Health Impact Assessment (HIA)

Definition
Rationale
HIA in Practice
Useful Resources

Definition

Health Impact Assessment (HIA) is a practical tool, which allows for evaluating the health impact of policies, strategies and initiatives in sectors that indirectly affect health, such as transportation, employment and the environment.

The overall goal of HIA is to inform decision-makers of adverse health effects of proposed actions, and support identification of appropriate policy options. (Source)

Rationale

The application of HIA is based on the recognition that health is determined by actions within a broad range of policy areas, including education, housing, employment etc. The objective of HIA is therefore to examine variations in these health determinants as consequences of proposed policy or practical initiatives, and thereby consider the impact on health. HIA is an important tool in tackling health inequalities given its capacity to map and make transparent the effect of an initiative on different social groups.

The purpose of HIA is both to prevent unintended consequences, and also to reinforce positive health outcomes of decisions, made in the spectrum of policy areas. The HIA is strongly reliant on inter-sectoral collaboration, both across various sectors, but also across policy making and practice. (Source)

HIA in Practice

Health Impact Assessment is a prospective tool, which can be used to adapt proposals prior to their implementation. It is a multistep process - as indicated below -, of which the first stage is a preliminary screening of the proposed action and the immediately apparent health implications. The second stage is a scoping exercise, which brings together relevant actors and defines the exact nature of the assessment. Based on the agreed scope, an assessment is conducted, often with use of multiple data collection methods.

The results from this multifaceted assessment feed into an overall impact analysis, which outlines the impact scenarios of the initiative, and accordingly, presents policy options with positive effects on health. After launch, implementation is monitored with respect to defined indicators, which allows for precise evaluation of the impacts and outcomes. (Source)

HIA is widely used in the EU context, and has supported major policy initiatives such as the European Employment Strategy. (Source)

Schematic Representation of the European Policy Health Impact Assessment (EPHIA)

Source: European Policy Health Impact Assessment (EPHIA) - The Guide, ISBN 1-874038-75-9 (2004)

Useful Resources

• Website by DG SANCO, European Commission, on the impact of health policies. Includes Commission's Impact Assessment Guidelines, HIA Guide, Health Systems Impact Assessment (HSIM), Guidance on assessing social impact and an overview of projects on HIA.
  http://ec.europa.eu/health/health_policies/impact/index_en.htm

• Website by WHO on Health Impact Assessment (HIA)
  http://www.who.int/hia/en/

• European Policy Health Impact Assessment (EPHIA) - The Guide, ISBN 1-874038-75-9 (2004)
  http://ec.europa.eu/health/ph_projects/2001/monitoring/fp_monitoring_2001_a6_frep_11_en.pdf

• Website by Department of Health (UK) on Health Impact Assessment. Including HIA Tools, HIA Guides, HIA reports, and more
  http://www.dh.gov.uk/en/Publicationsandstatistics/Legislation/Healthassessment/index.htm