Health Impact Assessment (HIA)

Evidence that HIA works

HIA is a developing approach that has started to provide evidence that it positively influences policies, programmes and projects. Beyond the countless number of positive anecdotes about the success of HIA, practitioners are now providing evaluation data to show the effectiveness of HIA. Like all public health interventions, little formal evaluation has been done and ‘proving’ HIA works is very difficult, but the three examples given show how the HIA community is now beginning to engage with evaluation.

Finningley Airport HIA (England)

What was the HIA on?

An HIA undertaken on a proposed development of a former RAF airbase at Finningley in Doncaster into a large commercial airport. This was the first time for an HIA to be undertaken as part of the planning process for an airport in the UK.

How did they evaluate it?

A descriptive process evaluation was undertaken. The source of data was a document analysis of the minutes of Working Group and Steering Group meetings. An impact evaluation is currently underway. This uses Theory of Change modeling to predict future health outcomes.

What did it show?

The process evaluation showed that the HIA had been systematic and comprehensive. The Merseyside model for comprehensive HIA lent itself particularly well for an HIA on a planning application.

Useful lessons were identified from the evaluation:

  • The technical information in the environmental impact assessment was used to predict health impacts. Experts were commissioned to fill gaps in local expertise.
  • WHO guidelines were used in the HIA which, in some instances, were more stringent than statutory levels.
  • Recommendations were made to maximise positives and minimise health risks, without needing to quantify or rank the predicted impacts.
  • Ensuring planners and developers recognised the importance of the HIA (and were informed of its progress) helped take the recommendations forwards.

The Health Authority worked proactively with planners and the airport developers to implement the recommendations, and influence the regulatory agreement between planners and developers. It is planned that an Airport Health Impact Group will continue HIA activities throughout the lifetime of the airport.

The impact evaluation demonstrates how the HIA has added value to the planning process, and predicts the future health outcomes expected.