Decisions about policies, programs, and projects in sectors such as housing, transportation, and education can affect the health of individuals and communities.  Health impact assessments (HIAs) are one way to bring health evidence to decisions. HIA is a process that engages stakeholders to help communities and decision-makers identify the potential health effects of decisions in multiple sectors; how those impacts might disproportionately affect different racial, income, geographic, and other groups; and how that distribution can influence health outcomes. HIAs then use those findings to develop recommendations that can help maximize health benefits and minimize preventable risks, such as chronic disease and injuries.

The Health Impact Project provides technical and financial assistance and training to support the use of HIAs across the country and conducts research to examine the effects of these assessments.

HIAs involve six steps. Engagement with the communities and individuals that may be affected, policymakers, and other stakeholders occurs throughout the steps.

Step 1: Screening. The HIA team and stakeholders determine whether an HIA is needed, can be accomplished in a timely manner, and would add value to the decision-making process.

Step 2: Scoping. The HIA team and stakeholders identify the potential health effects that will be considered and develop a plan for completing the assessment, including specifying their respective roles and responsibilities.

Step 3: Assessment. The HIA team evaluates the proposed project, program, policy, or plan and identifies its most likely health effects using a range of data sources, analytic methods, and stakeholder input to answer the research questions developed during scoping.

Step 4: Recommendations. The team and stakeholders develop practical solutions that can be implemented within the political, economic, or technical limitations of the project or policy to minimize identified health risks and to maximize potential health benefits. 

Step 5: Reporting. The team disseminates information including the HIA’s purpose, process, findings, and recommendations to a wide range of stakeholders. 

Step 6: Monitoring and evaluation. The team and stakeholders evaluate the HIA according to accepted standards of practice. They also propose a plan for monitoring and measuring the HIA’s impact on decision-making and the effects of the implemented decision on health.

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