Glossary of Health Impact Assessment Terms
Broader Model of Health
"Poor health cannot be explained simply by germs and genes. It is influenced by how we live and work and feel about our lives. Health, in its broadest sense, includes:
- Confidence and self esteem,
- A sense of belonging within a community, and
- Physical and emotional wellbeing." (NPHS Wales 2003)
Comprehensive HIA
Comprehensive HIAs are intensive and often require additional data from diverse sources, including baseline assessment of health conditions. This level of assessment is rarely done in-house but usually by commissioning consultants.
Decision-Makers
The people who have control over the final content of the proposal and/or are responsible for its implementation, including the extent to which it is influenced by the HIA.
Determinants of Health
The range of personal, social, economic and environmental factors which determine the health status of individuals or populations.
Differential Impacts
Where impacts are distributed unequally across or within population groups.
Direct vs Indirect Impacts
Direct impacts affect the health of the population directly, for example exposure to pollutants (including noise) that a proposal may release in the air, water and soil. Indirect impacts affect the health of the population indirectly through the proposal’s influence on the determinants of the health, for example the effects a proposal might have on the local job market, access to local shops and amenities and the availability of public greenspace.
Enhancement Measures
Changes made to a proposal to increase the likelihood of positive impacts.
Environmental Impact Assessment
"A process of predicting... the effects of an action or series of actions on the environment, then using the conclusions as a tool in planning and decision-making." (Prictard 1996)
Health
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948).
Health Equity
Equity in health implies that ideally everyone should have a fair opportunity to attain their full potential and, more pragmatically, that no one should be disadvantaged from achieving this potential, if it can be avoided. (Whitehead 1990)
Health Hazard
An agent with a potential to create ill health (e.g., bacteria, toxins, chemicals).
Health Impacts
The effects, direct or indirect, of a policy, plan, program or project on the health of a population.
Health Inequality
Health inequality describes differences in health status usually between groups, such as the differences in health between older and younger people that occur due to natural factors. Unlike health inequity is is solely a statement of difference and does not involve a determination of whether that difference is unfair or unavoidable.
Health Inequity
Health inequity refers to differences in health status that are seen as potentially avoidable or unfair, as opposed to those that occur as part of normal life processes. (NSW Health 2004)
Health Outcome
A change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions, regardless of whether such an intervention was intended to change health status.
Health Promotion
Concerned with promoting health and wellbeing.
Health Protection
Concerned with protecting health from risks and hazards.
Health Risk
Indicates the extent to which the potential of a halth hazard may be realised.
Healthy Public Policy
"The main aim of health public policy is to create a supportive environment to enable people to lead healthy lives. Such a policy makes health choices possible or easier for citizens. It makes social and physical environments health-enhancing. In the pursuit of healthy public policy, government sectors concerned with agriculture, trade, education, industry, and communications need to take into account health as an essential factor when formulating policy. These sectors should be accountable for the health consequences of their policy decisions. They should pay as much attention to health as to economic considerations." (WHO 1988)
Human Impact Assessment
Combined social and health impact assessments are sometimes called Human Impact Assessments (HuIA). This approach has been pioneered by STAKES in Finland.
Locational Disadvantage
Locations that are disadvantaged through lack of access to services and infrastructure or experience high levels of social disadvantage, such as rural and remote areas, outer metropolitan areas, and pockets of disadvantage within metropolitan areas.
Mitigation Measures
Measures to reduce the likelihood or severity of negative impacts.
Project Team
Those responsible for leading the work of the HIA, for report writing, and for framing the recommendations about modifications to the proposal.
Proponents
Those responsible for developing the proposal being assessed.
Social Impact Assessment
Social Impact Assessment (SIA) looks at the impacts of a certain decision on people, on the community or on society. These impacts are assessed in advance of implementation, to determine the changes the proposal will cause in people's welfare or in the distribution of welfare.
Stakeholders
People involved in or affected by proposal development and implementation, drawn from public, private and voluntary sectors, and the communities or groups affected.
Steering Committee
Usually a Steering Committee is established between the screening and scoping steps to oversee the conduct and progress of the HIA. Establishing a steering committee is the core organising task of scoping.
Forming a steering committee involves balancing the
need to make it small enough (a maximum of eight) to be manageable and making it large enough to include a
diverse range of perspectives and expertise. Useful areas of expertise for the committee are:
- the proposal topic,
- the potential population(s) affected,
- community involvement,
- public health expertose,
- negotiation skills,
- policy analysis,
- equity issues, and
- the social determinants of health.
“I’d recommend having representation on the committee from decision-makers and those who are in control of the proposal. The HIA we undertook was on a proposal being developed by the NSW Department of Planning. Having representatives from the Department on the committee allowed recommendations to be better tailored to the language and approach of the department.” (Harris et al 2007)
Unanticipated Impacts
Impacts that may not have been considered for various reasons, such as time, resources or professional orientation, during the development of a proposal.
Values
Establishing an HIA steering committee's values and perspective on health early on in the proceedings of the steering committee helps to ensure that there is consensus on the scope of the impacts that will be assessed in the HIA. This involves answering questions such as:
- How will health be defined?
- How will health equity be defined?
- What specific groups, communities or populations will be considered in terms of differential impacts?
- How will evidence be valued and evaluated?
- How will competing or conflicting evidence be reconciled?
- How will recommendations be developed?
- What range of stakeholders will be consulted and how? (Harris et al 1997)
References
Harris P, Harris-Roxas B, Harris E, Kemp L. Health Impact Assessment: A practical guide, Centre for Health Equity Training, Research and Evaluation (CHETRE), University of New South Wales: Sydney, 2007. Access Guide
NPHS Wales. Health Inequalities Impact Assessment Checklist: Guidance notes, National Public Health Service for Wales: Cardiff, 2003. Access Review
NSW Health. In All Fairness: The New South Wales Health and Equity Statement, NSW Health: Sydney, 2004. Access PDF
Pritchard D. Environmental Impact Assessment: Towards Guidelines for Adoption under the Ramsar Convention, 6th Meeting of the RAMSAR Contracting Parties: Brisbane, 1996. External Link
Quigley R, den Broeder L, Furu P, Bond A, Cave B, Bos R. Health Impact Assessment International Best Practice Principles. Special Publication Series No. 5, International Association for Impact Assessment: Fargo. Access PDF
Whitehead M. The Concepts and Principles of Equity and Health, World Health Organisation: Copenhagen, 1990. Access PDF
WHO. Adelaide Recommendations on Healthy Public Policy, World Health Organization: Geneva, 1988. Access PDF
WHO. Constitution of the World Health Organization, World Health Organization: Geneva, 1948. Access PDF
