1. Health Impact Assessment Health Impact Assessment Colloquium Bondi, 9th December 2005 Prof Mark Harris Executive Director Centre for Primary Health Care and Equity* University of New South Wales Centre for Health Equity Training, Research & Evaluation *The Centre for Health Equity Training, Research and Evaluation (CHETRE) is part of the Centre for Primary Health Care and Equity

2. What are impacts? Both positive and negative changes in a community that are attributable to a policy, program or project. chetre.med.unsw.edu.au

3. Where does health come in? chetre.med.unsw.edu.au Source: Dahlgren G, Whitehead M. Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute of Futures Studies, 1991; cited in Acheson D, 1998.

4. What is HIA? A combination of procedures, methods and tools by which a policy, program or project may be assessed for its potential, and often unanticipated, effects on the health of the population and the distribution of these impacts within the population. (ECHP, Mahoney & Morgan) chetre.med.unsw.edu.au

5. When is it used? chetre.med.unsw.edu.au Needs Assessment PlanningDraft Proposal HIA Revised Proposal Implementation Monitoring Evaluation 123 4b56 7 Screening 4a4 Adapted from:Simpson S, Harris E & Harris-Roxas B (2003) Health Impact Assessment: An introduction to the what, why and how, Health Promotion Journal of Australia, 15(2): 162-167.

6. Key features of HIA Prediction Combination of methods Policy, program or project Positive & negative Unintended & intended effects Distribution of effects Solution focused Promote & protect health chetre.med.unsw.edu.au

7. Six steps of HIA 1.Screening 2.Scoping 3.Identification of potential health impacts 4.Assessment of potential health impacts (appraisal) 5.Negotiation & decision-making (recommendations) 6.Monitoring & evaluation chetre.med.unsw.edu.au

8. Assessment and recommendations chetre.med.unsw.edu.au If you implement the proposal These will be the impacts If you make these changes These will be the gains AssessmentRecommendations

9. Does it Work? What constitutes effectiveness? –Changes to decisions? –Changes to health outcomes? Monitoring Need for further evaluation Examples of effective use: –Finningley Airport HIA –CCDPHA HIA chetre.med.unsw.edu.au

10. 2 x one day workshops with range of NSW Health staff –Introduction to HIA –Exploring pros & cons of HIA Review of literature Establishment of HIA eNews What we’ve done NSW HIA Project Phase 1 chetre.med.unsw.edu.au

11. 5 Developmental Sites –Undertook HIAs on health proposals (except one) –CHETRE training & support Strategic Engagement Communication –HIA E-News ongoing –HIA Connect website What we’ve done NSW HIA Project Phase 2 chetre.med.unsw.edu.au

12. Related work Equity-focused Health Impact Assessment (EFHIA) –Consortium with Deakin and Newcastle Universities –Framework produced Discussion Paper on Impact Assessment for NSW Health Futures Planning chetre.med.unsw.edu.au

13. What we’re doing Phase 3 developmental sites We’re supporting 6 developmental sites in 2005 –Bigger proposals –Predominantly intersectoral chetre.med.unsw.edu.au

14. What’s next? NSW HIA Project Phase 3 1.2006 Developmental sites 2.Liaison 3.Manual 4.Masters-level subject 5.Electronic Resources chetre.med.unsw.edu.au

15. More Information HIA Connect http://chetre.med.unsw.edu.au/hia chetre.med.unsw.edu.au

16. Good intentions are not always enough The road to hell is paved with good intentions HIA helps identify the health impacts from unintended outcomes of a proposal