and in the
  long term contributes to the health of local

• Imagine someone was planning to build a new
  motorway. An HIA would answer ‘How would
  this new development affect people’s health?’
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     An HIA would ask….
• Would the motorway increase or decrease
  noise, air or light pollution?
• How would the motorway affect local
  businesses and jobs?
• Would the new motorway reduce or
  increase the stress for local people?
• How would a new motorway change the
  local infrastructure needs - and would this
  be good or bad for local people?
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The purpose/function of HIA is

•   Inform and influence the decision maker
•   Help address inequalities in health.
•   Promote joined-up working.
•   Place public health on the agenda
•   Reduce conflict between stakeholders
•   Encourage sustainable development

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          HIA does this by:
• Using a broad understanding of health.
• Using a participatory approach that considers which
  stakeholders need to be involved
• Helping involve local people in decisions and responding
  to their concerns about health.
• Considering different types of evidence - from local
  views to scientific information.
• Assessing how the proposal will affect all members of
  the community – particularly the most vulnerable.
• Assisting with sustainable development by considering
  short and long term impacts.
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   Many factors impact on
        your health

• the social and economic environment
• the physical environment
• and the person’s individual characteristics and
For example, income and social status - higher income and
  social status are linked to better health. The greater the
  gap between the richest and poorest people, the greater
  the differences in health.
For example, education – low education levels are linked
  with poor health, more stress and lower self-confidence.
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What international policies
       support HIA?
• Article 152 of the Amsterdam Treaty - the European Union
  (EU) should examine the possible impact of major policies on
• The new Strategic Environmental Assessment protocol -
  places a special emphasis on the consideration of human health for
• 1997 Organisation of African Unity Harare Declaration on
  Malaria Prevention and Control in the Context of African
  Economic Recovery and Development - included calls for EIA
  and HIA of all new developments in Africa.
• Health21 – The health for all policy framework - outlines
  strategies to ensure the use of health impact assessment in Europe.
                              World Health Organization
What international policies
       support HIA?

• The Strategic Environmental Directive -adopted by
  the European Commission to ensure that environmental
  consequences of certain plans and programmes are
  identified and assessed during their preparation and
  before their adoption.
• Environmental impact assessment - a statutory
  requirement in many countries. Similar to HIA, EIA
  explores the effect of policies, programmes and projects
  on the environment.

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          When is an HIA

• Before implementation (prospective)              - to
 allow steps to be taken to change a proposal at the
 planning stage.

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              Steps in HIA

• Identifying if an HIA should occur (screening) -
  systematically deciding if an HIA necessary.
• Identifying what to do and how to do it
  (scoping) - reviewing the issue in more detail, setting
  the boundaries for the HIA, and considering how the
  HIA appraisal stage should be undertaken
• Identifying health hazards and considering
  evidence of impact - considering a range of evidence
  between the determinants of health and key elements of
  the proposal.
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             Steps in HIA
• Developing recommendations to reduce hazards
  and/or improve of health - set of recommended
  changes to the proposal to the decision makers.
• Evaluation and monitoring:
  • whether the HIA has influenced the decision making
    process (and the subsequent proposal);
  • monitoring the implementation of the proposal to
    ensure that any recommendations that decision-
    makers agreed to, actually occur;
  • longer term monitoring of the health of populations is
    sometimes a component of larger proposals.
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HIA tools and guidance

  Many different toolkits are
available, as are basic guides
 to carrying out HIA. Find all
  these at: www.who.int/hia

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Some examples of where
  HIA has been used.

• Building a new road near residential areas.
• The local village school policy to implement
  safer routes to school.
• Building an out-of-town shopping centre.
• Increasing runway & passenger capacity at
  an airport.
• Changing the fuel used in a cement kiln.
• Assessing the common agricultural policy.
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    Where to from here?

Many examples of HIA are available on
  www.who.int/hia website. The site also
  provides information:
• About HIA
• Tools and methods to do HIA
• How HIA contributes to policy making
• The evidence used in HIA
• HIA related links and networks.
                   World Health Organization

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