Workshop 4 Chair: Mary Mahoney Health Impact Assessment: Making the Difference

Ashley Gould Policy Officer (Health Improvement) Applying HIA in Local Government: Exploring the Reality Grace Blau Research Fellow School of Health & Social Development

31 Introduction - WLGA Represents the interests of local government and promotes local democracy in Wales. Promote better local government & support authorities in the development of policies and practices which will improve public services. Policy development and representative roles plus improvement and development, procurement, employment issues and health improvement.

Dedicated Health & Well-being Team Local HSCWB Strategies (employing HIA!) Recognise, maximise, promote – LA’s as Health Improvement agencies Briefings, networks, events & sessions Launched HIA guidance with WHIASU in ‘04 The Route to Health Improvement Health Improvement Context

HIA in ‘The Route to Health Improvement’ Policy Development (1 of the 5 key features) –Setting the vision ▪A Council that develops policy that maximises the positive health impact of services will have the following features: “Health Impact Assessment…is used on a regular basis as part of policy and decision making processes”

Deakin University, School of Health & Social Development, Melbourne (Australia) –Strategic promotion of HIA –Teaching –Research ▪HIA in local government project –Application of HIA Introduction - HIA Unit

Focus of my role Since October 2004 –Research –Capacity building –Teaching –Application Past experience –Health care services –Local government public health planning

So, does local government ‘do’ health ? Local government is best placed to change life circumstances and improve health 50% Social & economic environment 15% Genetic endowment 10% Physical Environment 25% Illness Care System Source: Canadian Institute for a Advanced Research Estimated Health Impact of ‘Determinants Of Health’ on Population Health Status An individuals life circumstances contribute more to health improvement than health care services …Absolutely!

Four aspects of the reality of HIA in local government Why HIA at the local level How HIA at the local level Drivers/ broader agenda Organisational context

That’s us – who are you? AND Why do you think local government should use HIA?

1.Social networks and the scale of operations within communities are such that the ties between policy makers and those affected are stronger 2.Policy makers live where they work so are identifiable and affected by their own policies 3.The bureaucracies of communities are relatively small and there is a greater chance of inter-sectoral cooperation Hancock’s rationale for using HIA in LG

The Workshop Bit – sharing your experiences Drivers/ broader agenda Organisational context

Workshop Task 1 From your experience in your organisation identify CONTEXTUAL FEATURES IN YOUR ORGANISATION that could –create barriers to positioning or applying HIA –enable the positioning or application of HIA As a group, decide if there are there any generic features that are common to many organisations. Rank the features…

Workshop Task 2 From your experience in your local region or your country identify EXTERNAL DRIVERS or AGENDAS that could –create barriers to positioning or applying HIA –enable the positioning or application of HIA Write these on sticky note paper and place on wall –clearly label BARRIER or ENABLER

Examples of ‘how’ in Welsh LG School Health Review - Pembrokeshire Screening linked to LA ‘Quality of Life’ checklist –against a proposal of NO school health service Two ‘rapid assessment’ workshops –against 11 aims for a reshaped service Systematic gathering of evidence to inform decision on reshaping service

Examples of ‘how’ in Welsh LG Highways Maintenance Policy Wrexham CBC –Policy being re-drafting/HIA profile raiser –Police, community reps, disability groups and insurers –driven monthly > walked weekly –More sharing of data to inform policy Maesincla Integrated Children’s Centre –Community engagement ‘vehicle’ –Parents, consultants, LA officers and community reps –Renamed by community and daily timetable changed –Report on

Examples from Victoria HIA of Family Violence Strategy –HIA identified increased perceptions of fear amongst community because strategy raised awareness of incidence of family violence HIA of Drought Social Recovery Strategy –Currently impact identification stage –Consecutive short term funding for rural counselling services may have increased mental health problems

Examples from you! ? So, what’s changed as a result of the HIA?

Workshop Task 3 When you leave this workshop today what action do YOU plan to take that will –reduce the barriers to the positioning or application of HIA in your organisation? –take advantage of the enablers?

Whys & Hows Drivers & Contexts

Ashley Gould Applying HIA in Local Government: Exploring the Reality Grace Blau

Inclusive decisions > ownership Exploration of what’s already known Focuses on the ‘better life’ contribution Achieve ‘healthier’ results Structured yet flexible Community development Evaluation & shared learning Open process > justifiable results

cynicism = resistance raising unrealistic expectations resource (time & £) constraints “used” to support controversial issues A Few disadvantages or weaknesses:

7th International Health Impact Assessment Conference Health Impact Assessment: Making the Difference Supported by: