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.
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
- 1 ARC Discovery Grant: The effectiveness of Health Impact Assessments Conducted in Australia and New Zealand.
- 2 Health Street Rapid HIA
- 3 HIA Training and Support – Tropical Population Health Service, Far North Queensland
- 4 HIA training
- 5 Technical support: Moorebank Intermodal Terminal Health Impact Assessment
- 6 Gunnedah Basin Community Led HIA Scoping
- 7 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
- 8 WA Oral Health HIA
- 9 HIA of the Emergency Intervention in the Northern Territory
- 10 Evaluating the Impact and Effectiveness of Equity Focused HIA
- 11 HIA and Health Equity in Greater Southern Area Health Service
- 12 HNEAHS Health Equity Framework
- 13 Implementation of Healthy Planning Principles in Two Local Councils in New South Wales
- 14 Health Impact Assessment Support: Queensland Tropical Population Health Unit
- 15 New South Wales HIA Project
- 16 Key Publications
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
- 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?
- What factors are associated with increased or reduced effectiveness of the HIAs in changing these decisions and the implementation of policies, programs or projects?
- 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
- To review Health St options in relation to identified population groups.
- To identify potential positive and negative health impacts resulting from the implementation of service delivery options.
- 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
- 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?
- 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
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
Project Related Publications
2010
- Harris E, Harris-Roxas B. Health in All Policies: A pathway for thinking about our broader societal goals, Public Health Bulletin SA, 7(2): 43-46, 2010. Access Articl
2009
- Ampt, M., Harris, P., Wise, M. The Health Impacts of the Design of Hospital Facilities on Patient Recovery and Wellbeing, and Staff Wellbeing: A Review of the Literature. Centre for Health Equity Training, Research and Evaluation. Part of the UNSW Research Centre for Primary Care and Equity, UNSW, Australia, 2008. Access PDF
- Christl, B., Harris, P., Wise M. A review of the evidence of the impact of public transport on population health in Australia. Centre for Health Equity Training, Research and Evaluation, UNSW, Australia, 2009. Access PDF
- Harris P, Harris E, Thompson S, Harris-Roxas B, Kemp L. Human Health and Wellbeing in Environmental Impact Assessment in New South Wales, Australia: Auditing health impacts within environmental assessments of major projects, Environmental Impact Assessment Review, 29(5); 310-318, 2009.doi:10.1016/j.eiar.2009.02.002
- Jones A, Harris-Roxas B. The Impact of School Retention and Educational Outcomes on the Health and Wellbeing of Indigenous Students: A literature review, Sydney: Centre for Health Equity Training Research and Evaluation (CHETRE) UNSW, 2009. Access PDF
- McDonald, J., Wise, M., Harris, P. The Health Impacts of the Urban Form: A Review of Reviews. Centre for Health Equity Training, Research and Evaluation. Part of the UNSW Research Centre for Primary Care and Equity, UNSW, Australia, 2008.Access PDF
- Wise M, Harris P, Harris-Roxas B, Harris E. The role of health impact assessment in promoting population health and health equity, Australian Health Promotion Journal of Australia, 20(3):172-179, 2009.
2008
- Maxwell M, Harris P, Peters S, Thornell M, D’Souza L. A health impact assessment on the construction phase of a major hospital redevelopment. Australia Health Review. 2008; 32 (3): 509-519.
- Tarantola D, Byrnes A, Johnson M, Kemp L, Zwi AB, Gruskin S. Human rights, health and human development. Australian Journal of Human Rights, in press.
2007
- Harris P, Harris-Roxas B, Harris E, Kemp L. 2007. Health Impact Assesessment: A practical guide. Sydney. Access PDF
- Harris P, Harris-Roxas B, Harris E. An overview of the regulatory planning system in New South Wales: identifying points of intervention for health impact assessment and consideration of health impacts. New South Wales Public Health Bulletin. September/October; 18(9-10): 188-191. Access PDF
- Harris P, Harris-Roxas B, Harris E, Kemp L. Health impact assessment and urbanization: lessons from the NSW HIA project. New South Wales Public Health Bulletin. May/June; 18(9-10): 198-201. Access PDF
- Harris P, Harris-Roxas B, Kemp L. Health impact assessment in urban settings. New South Wales Public Health Bulletin. September/October; 18(9-10): 149-150. Access PDF
- Harris-Roxas B, Harris P. Learning by doing: the value of case studies of health impact assessment. NSW Public Health Bulletin. May/June; 18(9-10): 161-163.Access PDF
- Hughes J, Kemp L. Building health impact assessment capacity as a lever for public health policy in urban planning. New South Wales Public Health Bulletin. May/June; 18(9-10): 192-195. Access PDF
- Larsen K. The health impacts of place-based interventions in areas of concentrated disadvantaged: A review of the literature, Sydney: Centre for Health Equity Training Research and Evaluation (CHETRE) UNSW, 2007. Access PDF
2006
- Harris P, Harris-Roxas B, Harris E, Kemp L. Healthy Urban Planning: Recommendations from the New South Wales Health Impact Assessment Project, Centre for Health Equity Training, Research and Evaluation (CHETRE): Sydney, 2006. Access PDF
2005
- Harris E, Sainsbury P, Simpson S, Harris-Roxas B. Addressing the Societal Determinants of Health: Investing in a sustainable health system, a discussion paper prepared for the NSW Health Futures Planning Project. Sydney: CHETRE UNSW; 2005. Access PDF
- Harris E. Contemporary Debates in Health Impact Assessment: What? Why? When?NSW Public Health Bulletin 2005; 16(7-8):107-108. Access PDF
- Harris E, Sainsbury P, Staff M. Health Impact Assessment in New South Wales. NSW Public Health Bulletin 2005; 16(7-8):105-106. Access PDF
- Harris-Roxas B, Simpson S, Harris E. Impact Assessment, a discussion paper prepared for the NSW Health Futures Planning Project. Sydney: CHETRE UNSW; 2005. Access PDF
- Harris-Roxas B, Simpson S. NSW Health Impact Assessment Project. NSW Public Health Bulletin 2005;16(7-8):120-123. Access PDF
- Simpson S. An Introduction to Health Impact Assessment. NSW Public Health Bulletin 2005;16(7-8):106-107. Access PDF
- Simpson S, Mahoney M, Harris E, Aldrich R, Stewart Williams J. Equity-Focused Health Impact Assessment: A tool to assist policy makers in addressing health inequalities. Environmental Impact Assessment Review 2005; 25(7-8):799-807.
- Simpson S, Harris E, Nutbeam D. Equity in Health: An important issue for a sustainable health system, a discussion paper prepared for the NSW Health Futures Planning Project. Sydney: CHETRE UNSW; 2005. Access PDF
2004
- Simpson S, Harris E, Harris-Roxas B. Health Impact Assessment: An introduction to the what, why and how. Health Promotion Journal of Australia, 15(2): 162-167, 2004.
2003
- Harris E. Health and Equity Profiles: project report, Sydney: CHETRE UNSW; 2003.Access PDF
- Simpson S, Harris E. New South Wales Health Impact Assessment Project: Phase 1 report, Sydney: CHETRE UNSW; 2003. Access PDF
A full list of publications is available on the publications page
NB: These publications broadly relate to the NSW HIA Project and HIA in NSW but may not have all been funded or carried out under the project’s auspices.