Health Impact Assessment (HIA)

Glossary of terms used


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Qualitative and quantitative

HIA tries to balance qualitative and quantitative evidence. It involves an evaluation of the quantitative, “scientific” evidence where it exists but also recognises the importance of more qualitative information. This may include the opinions, experience and expectations of those people most directly affected by public policies and tries to balance the various types of evidence (Barnes and Scott Samuel, 1999). Generally speaking, quantitative evidence is based on what can be counted or measured objectively whilst qualitative evidence cannot be measured in the usual ways and may more subjective, for example, encompassing people’s perceptions, opinions and views.

Rapid (mini) HIA

A rapid or “mini” HIA, as the name suggests, is done quickly. It may be a “desk top” exercise, reliant on information which is already available already available “off the shelf” (Parry and Stevens, 2001), or through a half day or one day workshop with key stakeholders (Barnes et al., 2001). In either case, there is usually a minimum quantification of the potential health impacts which are identified.

Regeneration

Regeneration is a broad concept used to describe a wide variety of measures that are designed to revive disadvantaged (mainly urban) areas. This might include · modifying the physical environment; · altering lifestyles; · improving leisure opportunities; · enhancing the training and employment prospects of local residents · reducing stress, anxiety and fear; · strengthening control over people's lives and fostering empowerment; · improving access to public services; and · enhancing relationships between local residents and public sector agencies. Since the second world war there have been many regeneration initiatives – the most recent being the neighbourhood renewal and other related programmes – and many inner city areas have been “regenerated” more than once. ((Hirschfield et al., 2001).

Resource allocation

The process of deciding what is needed to carry out an activity and providing for those needs. This can include making provision for financial resources (money), capital resources (such as buildings and computer hardware) and staff resources (including the number of staff needed and the skill mix required).

Retrospective HIA

Retrospective HIA is carried out after a programme or project has been completed. It is used to inform the ongoing development of existing work.

Scoping

Scoping refers to the process of identifying the potential health impacts of a policy, programme or project before they are quantified, as in a rapid HIA. It may include reviewing the relevant literature and evidence base and collecting the views of key stakeholders (those with expert knowledge of the project, those involved and those potentially affected) followed by the tabulation of the potential health impacts (Parry and Stevens, 2001).

Screening

In relation to HIA, screening usually refers to an initial step being taken in order to determine whether a policy, programme or project should be subject to a HIA. The criteria used for this process may include, for example, the size and cost of the activity in question, the extent of any obvious or immediate health effects or the perceived extent of longer term effects. A new road transport policy, for example, might meet these criteria in view of its potentially high financial cost, the possibility of immediate health effects in terms of road traffic accidents and likely longer term effects in terms of air quality.

Service user involvement

Involving those who use services in their planning and organisation by, for example, inviting them to give feedback on the quality of services and ease of access to them or by having service user representatives on the steering groups which monitor service provision and plan future developments.

Social impact assessment

Social impact assessment is “the process of assessing or estimating, in advance, the social consequences that are likely to follow from specific policy actions or project development, particularly in the context of appropriate national, state or provisional policy legislation” (Vanclay and Bronstein, 1995). It is based on the assumption that the way in which the environment is structured can have a profound effect on people’s ability to interact socially with other people and to develop networks of support. For example, a major road cutting across a residential area can have the effect of dividing a community with implications for social cohesion (Hendley et al., 1998).

Steering group

A group of people brought together to oversee a piece of work such as a HIA. Typically, a steering group might be made up of up of representatives of relevant professional groups, key stautory agencies and the local community and its terms of reference might include · overseeing development and progress of the work; · agreeing the methodological framework and timescales; · providing an input of local knowledge and information; · acting as a bridge between partners; · facilitating the implementation of the assessment's recommendations; and · helping to assimilate and disseminate the emerging lessons. (Barnes, 2000).

Strategic environmental assessment

SEA has been defined as “the environmental assessment of a strategic action: a policy, plan or programme (Therivel and Partidario, 1996). SEA developed out of the recognition that the environmental impact assessment of specific projects, whilst an extremely valuable device, does not allow sufficient scope for the examination of the effect of a combination of projects. A commitment to sustainable development requires that a strategic approach to the environment be adopted. (Wood, 1995).

Strategy

The term strategy usually refers to a series of broad lines of action intended to achieve a set of goals and targets set out within a policy or programme (Ritsatakis et al., 2000). For example, within the themes of Single Regeneration Budget or New Deal for Communities initiatives it is usual to set out the strategic direction needed to be taken in order to achieve the goals and objectives of each theme, such as reducing unemployment, improving health or raising educational attainment.

Sustainability and sustainable development

The plethora of regeneration and neighbourhood renewal initiatives under way are all intended to provide sustainable changes – that is to say, benefits for the future as well as the present. A commonly used definition of sustainable development is “development which meets the needs of present generation without compromising the ability of future generations to meet their own needs” (World Commission on Environment and Development, 1987).

Toolkit

The term toolkit is generally held to mean an information resource including, for example, routinely available data which may be required for quantifying potential health impacts, a compilation of literature on health determinants or a template for organising a HIA or parts of the HIA process such as a workshop for key stakeholders.

Well-being impact assessment

Well-being impact assessment is difficult to distinguish from HIA although it could be argued that, instead of looking at all aspects of health, including medical factors, it concentrates primarily on aspects of quality of life and physical and mental well being.

Working group

In contrast to a steering group, a working group convened for the purpose of carrying out usually consists of those charged with carrying out the work on a day to day basis. Typically it might include people with a range of complementary public health skills such as project management, epidemiology, statistical analysis and presentation, questionnaire design and community development (Barnes and MacArthur, 2000).

Workshops

Workshops involve bringing together a group of people for a specific purpose. In HIA this might include, for example, identifying key stakeholders’ health concerns in relation to the policy, programme or project being addressed, identifying sources of current knowledge in relation to the evidence base or training staff in HIA techniques. Workshops are usually structured in some way with a mixture of presentations and “hands on” participative work.

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