Healthy Places & Impact Assessment

Health Impact Assessment (HIA) is defined by the International Association for Impact Assessment as “a combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, programme, or project on the health of a population and the distribution of those effects within the population.” (Quigley et al. 2006). The final product of an HIA is a set of evidence-based recommendations that inform decision-makers and the general public with practical solutions that seek to magnify positive health impacts and remove or minimize negative impacts for a given project and often for future policies.

The shifting importance of issues from the traditional sphere of public health to that of the health and wellbeing of affected communities demands that our policymakers “be aware of the health consequences of their decisions and … accept their responsibilities for health” (WHO 1986).  However, health is not routinely addressed in planning, policy-making, and public works without a standard procedure in place for the inclusion of health concerns. Although the current practice of environmental impact assessments consider ecological effects for large projects, they fail to include many pressing health concerns. This lack leaves communities vulnerable to many types of health threats such as obesity, diabetes, and other chronic diseases; infectious diseases; environmental pollution; and mental illness.

Steps of Health Impace AssessmentThe steps of an HIA include:

  • SCREENING Determine whether or not there exists the potential for significant health impacts as the result of a policy, program, or project;
  • SCOPING Establishes the study area boundaries, identifies possible consequences, and determines a management approach for the HIA;
  • APPRAISAL Considers the nature and magnitude of health impacts and the affected populations;
  • RECOMMENDATION Develops practical recommendations as to whether the decision-makers will consider the results of the HIA in their decisions;
  • DISSEMINATION Circulates the results of the HIA to decision makers, individuals implementing the plan/policy, and community stakeholders; and
  • MONITORING & EVALUATION Reviews the effectiveness of the HIA process and evaluates the actual health outcomes as a result of the project or policy.

Four values are integral to HIA — democracy, equity, sustainable development and the ethical use of evidence that emphasizes an analysis that incorporates a range of scientific disciplines and methodologies.

  • Quigley R, L de Broeder, P Furu, A. Bond, B. Cave, R. Bos. (2006). Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5. Fargo, South Dakota, USA: International Association for Impact Assessment.
  • World Health Organization (1986). Ottawa Charter for Health Promotion. First International Conference on Health Promotion.  Ottawa, Canada.