An introduction to Health Impact Assessment Debbie Abrahams, - - PowerPoint PPT Presentation

An introduction to Health Impact Assessment

Debbie Abrahams,

Director, International Health Impact Assessment Consortium, University of Liverpool, ENGLAND

20th November 2009, Lisbon Seminar

Presentation Overview

• What is HIA?
• Concepts and definitions
• Current policy context

What is 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.’

ECHP, WHO (1999) Gothenburg consensus paper

What is HIA trying to achieve?

• Supports evidence based

decision-making, contributing to improvements in health and reduction in health inequalities

• Enhance the positive impacts of

any decision

• Reduce (or eliminate) the

negative impacts of any decision

The key HIA output

A set of evidence A set of evidence based based recommendations recommendations

Specifically designed to Specifically designed to influence decision influence decision-

• makers

makers

HIA methodologies

• Different models of

health

• Different HIA

methodologies, reflecting model of health:

‘Broad’ perspective ‘Tight’ perspective

Broad perspective Tight perspective View of health Holistic Definition and

• bservation

Disciplinary roots Sociology, epidemiology Epidemiology, toxicology Ethos Democratic Technocratic Quantification In general terms Towards exact measurement Types of evidence

Key informant data

Measurements Precision Low High

Broad v. tight methodologies

National Assembly for Wales (1999) Developing health impact assessment in Wales.

Stakeholder, ‘consultee’ Public involvement Policy analysis, Profiling Methods/tool Rapid, comprehensive Depth Prospective, concurrent Timing ‘Broad’ v. ‘Tight’ spectrum Methodological perspective Policy, programme, project, national, local Type/unit Transport, Employment Topic

Examples Typology Criterion

HIA Classification

HIA Classification

Impact, process Evaluation Purpose ‘Health in All Policies’ Openness, impartiality Transparency/ Objectivity Design, methods, tools Reliability/validity Examples Quality criterion

HIA Classification

Impact, process Evaluation Purpose ‘Health in All Policies’ Openness, impartiality Transparency/ Objectivity Design, methods, tools Reliability/validity Examples Quality criterion

ihia.org.uk Ron Labonte (1991) Inequalities in Health in the City of Toronto.

ihia.org.uk

A socio-environmental model of health determinants

(Dahlgren and Whitehead, 1991)

Levels of causation and corresponding types of health intervention

McKinlay and Marceau (2000), Lancet, 356, 757-761

Principles and values

• Socio-

environmental model

• Reduce

inequalities

• Democratic
• Transparent
• Ethical
• Robust
• Public

involvement

• Shared
• wnership
• Sustainable
• Practicable
• Objective

HIA Options

Desk- based Rapid In-depth

Broad

• verview
• Existing

accessible data

• 2-6 weeks

More detailed

• Existing data

and some new qualitative

• 12 weeks

Comprehensive assessment

• Multiple

methods and sources

• 6 months

Guidance on the type of HIA

Is the policy a key policy? Are there significant policy changes proposed? In-depth

HIA timing

• Reflects policy decision-making

time-line/cycle –Prospective HIA (before) –Concurrent HIA (during) –Retrospective HIA (after)

Policy context for HIA in Europe

• EC Treaty of Amsterdam, article 152, 1999
• EC Strategic Environmental Assessment,

2001

• EC Public Health Strategy, 2002
• ‘Policy HIA for the EU’ project, 2002-2004:

European Policy HIA (EPHIA) methodology

• EC Calls using EPHIA
• EC Health Strategy, 2008: ‘Health In All

Policies’

Policy context for HIA in England

• ‘Independent Inquiry into Inequalities in

Health’, 1998

• ‘Saving Lives’, 1999
• ‘Choosing Health’, 2004
• ‘Our Health Our Care Our Say’, 2006
• ‘Health Inequalities: progress and next

steps’, 2008

• ‘Global health 2008-2013’, 2008