Introduction to Health Impact Assessment (HIA) Julia Lester Wales HIA Support Unit (WHIASU)

Transcription

1 Introduction to Health Impact Assessment (HIA) Julia Lester Wales HIA Support Unit (WHIASU)

2 Objectives for the session Basic understanding of HIA Introduction to different influences on health and well-being Practical experience through group exercises Understanding of how HIA has been applied in Wales

3 Structure of the training session 1. What is health? 2. What is HIA? 3. How is HIA undertaken? 4. How to quality review a HIA 5. Case Study

4 1. What is Health?

5 What is health? Health and HIA HIA uses a broad definition of health: A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (World Health Organisation, 1948)

6 Health and HIA Source: Based on Dahlgren and Whitehead (1991)

7 2. What is Health Impact Assessment?

8 What is Health Impact Assessment? Definitions Context Who uses HIA and why HIA and other impact assessments Principles of HIA Types of HIA What HIA is and is not HIA and planning

9 Definition of HIA (1) a combination of procedures, methods and tools by which a policy, programme 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 (Gothenberg consensus, 1999)

10 Definition of HIA (2) Health impact assessment is a process through which evidence (of different kinds), interests, values and meanings are brought into dialogue between relevant stakeholders (politicians, professionals and citizens) in order imaginatively to understand and anticipate the effects of change on health and health inequalities in a given population (Elliott et al., 2010)

11 Context Acheson Report (1998) Better Health, Better Wales (1998) Article 152 of Treaty of Amsterdam (1999) Well-Being in Wales (2003) Health, Social Care and Well-Being Strategies (2003) Health Challenge Wales (2004) Making the Connections (2004) EU Health Strategy (2007) One Wales (2007) Fairer Health Outcomes for All (2011) Public Health Bill Green Paper (2012)

12 Who uses HIA and why? Who uses HIA? National government Local government Health Boards Policy and decision makers Communities Voluntary groups Private companies Benefits of HIA Promotes greater equity in health Increases awareness of how decisions may affect health Identifies connections between health and developments in other policy areas Promotes evidence and knowledge-based planning and decision-making Better co-ordination of action between sectors to improve and protect health Maximises health benefits and minimises health risks

13 HIA and other impact assessments Health Needs Assessment (HNA) Environmental Impact Assessment (EIA) Social Impact Assessment (SIA) Regulatory Impact Assessment (RIA) Equality Impact Assessment (EqIA) Mental Well-being Impact Assessment (MWIA) Integrated Impact Assessment (IIA) Strategic Environmental Assessment (SEA)

14 Principles of HIA Open Transparent Ethical Democratic Values of HIA Equitable Sustainable Participatory Robust

15 Types of HIA Timing Prospective prior to implementation Concurrent during implementation Retrospective after implementation Depth Desktop Rapid Intermediate Comprehensive Mini, Midi, Maxi...

16 What HIA is and is not HIA is... A tool to inform/support decisionmaking A flexible and scalable tool Useable for everyone brings people together to work in partnership A systematic way of assessing health and well-being impacts A tool to identify both positive and negative health and wellbeing impacts A tool to identify issues and influence change Recommended HIA is not... A decision-making tool A rigid set of procedures Limited to experts/professionals Looking just at impacts on illness and disease A protest tool, to identify only negative health and well-being impacts An evaluation exercise Statutory

17 HIA and planning Guidance Document Technical Advice Note (TAN) 21: Waste (2001) Welsh Transport Appraisal Guidance (WelTAG) (2008) Minerals Technical Advice Note (MTAN) 2: Coal (2009) Ministerial Interim Minerals Planning Policy Statement (MIMPPS) (2009) Vibrant and Viable Places: New Regeneration Framework (2013) Recommendation Use of HIA in Regional Waste Plans Screening for HIA a mandatory requirement HIA to be included as part of EIA (where significant effects on human health may occur); 500m buffer zones HIA required for all planning applications for opencast coal mining in Wales Highlights HIA as useful tool for assessing physical and mental health impacts of regeneration programmes

18 3. How is HIA undertaken?

19 Five stages of HIA Stage 1: Screening Stage 2: Scoping Stage 3: Appraisal/Assessment Stage 4: Reporting and Recommendations Stage 5: Monitoring and Evaluation

20 Stage 1: Screening - assessing if and what type of HIA is required Key Questions: Is the proposal likely to impact on health? Who will be affected? What will the scale of impacts be? Are impacts likely to be positive or negative? What type of HIA is appropriate?

21 Vulnerable groups Vulnerability:...the set of factors associated with an individual or group that increases their probability of experiencing a reduction in wellbeing associated with change. (Birley, 2011:70) Age related groups (could specify age group where appropriate) Income related groups Groups who suffer social discrimination or other social disadvantage (specify) Geographical groups

22 Health and Well-Being Determinants Lifestyles Social and community influences on health Living/environmental conditions affecting health Economic conditions affecting health Access and quality of services Macro-economic, environmental and sustainability factors

23 Exercise 1: Screening Read through the scenarios and discuss the questions posed at the end of them

24 Stage 2: Scoping deciding what the HIA is going to focus on, how and when Key questions: What are the timescales for undertaking the assessment? What financial and human resources are available? What are the geographical boundaries of the project? What type of assessment is necessary and/or possible in the time available? Will the HIA be undertaken in-house or commissioned? Who are the stakeholders/how should they be involved? Should a Steering Group be set up? Who should be on it? What are the roles/responsibilities of those involved in the HIA? What methods should be used for collecting evidence?

25 Sources of evidence Information on existing population: Routinely collected local statistics Community profiles Opinion surveys Expert opinion: Residents and professionals with local knowledge Specialists academics, professionals, organisations Wider evidence: Research Predictions from models Case studies

26 Community profile Provides current picture of the locality and baseline for later evaluation. Useful information may include: General attributes of community Health data Quality of life indicators Environmental information Views of local people

27 Who are the stakeholders? HIA works best when people with the relevant knowledge and skills work in partnership. Some examples are: Community members Community organisations Statutory organisations Developers Key decision makers HIA Support

28 Involving people Techniques include: Steering group Participatory workshop Focus group Interviews Public meeting Expert advisors

29 Should a Steering Group be set up - if so, who should be on it? A steering group is not essential but can help with: Distributing tasks Promoting wider participation/ownership of HIA process Building trust Who should be on it? People who can provide specific knowledge A strong and impartial chair People who are committed to the process Specialists from local public health teams Community representatives

30 Participatory Workshop Half day workshop Overview of proposal Introduction to HIA Gain views and input from a wide range of stakeholders who are invited to take part Facilitated by neutral person Working systematically through wider determinants checklist Invite those affected by or involved in the development/implementation of the proposal

31 Focus Group Smaller group Utilise existing groups Target particular groups Greater depth of discussion and understanding

32 Exercise 2: Scoping Read through the scenarios and consider the questions posed at the end of them...

33 Stage 3: Assessment establishing the health impacts Where possible, potential impacts should be described according to: Whether they are positive or negative Population groups affected How impact may occur Scale of impact When impact may occur Any evidence to support the above...

34 Stage 4: Reporting and Recommendations Recommendations should be: Clear and concise Realistic and achievable Manageable in number Mitigate for negative impacts and maximise positive impacts Report Style and format of report should be appropriate for target audience

35 Report structure Executive summary Introduction Methodology Assessment overview Recommendations Next steps

36 Stage 5: Monitoring and Evaluation Monitoring and evaluation is important part of HIA process post implementation of a proposal Useful questions: How was the HIA used? How useful was the HIA to its target audience(s)? Did the HIA influence the decision-making process? If so, how? What lessons have been learned?

37 4. How to quality review a HIA

38 How to quality review a HIA Reviewing and assessing the quality of a HIA report Few review tools exist Ben Cave Associates review tool: Structured assessment process Independent assessment, preferably by two people Consensus on final grade of HIA report Consider sections in review package when writing a HIA report it may be reviewed using the same tool

39 5. HIA Case Study Margam Opencast HIA

40 Aerial View

41 Resident View

42 Proposed Extension Produced by Public Health Wales Observatory Crown Copyright and database right Ordnance Survey

43 Margam Opencast HIA-Method Community-led HIA approached WHIASU May 2005 Steering Group WHIASU, National Public Health Service, community members Methodology literature review, technical advice (Environmental Health, Public Health), focus groups

44 Margam Opencast HIA-Findings Key potential health impacts: Environment nuisance dust, particulates, loss of amenity, visual impact Economic effect on local businesses Individual stress, physical activity, noise and vibration, light pollution, effect on property values and character of neighbourhood Potential negative impacts outweighed positive impacts

45 Margam Opencast HIA - Recommendations Priority to individual health and wellbeing precautionary principle Basic human rights not to be overridden by economics of coal extraction Sustainable development and move away from reliance on fossil fuels should be underlying aim

46 Margam Opencast HIA - Conclusions Good example of HIA within planning process Empowered community members Change in Welsh Government policy: One Wales (2007) MIMPPS (2009) MTAN2:Coal (2009)

47 Useful websites/contacts Organisation Wales HIA Support Unit HIA Gateway World Health Organisation International Association for Impact Assessment Website Contact Wales HIA Support Unit Julia Lester Liz Green Address

48 Introduction to Health Impact Assessment (HIA) Julia Lester Wales HIA Support Unit (WHIASU)