Day 4 Session 3:

Health Impact Assessment (HIA)

Kate Saffin May 2009

Based on a presentation prepared byDave Jenner (EMPHO)

Adapted from Material provided by:Andrew Pratt (Plymouth PCT)

Neil Bendel (Manchester Joint Health Unit)John Kemm (WMPHO)

This session will cover:

• key features

• case-study

• how to find out more

Welcome to the world of impact assessment!

• Environmental Impact Assessment• Strategic Environmental Assessment• Sustainability Appraisals• Equality Impact Assessment• Integrated Impact assessment• Health Impact Assessment

HIA is…

…a combination of procedures, methods & tools

…that systematically judges the potential, & sometimes unintended, effects of a policy, programme or project

… on both the health of a population, & the distribution of those effects within the population

…HIA identifies appropriate actions to manage those effects

International Association for Impact Assessment 2006

NOT statutory but widely advocated

• (Acheson) Inequalities in Health (1998)• Our Healthier Nation (DH 1999)• Article 152, EU Amsterdam Treaty (1999)• DH & NRU guidance (2002)• Securing Health (Wanless, Treasury, 2004)• Choosing Health (DH 2004)• Council for Science and Technology 2006

http://www.nice.org.uk/niceMedia/documents/clarifying_approaches.pdf

Assessing the impact of ahealth intervention

Prospective = HIA

Concurrent = Monitoring

Retrospective = Evaluation

Applications of HIA

• new urban housing scheme• proposed waste incinerator• new casino in Manchester• hospital vending machines policy• third runway at Heathrow• motorway widening• leisure centre charging policy• home energy efficiency scheme

Health Impact Assessment - Key FeaturesHealth Impact Assessment - Key Features

1. List all the aspects of the proposal that are likely to have an impact on the health of the population

2. Decide whether the identified impacts are positive (+) or negative (-), i.e. are they likely to make people’s health better or worse?

3. Identify when this impact is likely to occur, i.e. in the short, medium or long term?

4. Decide how certain you are that the impact will occur, i.e. is it definite, probable or speculative?

5. Note likely differential impacts on different groups (e.g. women, children, elderly people, BME communities, etc.)

6. identifying recommendations for maximising the positive and minimising the negative health impacts of the proposal.

HIA of a Home Energy Efficiency Scheme

Intermediate Factor Health Impact

Warmer house Excess winter deaths Asthma, cough, wheeze Mental health

Make heating systems safe CO poison deaths Burns & fire

More disposable income Spend on food & clothes Spend on cigarettes & drink Self esteem & Mental health

Improved security Fear of crime Mental health

Surveillance network Contact with services

Work for local business Viability of local business

Reduce CO2 emissions Global warming

Case-study: redevelopment of social housing

• Devonport in Plymouth c5000 people• temporary ‘decanting’ of residents• rebuilding 448 dwellings

• What might be the key issues?

The HIA Gateway site is at www.apho.org.uk