Health in Planning Wollondilly Shire Council

CHETRE has been working with Population Health Unit South Western Sydney Local Health District and Wollondilly Shire Council (WSC) to identify ways of integrating health considerations into Council policy and planning processes. This work began with WSC’s involvement in the 2013/14 Health Impact Assessment (HIA) Learning by Doing Training in which they completed an HIA on a large new housing development. In November 2015, a joint Planning and Health Forum was held to discuss potential ways of progressing this work. As an outcome of the forum it was decided that CHETRE, in partnership with SWSLHD Population Health and WSC, would conduct a research study to identify strategies to integrate health into planning processes within Council.

In May 2016, WSC and SWSLHD formed a memorandum of understanding (MOU). As part of this, CHETRE was funded by SWSLHD to lead a research project to identify strategies to integrate health into planning processes within Council. Additionally, the MOU established a reference group, comprised of one key staff from each organisation, and a steering committee comprised of additional relevant staff from across the three participating organisations.

The aims of this research were:

• To develop a shared understanding of Wollondilly Shire Council planning processes and opportunities for the consideration of health within those processes;
• To identify and appraise various tools, processes, and assessment strategies that may be used to integrate health considerations into the planning process; and
• To appraise the applicability and appropriateness of various tools, approaches, or assessment strategies to both the Wollondilly Shire context and other planning contexts.

The project identified a need to implement actions or approaches that can develop buy-in from staff, Council, community, and developers; increase capacity through improving understanding and skill building to assess health impacts; and to develop a high-level health policy that can influence all other levels of planning.

Key actions were recommended in order to achieve these goals:

1. Create a high-level health policy
2. Create a health assessment policy
3. Establish a joint staff position with SWSLHD, and
4. Develop an overarching strategy that will guide this work moving into the future.

Wollondilly

Health Planning Tool Audit

Enabling healthier communities through working with local government: Developing a health assessment framework for Wollondilly Shire Council This project builds on previous Wollondilly partnership work. The project is developing a Health Assessment Protocol for integrating health into high level policy making and development control processes. The Health Assessment Protocol will define how the Council will integrate the consideration of health into all strategic and high-level planning and policy making, and into the Development Control Plans that provide planning standards and controls to guide new development in Wollondilly. In addition, joint work between the council, LHD and CHETRE has recently been incorporated into the Wollondilly Health Alliance through the development of a Health In Planning Working Group (HIPWG).

International Union for Health Promotion and Education (IUHPE) Global Working Group on Health Impact Assessment

Background
Fiona Haigh represents CHETRE on the IUHPE Global Working Group on Health Impact Assessment. CHETRE and the UNSW Research Centre for Primary Health Care and Equity provided secretariat support for the IUHPE Global Working Group on Health Impact Assessment (until 2017).

Mission
To support the development of Health Impact Assessment as a technology and a process to assist the health and other sectors, and communities to influence public policy to create social, economic and environmental conditions for health and health equity within and between populations.

Aims

• To facilitate the development of, and communicate, theory, policy and practice-derived evidence of the design, application and effectiveness of health impact assessment at international and national levels;
• To develop an evidence base for appropriate methodologies to use in the identification step (data collection) of HIAs;
• To enable discussion, debate and shared learning among the researchers, practitioners, policy makers and communities engaged in health (and other forms of) impact assessment in order to develop a research/practice/policy agenda for advancing HIA;
• To encourage collaboration among researchers, practitioners, policy makers and communities to build the theory and evidence base informing the practice of health impact assessment;
• To collaborate with policy makers, researchers, practitioners, and communities to ensure that health impact assessment (and related, relevant forms of impact assessment) contribute to reducing (and eliminating) inequities in health;
• To contribute to actions within the health and other sectors to ensure that health impact assessment plays a positive role in ensuring that the directions taken by globalisation and other 21st century forces such as climate change have positive population health outcomes, including closing the equity gap.

IUHPE Website Page on the HIA Global Working Group

Health Impact Assessment of the Proposed Trans-Pacific Partnership Agreement

CHETRE has been working with a group of Australian academics and non-government organisations interested in the health of the Australian population to carry out a health impact assessment (HIA) on the Trans Pacific Partnership Agreement negotiations.

In the absence of official publicly available drafts of the trade agreement, the health impact assessment drew on leaked texts of potential provisions and formulated policy scenarios based on high priority health policies that could be affected by the TPP. The HIA found the potential for negative impacts in each of the four areas under investigation: the cost of medicines; tobacco control policies; alcohol control policies; and food labeling.

In each of these areas, the HIA report traces the relevant proposed provisions through to their likely effects on the policy scenarios onto the likely impact on the health of Australians, focusing particularly on vulnerable groups in the Australian community.

The report makes a number of recommendations to DFAT regarding the TPP provisions and to the Australian Government regarding the TPP negotiating process.

HIA report

Joint work with Population Health, South Western Sydney & Sydney Local Health Districts

CHETRE works closely with the Population Health unit of South Western Sydney & Sydney Local Health Districts on a body of work focusing on healthy spaces, places and people.

This includes:

• Points of health influence in the Housing NSW Master Planning process
• Working with local government to create healthy environments
• Influencing health and wellbeing considerations in EIA (Phase 1)
• Improving the consideration of health within local government planning processes (Phase 2)
• Audit of urban development and land use planning correspondence between LG and SWSLHD

Villawood East HIA Literature Review: Housing Estate Redevelopment and Health

Incorporating health considerations in land-use planning and policy development: a review of activities in Stoke City Council in the UK and suggestions for application in NSW

 

 

ARC Discovery Grant: The effectiveness of Health Impact Assessments Conducted in Australia and New Zealand.

Project coordinator
Elizabeth Harris

Investigators
E Harris, F Baum, B Harris-Roxas, L Kemp, J Spickett, H Keleher, M Harris, R Morgan, A Dannenberg, D Sukkumnoed, A Wendel

Research support
Fiona Haigh (Project manager) and Harrison Ng Chok

Funding
Australian Research Council Discovery Project Grants; 2010-2011. [DP1096211]

Background
This study is the first systematic, empirical study of the influence of HIA on decision making and implementation of policies, programs and projects in Australia and New Zealand. This growing use needs to be to be supported by a strong evidence base, both to validate the value of its application and to make its application more robust. If HIA is to become routine in the already complex set of planning and assessment processes of both government and the private sector it will require decision-makers to be convinced of its “value add”.

Aim
To describe and explain changes to decision-making and implementation associated with the use of health impact assessments (HIAs) completed in Australia and New Zealand between 2005 and 2009.

Research Questions

1. Is there evidence that HIAs have changed decision-making and the implementation of policies, program or projects to strengthen positive and mitigate negative health impacts?
2. What factors are associated with increased or reduced effectiveness of the HIAs in changing these decisions and the implementation of policies, programs or projects?
3. What impacts do participants/stakeholders report following involvement in these health impact assessments

Design and methods
The research involved the use of multiple methods for the gathering and analysis of both qualitative and quantitative data. This included: identification and mapping, survey and structured interviews and retrospective multiple case studies using qualitative methods.

 

Health Street Rapid HIA

Project coordinator
Marilyn Wise

Investigators
Marilyn Wise, Fiona Haigh and Larissa Collins

Funding

Background
The Health Street Project has the goal of meeting gaps in the reach, quality, and impact of urban health care by educating communities on the health care and other social services and resources that are available to them, and bringing together communities, service providers and researchers to diversify the population groups who participate in and are served by research programs intended to improve the reach, quality, and outcomes achieved by health and social services.

Aims
To inform the Business Case currently being developed, through an analysis of the possible health impacts associated with Health St

Objectives of the Project

1. To review Health St options in relation to identified population groups.
2. To identify potential positive and negative health impacts resulting from the implementation of service delivery options.
3. To develop recommendations regarding Health St from the implementation of the options through the process of Health Impact Assessment

Design and methods

Rapid Health impact Assessment focussing on:

• Access of priority populations to health and social services;
• Formation / maintenance of collaborative networks among health and social services in defined locations;
• Reductions in inappropriate use of A & E;
• Engagement of priority populations in horizontal and vertical social networks.

HIA Training and Support – Tropical Population Health Service, Far North Queensland

Project coordinator
Patrick Harris

HIA training

Project coordinator
Patrick Harris and Fiona Haigh

Background
CHETRE runs a masters level course in HIA and also provides professional short courses.

Technical support: Moorebank Intermodal Terminal Health Impact Assessment

Project coordinator
Fiona Haigh and Patrick Harris

Background
The proposal involves the development of approximately 220 hectares (ha) (which is around 2km in length) for the construction and operation of the an intermodal terminal and associated infrastructure A key role for the terminal will be to promote the movement of container freight by rail between Port Botany and south western Sydney as well as on the interstate rail network. The requirement to conduct a HIA is outlined in the NSW Department of Planning and Infrastructure’s (DP&I) Director General Requirements DGRs) and Guidelines for the content of a Draft Environmental Impact Statement (EIS) provided by the Commonwealth Department of Sustainability, Environment, Water, Population and Communities (SEWPaC).The DGRs for the Project require:

“A health impact assessment of local and regional health risks associated with the development, including those health risks associated with relevant key exposures.”

Aims
CHETRE has been engaged as technical advisors throughout the conduct of the HIA and are included in the working group established for the HIA.

Gunnedah Basin Community Led HIA Scoping

Project coordinator
Fiona Haigh

Investigators
Fiona Haigh, Harrison Ng Chok

Funding
Pro bono

Background
The Gunnedah Basin in the north-west region of NSW is seeing an expansion of coal and coal seam gas operations. CHETRE is supporting some members of the local community to carry out the scoping stage for a HIA assess the potential cumulative impacts of the proposed mining developments.

Aims
To assess the potential cumulative impacts of current and potential coal and coal seam gas exploration and development on the health of the people living and working in the Gunnedah Basin

Design and methods
Currently we are supporting the screening and scoping stage of the HIA.

The impact of a Rapid Equity Focussed Health Impact Assessment (EFHIA) on local planning for after hours care to better meet the needs of vulnerable populations

Project coordinator
Elizabeth Harris

Investigators
Elizabeth Harris, Fran Baum, Marilyn Wise, John Furber, Angela Lawless, Patrick Harris, Ben Harris-Roxas, Sarah Denis, Lynn Kemp

Research support
Fiona Haigh

Funding
Australian Primary Health Care Research Institute

Background
Equity Focussed Health Impact Assessment (EFHIA) is a formal step wise process which involves a range of stakeholders in assessing assessing the consequences of a proposed policy, program or project, before it is implemented. The needs of vulnerable populations are considered at each step and all the impacts – positive, negative or unintended are considered. As a result it makes recommendations to improve the proposal so that any positive impacts are enhanced and and negative or unintended impacts are minimised.

Aims
The project aims to develop and evaluate EFHIA as a practical tool for Medicare Locals and Local Health Districts to use in modifying their service plans to engage vulnerable groups and address their needs. It will examine how feasible and effective this approach is.

Primary research questions

1. Is the use of Equity Focussed Health Impact Assessment (EFHIA) a feasible and effective way to improve local planning for Medicare Locals/LHDs to improve the access of vulnerable groups to afterhours care?
2. In the emerging governance structures of Medicare Locals and Local Health Districts does EFHIA offer an effective mechanism to engage health service consumers and other members of vulnerable groups in local health planning?

Design and methods
The project will involve piloting the use of an EFHIA intervention in at least 4 geographical areas in at least 3 states (NSW, Victoria, South Australia) where there is a commitment to joint planning by the Medicare Local and the Local Health District.

WA Oral Health HIA

Project coordinator
Patrick Harris

HIA of the Emergency Intervention in the Northern Territory

Project Coordinator
Elizabeth Harris

Investigators
Elizabeth Harris, Tamara Mackean, Mark Harris, Marlene Kong, Alex Brown, Ngaire Brown, Helen Milroy, Ben Harris-Roxas, Terry Dunbar, Marilyn Wise, Jane Lloyd, Lynn Kemp

Partners
Australian Indigenous Doctors’ Association

Background

The Centre for Health Equity Training, Research and Evaluation (CHETRE) was approached by the Australian Indigenous Doctors’ Association (AIDA) to undertake a Health Impact Assessment (HIA) of the Australian Government’s National Emergency Response to Protect Aboriginal Children in the Northern Territory.

Aims

In collaboration with AIDA and several communities affected by the Australian Government Intervention we will undertake a Health Impact Assessment (HIA) of the implementation of the Australian Government’s National Emergency Response to Protect Aboriginal Children in the Northern Territory.

Design and Method

The HIA was undertaken in partnership with AIDA and several communities who were directly affected by the NTER.

Evaluating the Impact and Effectiveness of Equity Focused HIA

Project Coordinator
Ben Harris-Roxas

Investigators
Ben Harris-Roxas, Pat Bazeley, Lynn Kemp

Funder
National Health and Medical Research Council Postgraduate Research Scholarship

Background

Equity focused HIA, or health equity impact assessment, is being increasingly promoted internationally as a mechanism to reduce and redress health inequities. Despite this little is know about the conditions under which it is most effective in influencing decision-making and the implementation of projects, plans or policies.

Aims

To answer:

• What are the direct and indirect impacts of EFHIAs conducted on health service plans?
• Does EFHIA improve the consideration of equity in planning and implementation compared to usual practices within the health sector?
• How does EFHIA improve the consideration of equity in proposal development and implementation within the health sector?

Design and Method

• Retrospective case study of 3 completed EFHIAs
• Prospective multiple case study of 3 health plans and subsequent EFHIAs

 

HIA and Health Equity in Greater Southern Area Health Service

Project Coordinator
Patrick Harris

Investigators
Marilyn Wise, Ben Harris-Roxas, Andrew Gow, Tony Kolbe, Maggie Jamieson, Jane Lloyd

Partners
Greater Southern Area Health Service

Background

The Centre for Health Equity Training, Research and Evaluation (CHETRE) worked with Greater Southern Area Health Service to enhance the organisation’s capacity to undertake HIAs and to address health inequities.

Aims

To investigate the use of health impact assessment and health equity filters in Greater Southern Area Health Service

Design and Method

CHETRE supported HIAs in Greater Southern Area Health Service, as well as developing and trialling an equity filter to assist internal planning and decision-making.

HNEAHS Health Equity Framework

Project Coordinator
Marilyn Wise

Investigators
Marilyn Wise, Elizabeth Harris, Ben Harris-Roxas, Patrick Harris, Jane Lloyd

Partners
Hunter New England Area Health Service – Ms Kim Browne, Dr Sue Carter

Background

The development of a Framework to guide the clinical, administrative, and managerial staff of the Hunter New England Area Health Service (HNEAHS) in integrating a focus on health inequity into their core business was given priority by the AHS and the NSW Department of Health (now, Ministry of Health).

The HNEAHS Equity Framework Core Planning Group Core led work on the development of an Equity Framework, with a substantial amount of work already completed. The UNSW Centre for Health Equity Training, Research and Evaluation’s (CHETRE) was contracted to assist with developing and finalising the Equity Framework.

Design and Method

The Hunter New England Health Equity Framework was finalised in 2009.

Implementation of Healthy Planning Principles in Two Local Councils in New South Wales

Project Coordinator
Patrick Harris

Investigators
Patrick Harris, Marilyn Wise, Ben Harris-Roxas, John Kurko

Partners

• National Heart Foundation NSW
• Liverpool City Council
• Blacktown City Council

Background

This study examines the implementation of healthy planning principles in two local governments in New South Wales. The study will look at how each Council has incorporated healthy planning principles within their contemporary planning practices in relation to a single policy that each council has implemented.

Aims

• To investigate the implementation of healthy planning principles in two local governments in NSW
• To investigate the use of Healthy by Design as a mechanism to promote the use of healthy planning principles

Design and Method

The Healthy by Design guidance will be used by two local governments in NSW. Data on the implementation of the healthy design principles will be collected through document review and semi-structured interviews.

Health Impact Assessment Support: Queensland Tropical Population Health Unit

Project Coordinator
Patrick Harris

Investigators
Patrick Harris, Marilyn Wise, Ben Harris-Roxas

Funder
Queensland Health Tropical Population Health Services

Background

Our work with Queensland Health’s Tropical Population Health Services has been to build the service’s capacity to undertake health impact assessment. In 2008 we provided three day HIA training to facilitate the unit to ‘learn by doing HIA’s. We subsequently have provided help desk support for the conduct of two HIAs in 2008/9; a rapid HIA on the re-development of Townsville’s urban centre, and an intermediate HIA on the Mackay regional development plan. We will be providing further help desk support and training for HIA work in 2009/10. The unit recently received the CPHCE HIA award for their ongoing capacity building work.

New South Wales HIA Project

The New South Wales Health Impact Assessment Project ran from 2003 to 2009 and was funded and extensively supported by NSW Health. The project sought to build the capacity of NSW Health to use HIA to improve internal planning and decision-making, and as a way to engage external partners on initiatives which influence health outcomes.

More than 20 HIAs were undertaken as part of the NSW HIA Project, it led in more than a dozen publications and two major HIA events.

Key Publications

Formal Project Evaluations

• Quigley and Watts. 2008. Independent Evaluation of Phase 3 of the NSW HIA Project, Quigley and Watts Pty Ltd: Wellington. Access Full Report PDF | Access Sumary Report PDF
• Harris, E. 2007. NSW Health HIA Capacity Building Program: Mid-term Review. UNSW Research Centre for Primary Health Care and Equity, University of New South Wales: Sydney. Access PDF
• Menzies, T. 2007. Reflections on ways HIA can be made most useful to Local Government in NSW. UNSW Research Centre for Primary Health Care and Equity, University of New South Wales: Sydney. Access PDF