Health Impact Assessment of the Green Square Draft Infrastructure Strategy and Plan
Creating liveable and healthy communities within former industrial sites involves unique opportunities for developers and councils to imagine and create new communities through the provision of a high level of amenity and facilities, and connected active and public transport. However, delivering diversity, a sense of community and healthy environments for people across the life course in higher density environments is an emerging challenge. Therefore, a Health Impact Assessment (HIA) was conducted to identify the potential health impacts of the Green Square development. This report describes the HIA findings and its recommendations.
Health Impact Assessment of Stage 3 of the Airds Bradbury Renewal Project
Is anyone listening? A Health Impact Assessment of the Western Sydney Airport Community Engagement Process
The Western Sydney Airport (WSA) is a proposed second airport to be located about 50km west of the Sydney central business district. In addition to relieving congestion for the Kingsford Smith Airport, it will serve as a focal point of urban growth for south western metropolitan Sydney.
Community engagement is an important process for providing and responding to community input into large-scale developments such as the WSA. To date there has been limited engagement with various communities and relevant stakeholders, such as affected local governments. Bringing a health lens to any community engagement strategies may help to improve health and wellbeing of communities. For this reason, it was decided to undertake a Health Impact Assessment (HIA) of community engagement for the WSA.
The HIA began in June, 2015 and was completed in February, 2017. It was conducted through a partnership between CHETRE and Western Sydney Community Forum. It was supported by South Western Sydney Local Health District. Evidence was collected through literature reviews, community profiling and community workshops that provided qualitative evidence on the impacts of existing engagement strategies, and recommendations to improve engagement processes in the future.
The HIA found that community engagement practices have been very limited and considered insufficient by most affected community members. Current engagement practices are impacting on important determinants of wellbeing, such as: access to information, feeling of control, participation, and risk perception.
It will be important for developers to consider their approach to community engagement as development of the airport and surrounding urban growth area will continue over the next 50 years. The HIA provides recommendations to improve community engagement practices that may be relevant to other airport and large urban development projects.
Villawood East Master Plan HIA
Villawood East is a public housing estate in Western Sydney, established during the early 1950s and in need of improvement. NSW Finance and Services and NSW Family & Community Services are developing a Master Plan for the Villawood East area. The key objectives of the Master Plan are to:
- Reduce the concentration of public housing and increase the availability of affordable housing.
- Enhance the urban structure.
- Enable the formulation of detailed planning controls to achieve high quality urban design outcomes.
In 2008 Housing NSW , Sydney and Sydney South West Local Health Districts and the Centre for Health Equity Training Research and Evaluation formed the Health and Housing Partnership. The vision of the housing and health partnership is working together to improve the health and wellbeing of the communities of South West Sydney. As part of the partnership’s strategic development, in late 2010 it was decided to follow the planning process for the Master Plan being developed for Villawood East. Health would collaborate with housing NSW across the process to understand the points where health could usefully add value to that process. This health impact assessment (HIA) forms part of this
activity.
- Villawood East Master Plan HIA (print version)
- Villawood East Master Plan HIA (screen version)
- Villawood East Master Plan Literature Review (print version)
- Villawood East Master Plan Literature Review (screen version)
Draft Residential Densities Strategy Mackay: Health Impact Assessment
Carless, F. & Gunning, C. (2011). Draft Residential Densities Strategy Mackay: Health Impact Assessment. Mackay Public Health Unit, Queensland Health: Mackay.
The Mackay Regional Council area is one of the fastest growing in Queensland, with strong growth forecast over the coming decades. Managing the challenges associated with high population growth is one of the drivers of Council’s Draft Residential Densities Strategy which outlines its vision for more compact urban areas within the region.
Recognition of the relationship between land use planning and health is not new and nationally there is much interest in translating this knowledge into practice. A tool which has emerged to contribute to this practice is Health Impact Assessment (HIA), a process which engages decision makers to consider health impacts in their planning, policy and program deliberations. To identify indirect health impacts that may be associated with the Draft Residential Densities Strategy, Queensland Health initiated a Health Impact Assessment with assistance from the Department of Communities, Mackay Regional Council and the Centre for Health Equity Training Research and Evaluation. Using a rapid HIA process, including collection of data via literature review and stakeholder consultation, and development of a population profile, the HIA project team generated a set of recommendations.
Marang Dhali Eating Well EFHIA
David Meharg, Aboriginal Population Health Trainee
Western NSW Local Health District
November 2011
This prospective desk-based Equity Focused Health Impact Assessment (EFHIA) aims to examine the equity issues relating to Marang Dhali Eating Well (MDEW). MDEW is a locally designed Aboriginal food and cooking program to improve food security in four Aboriginal communities within the Western New South Wales Local Health District (Western NSW LHD). This EFHIA makes predictions about the potential health impacts of MDEW and recommendations to maximise health gains and minimise health risks.
EFHIA_Marang_Dhali_Eating_Well
Health Impact Assessment of the Northern Territory Emergency Response
Australian Indigenous Doctors’ Association and Centre for Health Equity Training, Research and Evaluation, UNSW. Health Impact Assessment of the Northern Territory Emergency Response. Canberra: Australian Indigenous Doctors’ Association, 2010.
The Australian Indigenous Doctors’ Association (AIDA), in collaboration with the Centre for Health Equity Training, Research and Evaluation (CHETRE) at the University of New South Wales (UNSW) and with financial support from the Fred Hollows Foundation, undertook a health impact assessment (HIA) of the Northern Territory Emergency Response (NTER).
The purpose of the HIA is to predict what are likely to be positive, negative and/or unintended health consequences of the NTER, using a combination of evidence from a variety of sources.
The measures of the NTER outlined in the legislation, in associate media releases, and the NTER: One Year On report (Department of Families, Housing, Community Services and Indigenous Affairs, 2008) were assessed for their predicted health impacts based on the findings of community meetings with more than 250 Aboriginal people living in the prescribed communities, interviews with 25 Aboriginal and non-Aboriginal stakeholders, and a series of commissioned expert reviews.
Health Impact Assessment in New South Wales & Health in All Policies in South Australia: differences, similarities and connections
Delany T, Harris P, Williams C, Harris E, Baum F, Lawless A, Wildgoose D, Haigh F, MacDougall C, Broderick D et al: Health Impact Assessment in New South Wales & Health in All Policies in South Australia: differences, similarities and connections. BMC Public Health 2014, 14(1):699.
http://www.biomedcentral.com/1471-2458/14/699/abstract
Background
Policy decisions made within all sectors have the potential to influence population health and equity. Recognition of this provides impetus for the health sector to engage with other sectors to facilitate the development of policies that recognise, and aim to improve, population outcomes. This paper compares the approaches implemented to facilitate such engagement in two Australian jurisdictions. These are Health Impact Assessment (HIA) in New South Wales (NSW) and Health in All Policies (HiAP) in South Australia (SA).
Methods
The comparisons presented in this paper emerged through collaborative activities between stakeholders in both jurisdictions, including critical reflection on HIA and HiAP practice, joint participation in a workshop, and the preparation of a discussion paper written to inform a conference plenary session. The plenary provided an opportunity for the incorporation of additional insights from policy practitioners and academics.
Results
Comparison of the approaches indicates that their overall intent is similar. Differences exist, however, in the underpinning principles, technical processes and tactical strategies applied. These differences appear to stem mainly from the organisational positioning of the work in each state and the extent to which each approach is linked to government systems.
Conclusions
The alignment of the HiAP approach with the systems of the SA Government increases the likelihood of influence within the policy cycle. However, the political priorities and sensitivities of the SA Government limit the scope of HiAP work. The implementation of the HIA approach from outside government in NSW means greater freedom to collaborate with a range of partners and to assess policy issues in any area, regardless of government priorities. However, the comparative distance of HIA from NSW Government systems may reduce the potential for impact on government policy. The diversity in the technical and tactical strategies that are applied within each approach provides insight into how the approaches have been tailored to suit the particular contexts in which they have been implemented.
Health Impact Assessment of the Redevelopment of Liverpool Hospital
Sydney South West Area Health Service
A Steering Committee was established in July 2006 to conduct a prospective HIA on the Redevelopment of Liverpool Hospital. The focus of this project was on the construction phase of the redevelopment and the scope covered four issues – reduced parking for staff, patients and visitors; health and wellbeing of staff and the community; community and patient safety (non-traffic related); and increased traffic in the area (general and construction traffic). Recommendations were developed for the Executive User Group (EUG) and these are currently being monitored by the EUG.
In August 2007, the Executive User Group (EUG) for the Liverpool Hospital Redevelopment endorsed the conduct of a second Health Impact Assessment (HIA) for the redevelopment. The scope for the HIA was defined as being environmental effects; health promoting effects and effects on patient recovery and staff wellbeing. The current status of the redevelopment in August 2008 determined that we should focus on developing recommendations for the detailed design and commissioning phases of the project. An EFHIA was chosen for this project because it was thought that the most value that could be added at these stages of the design process would be to focus on a consideration of equity issues related to the redevelopment. This consideration is most relevant to the Liverpool Hospital Redevelopment
- Phase 1 HIA Report
- Phase 2 Equity Focussed HIA
- Journal Article: HIA in Urban Settings
- Journal Article: HIA of Construction Phase of Hospital Redevelopment
South East Queensland Regional Plan Health & Social Impact Assessment
Queensland Health, Queensland Department of Communities & Queensland Office of Urban Management
Abstract: A health and social impact assessment of the South East Queensland Regional Plan was undertaken in 2005 (Queensland Government, 2005). It is one of few attempts nationally and globally to apply health and social impact assessment to a regional planning process. The assessment methodology builds on existing evidence-based research, methodologies and the combined professional experience of both health and social impact assessment practices in Queensland. The approach adds further strength and rigour to planning strategies to enhance the health and well-being of communities. The way the South East Queensland Regional Plan is implemented, and how the plan influences access to jobs, education, affordable housing and social infrastructure, and the achievement of social inclusion and connectedness within communities, will be central to future health and well-being of people in South East Queensland.
Evaluating the impact of equity focused health impact assessment on health service planning: three case studies
Harris-Roxas B, Haigh F, Travaglia J, Kemp L: Evaluating the impact of equity focused health impact assessment on health service planning: three case studies. BMC Health Services Research 2014, 14(1):371.
http://www.biomedcentral.com/1472-6963/14/371
BACKGROUND:Health impact assessment has been identified internationally as a mechanism to ensure potential health impacts and health equity impacts of proposals are considered before implementation. This paper looks at the impact of three equity focused health impact assessments (EFHIAs) of health service plans on subsequent decision-making and implementation, and then utilises these findings to test and refine an existing conceptual framework for evaluating the impact and effectiveness of health impact assessments for use in relation to EFHIAs.
METHODS:Case study analysis of three EFHIAs conducted on health sector plans in New South Wales, Australia. Data was drawn from 14 semi-structured interviews and the analysis of seven related documents (draft plans and EFHIA reports).
RESULTS:The case studies showed that the EFHIAs all had some impact on the decision-making about the plans and their implementation, most clearly in relation to participants’ understandings of equity and in the development of options for modifying service plans to ensure this was addressed. The timing of the EFHIA and individual responses to the EFHIA process and its recommendations were identified as critical factors influencing the impact of the EFHIAs. Several modifications to the conceptual framework are identified, principally adding factors to recognise the role individuals play in influencing the impact and effectiveness of EFHIAs.
CONCLUSION:EFHIA has the potential to improve the consideration of health equity in health service planning processes, though a number of contextual and individual factors affect this. Current approaches can be strengthened by taking into account personal and organisational responses to the EFHIA process.
Equity Focused HIA of the South Australian ABHI School and Community Initiatives
Centre for Health Equity Training, Research and Evaluation (CHETRE)
(EFHIA) undertaken on the South Australian Program Reference Document of the School and Community Based Activities under the Australian Better Health Initiative 2006-2010. The EFHIA focussed on four components: Regional Healthy Weight Coordinators, the Healthy Ways project in Aboriginal communities, CYWHS parent focused project, and professional development to support these initiatives.
Flinders Street Redevelopment Project (Townsville) HIA
Queensland Health Tropical Population Health Services
In November 2008 a Rapid Desktop Health Impact Assessment was conducted on the Flinders Street Redevelopment project by the Health Promotion Service of the Tropical Population Health Services, Population Health Queensland. The identified health determinants were safety and security, access for all ages and abilities, social connectedness, participation and identity.
The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005-2009.
Haigh, F., F. Baum, A. Dannenberg, M. Harris, B. Harris-Roxas, H. Keleher, L. Kemp, R. Morgan, H. Chok, J. Spickett and E. Harris (2013). “The effectiveness of health impact assessment in influencing decision-making in Australia and New Zealand 2005-2009.” BMC Public Health 13(1): 1188.
Background
Health Impact Assessment (HIA) involves assessing how proposals may alter the determinants of health prior to implementation and recommends changes to enhance positive and mitigate negative impacts. HIAs growing use needs to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. We have carried out the first systematic empirical study of the influence of HIA on decision-making and implementation of proposals in Australia and New Zealand. This paper focuses on identifying whether and how HIAs changed decision-making and implementation and impacts that participants report following involvement in HIAs.
Methods
We used a two-step process first surveying 55 HIAs followed by 11 in-depth case studies. Data gathering methods included questionnaires with follow-up interview, semi-structured interviews and document collation. We carried out deductive and inductive qualitative content analyses of interview transcripts and documents as well as simple descriptive statistics.
Results
We found that most HIAs are effective in some way. HIAs are often directly effective in changing, influencing, broadening areas considered and in some cases having immediate impact on decisions. Even when HIAs are reported to have no direct effect on a decision they are often still effective in influencing decision-making processes and the stakeholders involved in them. HIA participants identify changes in relationships, improved understanding of the determinants of health and positive working relationships as major and sustainable impacts of their involvement.
Conclusions
This study clearly demonstrates direct and indirect effectiveness of HIA influencing decision making in Australia and New Zealand. We recommend that public health leaders and policy makers should be confident in promoting the use of HIA and investing in building capacity to undertake high quality HIAs. New findings about the value HIA stakeholders put on indirect impacts such as learning and relationship building suggest HIA has a role both as a technical tool that makes predictions of potential impacts of a policy, program or project and as a mechanism for developing relationships with and influencing other sectors. Accordingly when evaluating the effectiveness of HIAs we need to look beyond the direct impacts on decisions.
Good for Kids Good For Life Equity Focused Health Impact Assessment
Hunter New England Area Health Service
This report outlines the methods and findings from the Hunter New England Area Health Service’s (HNE AHS) ‘Good for Kids. Good for Life.’ program (Good for Kids) Health Impact Assessment (HIA). The HIA was completed in the period December 2006 – August 2007 and was implemented under the direction of a Good for Kids HIA working party and staff of the Good for Kids program. As an HIA development site, the working party and program staff received additional support from the University of NSW Research Centre for Primary Health Care and Equity (CHETRE).
The purpose of the Good for Kids equity-focused HIA was to improve the equity with which the program was delivered to Aboriginal and non-Aboriginal children. The use of HIA’s in Aboriginal health contexts has been limited, so the HIA working party took the opportunity modify the HIA so that it better reflected the principles of Aboriginal Health. This involved drawing on equity-focussed HIA methodology, learning from HIA’s completed in indigenous communities overseas and adopting an Aboriginal model of health.
Housing, Health and Master Planning: rules of engagement
Harris P, Haigh F, Thornell M, Molloy L, Sainsbury P. Housing, Health and Master Planning: rules of engagement. Public Health 2014http://dx.doi.org/10.1016/j.puhe.2014.01.006
Abstract
Objectives: Knowledge about health focussed policy collaboration to date has been either tactical or technical. This article focusses on both technical and tactical issues to describe the experience of cross-sectoral collaboration between health and housing stakeholders across the life of a housing masterplan, including but not limited to a health impact assessment(HIA).
Study design: A single explanatory case study of collaboration on a master plan to regenerate a deprived housing estate in Western Sydney was developed to explain why and how the collaboration worked or did not work. Methods: Data collection included stakeholder interviews, document review, and reflections by the health team. Following a realist approach, data was analysed against established public policy theory dimensions.
Results: Tactically we did not know what we were doing. Despite our technical knowledge and skills with health focussed processes, particularly HIA, we failed to appreciate complexities inherent in master planning. This limited our ability to provide information at the right points. Eventually however the HIA did provide substantive connections between the master plan and health. We use our analysis to develop technical and tactical rules of engagement for future cross-sectoral collaboration.
Conclusions: This case study from the field provides insight for future health focussed policy collaboration. We demonstrate the technical and tactical requirements for future intersectoral policy and planning collaborations, including HIAs, with the housing sector on master planning. The experience also suggested how HIAs can be conducted flexibly alongside policy development rather than at a specific point after a policy is drafted.
Health Impact Assessment of Lithgow City Council’s Strategic Plan
Sydney West Area Health Service and Lithgow City Council
This report explains the Health Impact Assessment (HIA) process and presents the findings of the HIA of the Lithgow City Council Strategic Plan, 2007. The primary output of the HIA is a set of evidencebased recommendations geared to informing the decision-making process. These recommendations aim to highlight practical ways to enhance the positive impacts or minimise any negative impacts on health, well being and health inequalities that might arise or exist in response to the Lithgow City Council Strategic Plan.
The Lithgow City Council Strategic Plan is the first long-term plan to be developed by Lithgow City Council in collaboration and consultation with the community and government. It introduces a new framework of strategic planning in the Lithgow local government area, which is driven by the community’s vision and issues. The Plan incorporates the visions and strategies and feeds these into Council’s management and operational plans to deliver actions that ultimately achieve the vision for the community. The objective of the Strategic Plan is to provide the strategic framework for the future development of the Lithgow Local Government Area and to encourage environmental, economic and social sustainability (Lithgow City Council Strategic Plan, 2007, Page 4).
The fit between health impact assessment and public policy: practice meets theory.
Harris P, Sainsbury P, Kemp L. The fit between health impact assessment and public policy: practice meets theory. Social Science & Medicine 2014;108:46-53. http://dx.doi.org/10.1016/j.socscimed.2014.02.033
Abstract
Objectives
Knowledge about health focussed policy collaboration to date has been either tactical or technical. This article focusses on both technical and tactical issues to describe the experience of cross-sectoral collaboration between health and housing stakeholders across the life of a housing master plan, including but not limited to a health impact assessment (HIA).
Study design
A single explanatory case study of collaboration on a master plan to regenerate a deprived housing estate in Western Sydney was developed to explain why and how the collaboration worked or did not work.
Methods
Data collection included stakeholder interviews, document review, and reflections by the health team. Following a realist approach, data was analysed against established public policy theory dimensions.
Results
Tactically we did not know what we were doing. Despite our technical knowledge and skills with health focussed processes, particularly HIA, we failed to appreciate complexities inherent in master planning. This limited our ability to provide information at the right points. Eventually however the HIA did provide substantive connections between the master plan and health. We use our analysis to develop technical and tactical rules of engagement for future cross-sectoral collaboration.
Project report: The Effectiveness of Health Impact Assessment in New Zealand and Australia: 2005-2009
Harris E, Haigh F, Baum F, Harris-Roxas B, Kemp L, Ng Chok H, Spickett J, Keleher H, Morgan R, Harris M, Dannenberg AL. The Effectiveness of Health Impact Assessment in New Zealand and Australia 2005-2009. Sydney: Centre for Primary Health Care and Equity, Faculty of Medicine, University of NSW, 2013.
Oran Park and Turner Road Health Impact Assessment
Sydney South West Area Health Service and Camden City Council
In May 2007, the NSW Government released detailed draft plans to develop 12,000 new homes in Sydney’s south-west – with construction to start as early as 2008 in Oran Park and Turner Road. It is anticipated that these plans will create healthy communities for families, with a mix of housing, jobs, schools, parks, transport, community facilities and shops. These precincts will offer a choice of accommodation including houses, terraces and units, to cater for singles, families and seniors. The Oran Park & Turner Road precincts are expected to provide 7,700 new jobs for Western Sydney – helping to achieve a key State Plan priority of more jobs close to home. Oran Park and Turner Road precincts are located in the Camden Local Government Area (LGA).
Sydney South West Area Health Service (SSWAHS) has been involved in the Greater Western Sydney Urban Development HIA with Western Sydney Region of Councils (WSROC) and Sydney West Area Health Service (SWAHS), which assessed aspects of the Sydney Metropolitan Strategy. The Oran Park &Turner Road Health Impact Assessment (HIA) is seen as a valuable extension and application of this previous project.
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