The many kinds of health impact assessments

Dr. Andrew Dannenberg and his co-authors describe the health impact assessment (HIA) as “a tool to help planners and other decision-makers better recognize the health consequences of the decisions they make.”

The commonly accepted steps for conducting an HIA, as outlined in their March 2008 article in the American Journal of Preventive Medicine, are screening (determining if health effects are involved); scoping (determining which health effects will be examined, how, and for whom); assessment of the direction and magnitude of the health effects; communication of results and recommendations to decision-makers; and evaluation of the HIA’s impact on the decision-making process.

There are three main types of HIAs.
1) Prospective HIAs are conducted before a policy or project is implemented.
2) A retrospective HIA takes place afterward.
3) Concurrent HIAs are simultaneous; these are more common for projects or policies that are put into effect over an extended period.

HIAs are also categorized as “rapid,” “intermediate,” and “comprehensive,” reflecting the amount of time and effort they require. The most rapid is a “desktop review,” which can be done in the office. The BeltLine HIA was comprehensive, investigating issues such as access to healthy foods in a sizable portion of Atlanta. “We mapped full-service grocery stores,” Karen Leone de Nie of the Federal Reserve Bank of Atlanta pointed out. “You have to get creative.” Decatur’s HIA was rapid; nonetheless, its 70-page final report would strike many readers as having plenty of substance.

HIA results may be integrated into an environmental impact assessment, possibly increasing their effectiveness. Although HIAs often focus on land use and transportation planning, the full range of HIAs in the US has also included wage policies, walk-to-school programs, after-school programs, farm policy, power plants, and public subsidies for housing and home heating.

See also: Public health: the next driver of planning decisions?