The screening portion of a HIA considers whether or not a HIA should actually be conducted, including aspects related to timing, feasibility, whether or not health impacts are already being considered in the project, plan, policy or proposal, and if conducting the HIA would be beneficial to the decision-making process.
The scoping process of a HIA typically sets the boundaries of the HIA, including which topics or areas of interest will be considered in the HIA process, what the research questions are, what the health pathways are for each area of interest, identifying the type of HIA to be conducted, who will be involved and the timeline.
There are two kinds of ways to conduct an HIA and determining which ones should be used is usually determined by the time available and data available. A rapid HIA, as its name might suggest, is conducted quickly, often within days or weeks. A comprehensive HIA, on the other hand, takes more time. Primary data is collected, literature reviews are undertaken, and stakeholders are often consulted.
The assessment phase of a HIA is the information-gathering phase. Information on baseline conditions is collected, public participation meetings are held, primary or secondary research of impacts is conducted, and conclusions about health impacts are made.
Human Impact Partners defines the two key components of assessment this way:
“Profile Existing Conditions: Research baseline conditions, including health outcomes and determinants of health disaggregated by income, race, gender, age, and place when possible.”
“Evaluate Potential Health Impacts: Use theory, baseline conditions, and population concerns; consider evidence that supports and refutes health impacts; assess affects by income, race, gender, age, and place; include assessments of the certainty, significance, and Equity of impacts; justify the selection or exclusion of data/methods; identify data gaps, uncertainties, and limitations; allow stakeholders to critique findings.”
The recommendation phase proposes ways to mitigate negative health impacts and emphasize positive health impacts. They can be policy interventions, related to the design physical environment, or can propose changes to the development process, such as encouraging more community meetings and getting more feedback from stakeholders moving forward.
Reporting involves disseminating the findings and recommendation of the HIA.
Evaluation and monitoring
The evaluation step of an HIA involves determining whether or not the HIA was successful, and why, or why not. This often involves understanding whether or not the HIA was taken into consideration by decision makers, and if the recommendations were implemented.
The monitoring step involves evaluating if recommendations that were actually agreed to were implemented, and gathering additional data to understand if predicted health impacts were realized.