Good for Regeneration, Good for Health Using an HIA approach to develop indicators for regeneration Erica Ison on behalf of Belfast Local Support Group Building Healthy Communities

Good for Regeneration, Good for Health Aim of Project To use an HIA approach to develop a set of indicators appropriate for monitoring the effects of regeneration Additional aim once indicators agreed To develop a set of checklists based on the indicators for the prospective assessment of regeneration proposals

Good for Regeneration, Good for Health Context for work on regeneration in Belfast Some of the most deprived communities in Northern Ireland live in Belfast 30 years of conflict and violence, known as “The Troubles”, has had a cumulative and damaging effect on people’s health and well-being, both mentally and physically Since the start of the Peace Process, an important focus of the city is regeneration, especially in terms of economic development The 5 Area Partnerships in Belfast have been developing a Strategic Regeneration Framework (SRF) since 2008

Good for Regeneration, Good for Health The problem with regeneration Although regeneration and environmental improvement can be beneficial to people’s health and well-being, it can have unintended harmful effects, especially for vulnerable groups: Gentrification Displacment If displacement does not occur, there can still be prolems if new residents and existing residents do not integrate, exacerbating social exclusion and isolation, reducing social cohesion Presentazione BHC – Pag. 4 /18

Good for Regeneration, Good for Health The problem with existing indicators when using HIA Some routinely collected data and the associated indicators are not fit for purpose, measuring effects not of interest when using HIA to investigate the impacts of a proposal Indicators available do not necessarily reflect important determinants of health to reduce health inequalities and health inequities Presentazione BHC – Pag. 5 /18

Good for Regeneration, Good for Health Method Health impact analysis of the East Belfast SRF, including community consultation, to identify: * determinants of health affected by regeneration; * determinants of health affected with different types of regeneration proposal Triangulation of the results with a desk-top analysis of the other 4 SRFs for Belfast. Review of various indicator sets relating to health, regeneration and sustainable development Presentazione BHC – Pag. 6 /18

Good for Regeneration, Good for Health Method Steering Group agreed a priority set of determinants of health Using the determinants of health prioritised as important to regeneration, the next step was to identify appropriate indicators that would show an effect on the determinant of health The ground rule was not to work from a basis of what indicators were already available but what would show whether a regeneration proposal was having an effect on the determinant Presentazione BHC – Pag. 7 /18

Good for Regeneration, Good for Health Method For each determinant of health, several indicators were indentified: * existing indicators; * new indicators Indicators were selected by Local Support Group and Indicators Working Group A framework was developed to house the indicators Presentazione BHC – Pag. 8 /18

Good for Regeneration, Good for Health Indicator Framework Four main domains: * Economic * Social * Environmental * Access Community and Neighbourhood Domain – representing a baseline profile Presentazione BHC – Pag. 9 /18

Good for Regeneration, Good for Health Special Features of Framework * A “Headline Indicator” for each of the main domains * A “Twin Indicator” to show the effect on people experiencing inequalities or inequities who are in vulnerable groups * Key indicators for the Community & Neighbourhood domain * Area-specific indicators – the choice of each Area Partnership Presentazione BHC – Pag. 10 /18

Good for Regeneration, Good for Health Economic Domain Headline Indicator Gross value added per capita matches to “Creation of wealth” as a determinant of health Twin inequalities indicator Comparison of the average top 20% of after-tax incomes and the average bottom 20% of after-tax incomes Presentazione BHC – Pag. 11 /18

Good for Regeneration, Good for Health Indicators document Introduction, including a description of the framework Part 1: Introduction to each domain: list of the indicators in each domain, an introduction to each “headline” indicator, a description of the “twin” indicator, and guidance on how to interpret the “headline indicator in relation to other indicators in the set Part 2: Instructions on how to select the indicators to use depending on the contents of the proposal that is being monitored and evaluated Presentazione BHC – Pag. 12 /18

Good for Regeneration, Good for Health Other resources * A set of checklists based on the indicator sets for prospective assessment of regeneration proposals: a universal checklist based on 4 headline and 4 twin indicators, 4 checklists based on the domain indicators, and a checklist based on the Community and Neighbourhood indicators to help developers identify the existing vulnerabilities in a community that need to be taken into account in the proposal; case-studies * A Training Programme on how to use the checklists and indicator set * A Training the Trainers course Presentazione BHC – Pag. 13 /18

Good for Regeneration, Good for Health Ongoing and future work Working with Northern Ireland Statistics and Research Agency (NISRA) to collect and analyse data for some of the “new” indicators A interactive tool based on the checklists Building capacity in the Area Partnerships and in other key organisations in Belfast Using this approach in other subject areas as part of Health in All Policies, e.g. Housing, and planning children’s services Presentazione BHC – Pag. 14 /18

Good for Regeneration, Good for Health Organisations involved Belfast City Council (Project Manager: Adele Keys) Belfast Healthy Cities (Chair of the LSG: Joan Devlin) Belfast Health and Social Care Trust Health Protection Agency Northern Ireland Northern Ireland Housing Executive Planning Service, DoE East Belfast Partnership Greater Shankill Partnership North Belfast Partnership South Belfast Partnership West Belfast Partnership Expert Adviser: Erica Ison Presentazione BHC – Pag. 15 /18