Transcript An Introduction to Health Impact Assessment London Health Observatory Anna Boltong HIA & Network Facilitation Manager.

An Introduction to Health Impact
Assessment
London Health Observatory
Anna Boltong
HIA & Network Facilitation Manager
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About the LHO
Work in partnership with the London Health
Commission and others to monitor and interpret
information on health and Health Inequalities in London
Provide answers to questions on information and data
available about health in London that can't be answered
locally
Promote HIA as a tool for embedding health
into local and pan-London policy and practice.
Lead Observatory for co-ordinating national input on
health inequalities, regeneration and
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social exclusion.
AIM:
• To increase participants’ knowledge and awareness of HIA
and its uses
OUTCOMES:
By the end of the course, participants will have:
• A brief overview of the policy context of HIA
• An understanding of the principles and rationale that
underpin the HIA processes
• An understanding of the stages involved in carrying out an
HIA
• Knowledge of how to access what further support and
resources are needed in order to take HIA forward
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What is Health Impact Assessment
(HIA)?
“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 population”
Gothenburg consensus
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International, national & local interest

Article 152 Amsterdam Treaty

“Independent Inquiry into Inequalities in Health”
chaired by Sir Donald Acheson

Saving Lives: Our Healthy Nation

Neighbourhood Renewal Strategy (LSP’s)

Modernising Government (Cabinet Office)

Health Development Agency

London Health Commission
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Understanding what HIA is trying to
achieve
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
Encourage/persuade those who make
decisions to consider and take into
account any effects on health their
decision may have

Enhance the positive impacts of any
decision

Reduce (or eliminate) the negative
impacts of any decision
What is HIA for?

To support and improve evidence based
decision-making, contributing to
improvements in health and reduction in
health inequalities

It is important to acknowledge that HIA
can make an important contribution to
decision making but does not replace it
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What are the principles underlying
HIA?
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
Democracy

Openness & transparency

Equity

Sustainable development

Ethical use of evidence

Addressing health inequalities
A wider model of health
Living and working
conditions
Work
environment
Unemployment
Water &
sanitation
Education
Health
care
services
Agriculture
and food
production
Housing
Age, sex and
constitutional
factors
Source:
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Dahlgren and Whitehead, 1991
The key HIA output
A set of evidence based
recommendations
Specifically designed to influence
the decision-makers
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Identifying key decision points
Identifying and considering where the
key decision points are is critical before
deciding on when (& what) HIA to undertake
Retrospective
Concurrent
Prospective
HIA
start
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

HIA
HIA
Key
decision
point - 2
Key
decision
point - 1
during
proposal time line
Key
decision
point - 3
end
HIA - Core Elements
Stage 1
SCREENING
Policies/programmes/projects
Stage 2
SCOPING
Stage 3
APPRAISAL:
Identifying, examining &
considering different evidence
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Should an HIA be undertaken? ie:
is there a clear value to doing it?
(Not just in terms of health but also the ability
to influence the decision making process)
Agreeing how best to undertake
(for greatest potential influence on the
decision-making process)
Ensuring different types of
evidence are effectively identified
and considered through a process
that engages stakeholders
HIA core elements (cont.)
Stage 4
Formulating / Prioritising
Specifically designed to inform
& influence the decision-makers
RECOMMENDATIONS
Stage 5
Further engagement
with the decisionmakers
Help to reinforce the value of
the evidence-based
recommendations & encourage
them to adapt the proposal
Stage 6
MONITORING &
EVALUATION
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To assess if the adoption did
occur and if they contributed to
positive effects on health
& equity
Types of HIA

Rapid – brief investigation of the health
impacts of a proposal (days)

Intermediate – a more detailed
investigation of health impacts (weeks)

Comprehensive – an intensive
investigation of health impacts (months)
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Mayor of London strategies

Rapid prospective HIA of the draft transport
strategy

GLA Act – obliges mayor to consider health
inequalities & sustainability therefore agreed
draft strategies to be assessed for health impacts

Participatory workshop

Appraisal of congestion charging

Recommendations fed back into drafting process

Two audits of change to assess impact on policy
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Significant changes

Promoting sustainable travel plans for schools
and workplaces

Priority for infrastructure and services that
benefit deprived communities

Promotion of walking and cycling

A commitment to track the health impacts of the
final strategy and its implementation

Increased policy maker’s understanding of the
determinants of health
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Neighbourhood Renewal

Screen first – process itself may be
adequate. Many tools, one specifically
designed for Lambeth

Scoping – sets parameters – who, where,
how long, then what?

Appraisal – incl. community participation,
graffiti wall

Recommendations
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Lessons learnt

Need to have policy makers on board from the beginning
and to be able to demonstrate to people that it is worth
getting involved;

Be willing to seek to give voice and value to those who
are potentially affected by the proposed policy or
programme;

Realistic timescales – this work takes time and resources;

Payment of ‘volunteers’ has to be worked through at the
beginning;

Better to focus on smaller number of projects and to base
community participation on these as it makes it more real
for the community;

Open and transparent process which recognizes it is a
two way learning process, integrity crucial;
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Lessons learnt

Sending drafts out for approval builds trust and
shares responsibility

Develops a sustainable partnership with the
communities involved – be clear how the work
will go forward

Use creative, well resourced methodologies

Recognise and value diversity

Balance bottom up / top down standpoints

Has to be seen to deliver a difference which
means something to the communities who have
participated
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Contact Details
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
Anna Boltong

[email protected]

www.lho.org.uk

020 7307 2819

for courses: 020 7307 2835 or
[email protected]
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