What is a Health Impact Assess­ment?
Health Impact Assess­ments (HIA) can be used to eval­u­ate pro­grams, projects and poli­cies before they are built or imple­mented to assess poten­tial pos­i­tive and neg­a­tive health out­comes. The HIA process can lead to rec­om­men­da­tions that deci­sion mak­ers can use to advance well-informed pub­lic poli­cies, pro­grams and projects that avoid unin­tended health con­se­quences and unex­pected costs.

Why is an HIA needed?
An HIA can high­light or uncover health issues that may be unrec­og­nized. The HIA process also takes into account a wide range of envi­ron­men­tal fac­tors, such as hous­ing con­di­tions, road­way safety, and social and eco­nomic vari­ables to deter­mine how gaps in health dis­par­i­ties can be decreased.

What steps are needed to con­duct an HIA?
There are 5 major steps that need to be taken in order to con­duct an HIA:

1. Screen­ing – Deter­mines whether an HIA will suc­ceed and if it will add value. For exam­ple, some impor­tant ques­tions to ask include: Are there suf­fi­cient resources in place to con­duct an HIA? Will the HIA pro­vide insight into health prob­lems or concerns?

2. Scop­ing – Cre­ates an out­line for the HIA. Some impor­tant ques­tions to con­sider: What health effects should the HIA effect? (i.e. increased access to fresh pro­duce; walk­a­ble com­mu­ni­ties, etc.) Who will be affected by the pro­gram or pol­icy? What are the con­cerns raised by stakeholders?

3. Assess­ing Risks and Ben­e­fits – Two impor­tant steps need to be con­sid­ered dur­ing this stage and should be con­ducted in an impar­tial way

First, attempt to deter­mine the base­line health of the pop­u­la­tion that will be affected. For exam­ple, an assess­ment is needed to deter­mine what con­di­tions influ­ence the health of a pop­u­la­tion, whether it is related to the local econ­omy, access to healthy food choices, avail­abil­ity of recre­ation cen­ters, etc.

Sec­ondly, gather quan­ti­ta­tive and qual­i­ta­tive analy­ses of the pop­u­la­tion that will be affected to help deter­mine the risks and ben­e­fits. Assess­ment should also include the eco­nomic costs and ben­e­fits asso­ci­ated with the decision.

4. Report­ing – Find­ings are given to deci­sion mak­ers, stake­hold­ers, and affected com­mu­ni­ties to solicit feedback.

5. Mon­i­tor­ing and Eval­u­at­ing — Mon­i­tor­ing infor­ma­tion serves as the basis of eval­u­at­ing the impact of the HIA and also helps shape future pol­icy and man­age­ment deci­sions. Eval­u­a­tion should focus both on the process (In what ways did the HIA affect deci­sion mak­ing?) and on inter­me­di­ate out­comes (What health-oriented changes resulted? Did the HIA affect any spe­cific groups dif­fer­ently than it did the broader population?)

What cities in the U.S. have con­ducted HIA?

Atlanta, GA – Atlanta Belt­Line, Con­ducted in 2005

Tren­ton Farm­ers’ Mar­kets, Con­ducted in 2007 

To read more about HIA that have been con­ducted in the U.S., please visit the UCLA Health Impact Assess­ment Clear­ing­house Learn­ing and Infor­ma­tion Cen­ter at:
http://www.ph.ucla.edu/hs/hiaclic/index.htm