What is health impact assessment?
Health Impact Assessment (HIA) is a process which aims to identify and examine both the positive and negative health impacts of a new activity during its planning stages and provide decision makers with information about how these activities may affect the health of people. There is potential for the proposal to be improved if decision makers can be influenced through HIA outcomes.
Many activities may have unintended and unanticipated health impacts which may be good or bad for people’s health. For example, a new central retail development may bring employment but cause small local shops to close or result in reduced access to retail outlets for people with limited options for transport. It’s important that potential impacts are identified during early planning stages in order to enhance the benefits for health and minimise any risks to health.
HIA can be implemented on a range of activities including:
- proposal
- project
- plan
- programme
- policy
- operation
- undertaking or
- development.
HIA is usually forward or future looking, done at a time when it is possible to change the proposal if necessary. |
Community engagement
It is important that people have opportunities to participate in the consultation for activities that may impact on their lives, and to reach agreement with proponents about possible outcomes.
Individual physiological variation or behaviour can account for some health differences – but for many the opportunity for a healthy life is linked to social disadvantage. Consultation should examine how the proposal will affect the health of vulnerable people in terms of age, gender, ethnic background, socio-economic status or other positions of susceptibility. These vulnerable groups, where there is the potential for them to be affected, should be encouraged to participate in consultative processes.
Refer to the community consultation webpage for resources to assist with community consultation.
Why do a HIA?
Developers, planners, services providers and policy makers involved in new activities that involve people should consider the possible human health impacts of their proposals in Western Australia and think about the possible wider effects of their proposals.
Benefits of HIA
Introduces the concept of “better planning, better services”
Better understanding of health issues among decision makers allowing them to make decisions that are better for health
Greater openness and involvement of the public in decisions that affect them
Better co-operation between different agencies
Better understanding of health issues in the community
Remember: HIA is not only about mitigating risks, it should also enhance the positive effects of a wide range of policies and actions.
HIA can enhance the positive effects of a wide range of policies and actions. |
When should HIA be applied?
Potential proposals on which a HIA may be carried out are wide ranging and may be small or large. The HIA process can be used to generate debate and assess the potential impact on:
New or reconfigured services, e.g. extended schools, new supermarket opening, swimming pool closure, industrial expansions and new or existing health services.
- Planning or development proposals, e.g. mining or resource developments, the location of a casino, sporting facility or fast food outlet, new residential estate, wind farm development, and cultural initiatives.
Specific projects or programmes, e.g. Aboriginal training and employment programs, health-promoting schools, parenting skills support program
Policy implementation, e.g. reuse of treated wastewater, tobacco control, workplace health, school meals, and anti-social behaviour orders.
Strategy development, e.g. economic strategy, transport plans, community strategy, and obesity strategy.
- Major strategic plans in a locality or region.
What are the outputs and outcomes of doing a HIA?
The main output of a HIA is to develop a “set of evidence based recommendations” specifically designed to influence decision makers in Government, planners, developers, funders and those delivering proposals.
These recommendations are specifically designed to maximise potential positive impacts to health and minimise potential negative impacts.
The main outcomes of the proposal is of course improved health and wellness for current and future communities.
Process |
Output |
Impact |
Outcome |
Health Impact Assessment undertaken with stakeholders |
Set of evidence based recommendations agreed |
Improvements made to proposal (which maximise the positive impacts it has on community health and wellbeing and minimise the negative) |
Improved health and well-being (and/or its determinants) |
The main objective of a HIA is better health and wellness outcomes for current and future communities. |
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Why are “evidence based” recommendations important in HIA?
It is important when making an assessment to have relevant and credible information and evidence. The type and quality of evidence varies with the level of assessment. There are generally three types of evidence used in HIAs:
- Community profiling - What is the current status of the affected population and the local environment?
Literature review – e.g. published studies, books, local case studies
Stakeholder and key informant – public health consultation
What types of health determinants do you need to consider?
A HIA considers a range of determinants of health, as shown in the Figure below.
Download the Determinants of health table (word 40KB)
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What framework do you follow when implementing a HIA and are there resources available to help with implementation?
As well as ensuring that community engagement occurs throughout all components, there are seven stages of completing a HIA. The profiling stage can occur during the screening and scoping stages. Resources have been developed to assist with each stage of the process.
Stage |
What is it? |
Stage 1: Screening |
Should the project be subject to HIA? |
Stage 2: Scoping |
What issues must be addressed in the HIA? |
Stage 3: Profiling |
What is the current status of the affected population and the local environment? |
Stage 4: Risk Assessment |
What are the risks and the benefits? Who will be affected? |
Stage 5: Risk Management
|
Can the risks be avoided or minimised? Are better alternatives available? How can benefits and risks be evaluated and compared? How can differing perceptions of cost and benefit, nature and magnitude be mediated? Will predictions of future health risks be robust enough to withstand legal and public scrutiny? |
Stage 6: Implementation and Decision Making |
Does the assessment provide sufficient, valid and reliable information for decision-making? Is there a conflict to be resolved? How will conditions be enforced? How and by whom will impacts be monitored? How will post-project management be resourced? |
Stage 7: Evaluation |
Is the project complying with its conditions? How well is the HIA process as a whole achieving its aims of protecting health and the environment? |
For the history of HIA in Western Australia refer to:
These documents outline the potential for HIA to be integrated into current developmental approvals processes for environmental assessments, state and regional planning, Local Government decision making and State Government policies and programmes.
WA Health received almost 50 formal submissions from Government Agencies, Local Governments, interest groups including Non Government Organisations and members of the public. Majority of the respondents were supportive of the introduction of a formalised HIA process in WA.
For further information on HIA contact the Science and Policy Unit of the Environmental Health Directorate on (08) 9388 4999 or email ehinfo@health.wa.gov.au
Publications and resources
Refer to the Publications - useful tools and resources webpage for a list of HIA planinng tools.
Useful Websites
Australia Deakin University
International resources
- INTERNATIONAL - HIA best practice principles [pdf 78 kb] (External link)
Guidance on how to integrate health into impact assessments, mainly in the context of development planning. This concise document (4 pages) was published in 2006 by the International Association for Impact Assessment, in collaboration with WHO. - AUSTRALIA - Health impact assessment Guidelines [pdf 389 kb] (External link)
By the Commonwealth Department of Health and Aged Care. These Guidelines aim to promote and enhance the incorporation of Health Impact Assessment (HIA) into environmental and planning impact assessment generally, thereby improving the consideration of health issues. The guide aims to assist other sectors to better understand the rationale for HIA and the processes involved. - CANADA - Canadian handbook on health impact assessment (External link)
Published in 2004, this handbook has four volumes: the basics, approaches and decision-making, the multidisciplinary team, and health impacts by industry sector. Its main objective is to help professionals with an interest in health - whether from medical backgrounds, social sciences or government/industry - to integrate health into the environmental impact assessment (EIA) process. - IRELAND - Health impact assessment: an introductory paper (External link)
By the Institute of Public Health in Ireland. This paper provides a review of health impact assessment literature and practice, and outlines the Institute's position towards the development of HIA in Ireland. - NEW ZEALAND - A guide to health impact assessment (2nd edition) (External link)
This is a practical guide on exactly what HIA is, why it should be carried out and who should carry it out. The Public Health Advisory Committee of New Zealand designed it for policy-makers in central and local governments, and encourages feedback so that the guide can be enhanced over time. - SWEDEN - Focusing on health pdf, 103kb (External link)
How is the health of different groups affected by a proposed policy decision? This question may be answered by using the "Health Matrix", an easy-to-use checklist. - UNITED KINGDOM - Health impact assessment: a guide for local authorities (External link)
By Health Scotland. This practical guide covers what HIA is, why and how it should be used, and the different stages involved. There is particular emphasis on how HIA fits into the local authority planning framework. - UNITED KINGDOM - The Merseyside guidelines for health impact assessment [pdf 640 kb] (External link)
These guidelines address commissioning issues and procedures, and outline methods for undertaking HIA. They will be of use to those working in central or local governments, the health sector, the voluntary sector and other bodies whose work influences (or is influenced by) public policy. - UNITED KINGDOM - Introducing HIA: informing the decision making process [146 kb] (External link)
By the Health Development Agency. This is a basic introduction, discussing the concepts of HIA, the key stages involved and providing practical advice. The guide is useful for people or institutions that would consider undertaking, commissioning or promoting HIA. - UNITED KINGDOM - A short guide to HIA: informing healthy decisions [161 kb] (External link)
By the NHS Executive London. This guide introduces the key features involved in HIA and is complemented by a fuller resource that provides an in-depth review and offers practical tools for adapting the approach to different situations.
Last updated: July 2011
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