Conducting an HIA

HIA is a structured, yet flexible process by which to consider the health implications of a policy, plan, or investment, as well as how those impacts might disproportionately affect different racial, income, geographic, and other population groups. HIAs employ a variety of methods, bringing together qualitative and quantitative data, public health expertise, and stakeholder input to judge potential health effects and provide recommendations for enhancing health benefits and minimizing risks or harms.

HIAs are usually voluntary and conducted before a policy, plan or investment is implemented or built, sometimes in combination with environmental impact assessment (EIA), which examines environmental impacts of policies, plans and investments. Usually HIAs are conducted by public health professionals in health departments, universities, or health advocacy and consulting groups. Practitioners include local, state and federal public health officials, private consultants, public health students and faculty, medicine, built environment, and architecture.

Steps of an HIA Process

1

Screening

Determine if an HIA is needed and would add value to the policy, plan or investment

2

Scoping

Plan the HIA: determine project partners; identify risks and benefits to consider; decide on methodology; develop a work plan

3

Assessment

Assess health impacts: analyze existing conditions; identify affected populations; review the proposed policy, plan or investment; evaluate the potential impacts on existing conditions

4

Recommendations

Develop recommendations to promote positive health effects and minimize negative health effects

5

Reporting

Report findings: develop a report to communicates findings and recommendations; present results to decision-makers, affected communities, and other stakeholders

6

Monitoring and Evaluation

Determine the HIA’s impact on the decision and health status

Adapted from The Pew Charitable Trust, Do Health Impact Assessments Promote Healthier Decision-Making?

Types of HIAs

HIAs differ in terms of intensity, timeline, team, and budget required. Below are several types of HIAs.

    Desktop
    Rapid
    Intermediate
    Comprehensive
    Description
    Relies mainly or exclusively on existing research and remote contact with stakeholders
    Uses a shortened approach to an HIA, with a smaller amount of primary research and stakeholder engagement
    May involve a workshop with stakeholders in addition to desktop and rapid assessment techniques
    Uses as much evidence as possible including: An extensive search of the literature and other existing information; In-depth interviews; Community surveys; Some original research if appropriate; Input from experts and agencies
    Team Size
    1-2 team members
    1-2+ team members
    Varies
    May require team
    Timeframe
    2-6 weeks
    Up to 3 months
    Varies
    Up to 6 months+

    Related Resources

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    The following organizations offer valuable support for health impact assessments and health in all policies work. These partners have created a wealth of HIA and HiAP resources (including many available on this site), facilitate networking and peer connections, offer grant programs, and provide training and technical assistance. Follow the links below for more information.
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