Health Impact Assessment for Healthy Places: A Guide for Planning and Public Health Module 2: Screening Goal: The goal of screening is to determine if an in- depth impact assessment is necessary and if an HIA adds value to the decision-making process.

Module 2: Objectives 1. Identify steps 2. Use screening tools to select policies for assessment 3. Describe the role of the community and stakeholders in the screening process 4. Describe challenges communities have encountered with the screening process

Steps in the Screening Process Define the policy, program or project Determine whether you should conduct an HIA Choose what type of assessment to complete Identify the potential health impacts Review screening decision with stakeholders

HIA Steps are Fluid It is important to remember that the steps in the HIA process are fluid and it may be necessary to revisit previous steps in the process. For example if there is a major change in the proposed policy or project or the population it is expected to influence, it may be necessary to return to the screening process.

Define the Project or Policy Who is proposing the project or policy? What is their predicted timeframe? When is a decision going to be made? What are they proposing? Are there any other projects or policies that may be affected by the proposal or influence the proposal?

When is an HIA appropriate? Outside the health sector Significant health impacts that are not already being considered The HIA can be completed before key decisions are made Stakeholders will use information Sufficient data and resources are available

When is an HIA inappropriate? Information is vague and unreliable Little or no local support for an HIA Stakeholders will not take health into consideration Decisions have already been made

Selection Criteria Is the health impact significant? Does the HIA add value to the decision-making process? Is there enough knowledge and data available to conduct the HIA? Are resources such as time money and personnel available to conduct an HIA? Remember: For your first HIA, choose a project that is manageable.

Types of HIAs Rapid Intermediate Comprehensive

Provides a broad overview Used at an early policy development stage Limited time/resources are available Collecting and analyzing existing data and researching previous HIAs Days to weeks with minimal resources Rapid HIA

Intermediate HIA Provides more detailed information Most frequent HIA approach Allows more thorough investigation of health impacts which increases reliability Involves: – reviewing available evidence – looking at any similar HIAs – collecting and analyzing new data – gathering community input Can take weeks to months to complete

Thorough assessment of potential health impacts Least frequently used Involves: –review of available evidence and any similar HIAs –collecting and assessing new data using multiple methods and sources (quantitative and qualitative data including stakeholders’ opinions) – community input A comprehensive HIA may take a long time to complete Comprehensive HIA

A city plans to develop a run-down neighborhood-demolishing 3 blocks of dilapidated retail shops, an aging supermarket, and 200 low income housing units. The developer has agreed to allocate $5,000 to the health department to conduct the HIA if the city will expedite the approval process. This only gives the health department 2 weeks to complete the assessment. What type of HIA would you conduct…

A large metropolitan city has long- term plans to transform 22 miles of abandoned rail roads and brownfields in its inner city into transit, parks, trails, and mixed use developments. This project will intersect 45 neighborhoods and impact an estimated 100,000 people. The project will impact some of the wealthiest and poorest neighborhoods in the city.

Plans are being made to lay a pipeline through native territory in Alaska. There is fear that this will disrupt the native life style, hurting the traditional hunting and fishing practices of the people. What type of HIA would you conduct… There’s one person with a half time commitment to conducting this HIA and they have 1 year to complete the HIA.

Understanding the decision and its alternatives Judging the breadth and magnitude of health effects Determining the strength of the evidence Identifying available and ongoing analysis Understanding competing stakeholder positions Identifying potential for improvements How a community can help?

Ask a public or private agency to conduct HIA analysis directly Choose a high priority project among alternatives considered for an HIA Conduct interviews with community to inform the screening process Synthesize community testimony from public meetings and hearings What actions can a steering committee take?

Deciding between alternative projects/policies Choosing a project that is manageable so that there is not a sense of being overwhelmed Challenges in HIA Screening