1. Health in All Policies - Health Impact Assessment and other approaches
Margaret Douglas
August 2017
Scottish Health and Inequalities Impact Assessment Network

2. Outline Background to Health in All Policies HIA approach and steps
SHIIAN – current role, future directions?

3. How do we influence these decisions?
What policy decisions or plans have had a large impact on people’s health in your area in last 3 years?
How do we influence these decisions?
Beyond delivery of ‘projects’?
Without just ‘throwing tomatoes’
(And other pitfalls...)

4. Health in All Policies ‘Shared governance for health and wellbeing’
‘Government objectives are best achieved when all sectors include health and wellbeing as a key component of policy development ... Need for new social contract between all sectors to advance human development, sustainability and equity [and] health outcomes’

5. Health in All Policies - tools
Inter-ministerial and interdepartmental committees
Cross sector action teams
Integrated budgets and accounting
Cross cutting information and evaluation systems
Joined up workforce development
Community consultations and citizens juries
Partnerships platforms
Health Lens Analysis
Impact Assessments
Legislative frameworks

6. ‘Health Impact Assessment is a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.’
WHO Gothenburg consensus paper 1999

7. HIA steps Screening Scoping Appraisal Recommendations Reporting
Monitoring

8. Why use HIA for HiAP? Established, recognised approach
Uses different sources of evidence – research, stakeholder views, data
Good way to involve people meaningfully in decisions – fit with community empowerment
Comprehensive scoping of health issues
Report can be critiqued
Flexible in scale and methods

9. Disadvantages of HIA Scepticism about assessment burdens
(Perceived) skills gaps
‘Health imperialism’

10. HIA in Scotland – brief history

11. 2008: ‘Integrated impact assessment processes for public policies and programmes should be developed and implemented at national and local levels’
1998 Green paper:
6 mentions of Health Impact Assessment
1999: ‘The Public Health Strategy Group will promote the widespread use of Health Impact Assessment when formulating Government policies’

12. HIA in Scotland (Some) policy support… but not a requirement
No dedicated staff or other resource
No HIA consultancies
Environmental consultancies have no health professionals
> 1000 people in various public health roles, mostly in Boards

13. Scottish Health and Inequalities Impact Assessment Network
Running since 2001
Coordinator one day per week
Now part of Scottish Public Health Network
Aim to promote and support HIA and inclusion of health in other impact assessments
Evidence based guides to HIA of specific sectors
General HIA guidance
Training
Support and advice to colleagues

14. Recent work
Support to Health Impact Assessment of Unconventional Gas – led by HPS
Revised HIA Guidance
HIA of 50,000 affordable homes
Updating HIA Transport guide
Bespoke training
Support to colleagues

15. Pragmatic approach Aim is better policies – not better assessment
Proportionate resources and methods
Do a scoping workshop, other evidence only if it will inform decision
Integration of assessments, especially EQIA
Build into mainstream roles and other processes

16. How best to ensure health is considered?
Interest in social determinants, HiAP supported in PH review
How much support is there for HiAP in Scotland and how to capitalise on it?
Should we promote HIA, or another formal approach, or just aim to be ‘at the table’?
What should SHIIAN do to support it?

17. Outline Background to Health in All Policies HIA approach and steps
SHIIAN – current role, future directions?