Health Impact Assessment in NSW Welcome to CHETRE and NSW Health’s colloquium, the aim of which is to promote Health Impact Assessment (or HIA) and its progress in NSW. In the field of HIA, NSW is recognised as a world leader. This status has not only been gained through the innovative approach of ‘learning by doing’ that has occurred over the past few years across NSW developmental sites, but also through activities such as this colloquium. I would like to extend NSW Health’s appreciation and thanks to all the delegates from many different areas of expertise who are in attendance today. We are looking forward to a day that celebrates our achievements in HIA, while adding to the pool of knowledge and collaboration that is being established both in NSW and nationally. Dr Denise Robinson Deputy Director-General, Population Health and Chief Health Officer 9 December 2005

Colloquium HIA in infancy and evolving Value in diverse interests More and more people, as evidenced by the number of delegates here today, are taking an interest in HIA, as it is becoming recognised as an effective structured mechanism to engage key stakeholders around improving proposals, particularly by developing recommendations for decision making that are solution-focused. However, HIA is in its infancy and is evolving. Therefore NSW Health has a commitment to taking an exploratory approach to HIA, one that values progression and learning through encouraging diverse perspectives, debates and discussion. We recognise health is a broad concept that crosses a vast range of issues and areas of expertise. Events such as this colloquium are an important step to encouraging collaboration across the broad and growing range of stakeholders in the health of NSW and Australia.

Examining health impacts Environmental health Health promotion Chronic disease prevention Intersectoral work HIA as a mechanism NSW Health has a long-standing interest in examining health impacts. Various parts of both the NSW Department of Health and Area Health Services have been active in a number of areas, including environmental health, health promotion, and chronic disease prevention This has included a considerable amount of intersectoral work and one of the strengths of HIA is that it has emerged as a mechanism to do this in a structured manner.

Foundations NSW Health & Equity statement Capacity Building Framework CHETRE: Phases 1, 2 and 3 The NSW Health and Equity Statement, released by the Department in 2004, called for approaches to be developed to assess the impact of NSW Health proposals on health. This was taken up within the NSW Department of Health, principally through the Centre for Chronic Disease Prevention and Health Advancement who wanted to explore the development of HIA via the Capacity Building Framework outlined in NSW Health’s ‘A Framework for Capacity Building to Improve Health’ We contracted CHETRE to undertake this work, due to their experience in health systems research and the social determinants of health. CHETRE has been funded to do this over three phases. The first phase was focused on raising awareness of HIA and its potential benefit in identifying positive and negative impacts of proposed programs, services or projects. Phase two moved the initiative to adoption of the HIA principles into practice. This was the start of the ‘learning by doing’ approach by the identification of five developmental sites. The developmental sites in phase two (2004) were health system focused. The project is currently in its third phase, focusing on embedding HIA’s use within NSW. A feature of phase three is that many of the projects have an intersectoral base.

NSW Health and HIA Workforce development Organisational development – internal and facilitating external Population Health Priority Task Force As mentioned, we have taken a capacity building approach to doing this. Of relevance today are both workforce development and organisational development, and our work through the newly formed Population Health Priority Task force: Workforce development aims to progress knowledge and expertise in HIA across NSW. The delivery of this has been through training and support of a range of developmental sites, and through establishing links beyond CCDPHA throughout NSW. The focus of organizational development has been to position HIA in departmental planning and policy processes. We have been engaging areas within the Department around HIA issues. For example through events such as this colloquium However in both these approaches we have recognised the importance of external linkages. By its very nature HIA is a process that is broader than health. Because of this we are keen on extending dialogue on HIA with other agencies and departments. This Colloquium a useful step in forming these linkages In addition to these two areas, we are currently linking HIA with the work of the newly formed ‘Population Health and Priority Task Force’ which is focusing on public and private partnerships and urban planning. It will be important to position the learnings from the developmental sites with this group.

Future Directions Issues: Making sure HIA adds value to decision-making. What can Health’s contribution be? How can Health engage other sectors? Opportunities: Collaboration (2004 / 2005 / 2006 developmental sites) Promise of HIA: Action on health impacts As I mentioned previously, HIA is in its infancy and we are learning as we are doing. As part of this, some key issues have arisen that are worth noting. First, how can HIA be best seen as adding value to decision making? Second is what value do we place on diverse types of evidence when assessing health impacts? Related to this is the question of what evidence means to decision makers? And finally we are keen on establishing better ways that Health as a sector can work with others to add value to projects, programs and policies that are in development. NSW Health and CHETRE’s work has shown collaboration across agencies and departments on specific HIAs have been both useful and productive. This has been a constructive exercise in realising that intersectoral work is valuable and more importantly, possible. HIA provides a mechanism for action to minimise negative health impact and maximise health benefits. This colloquium is a useful step towards this. Once again I would like to express our gratitude to the range of representatives from diverse organisations that are in attendance today. I hope you enjoy the topics under discussion. While NSW Health is taking the lead on HIA, this colloquium is an important mechanism for us to work collaboratively with others.