Workshop 4

Chair: Mary Mahoney

Health Impact Assessment: Making the Difference

Ashley GouldPolicy Officer (Health Improvement)

Applying HIA in Local Government:

Exploring the Reality

Grace BlauResearch Fellow

School of Health & Social Development

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Introduction - WLGA

• Represents the interests of local government and promotes local democracy in Wales.

• Promote better local government & support authorities in the development of policies and practices which will improve public services.

• Policy development and representative roles plus improvement and development, procurement, employment issues and health improvement.

• Dedicated Health & Well-being Team

• Local HSCWB Strategies (employing HIA!)

• Recognise, maximise, promote – LA’s as Health Improvement agencies

• Briefings, networks, events & sessions

• Launched HIA guidance with WHIASU in ‘04

• The Route to Health Improvement

Health Improvement Context

HIA in ‘The Route toHealth Improvement’

• Policy Development (1 of the 5 key features)– Setting the vision

▪A Council that develops policy that maximises the positive health impact of services will have the following features:

“Health Impact Assessment…is used on a regular basis as part of

policy and decision making processes”

• Deakin University, School of Health & Social Development, Melbourne (Australia)– Strategic promotion of HIA– Teaching– Research

▪HIA in local government project– Application of HIA

Introduction - HIA Unit

Focus of my role

• Since October 2004– Research– Capacity building– Teaching– Application

• Past experience– Health care services– Local government public health planning

So, does local government ‘do’ health ?

Local government is best placed to change life circumstances and improve health

50%

Social & economic environment

15%

Genetic endowment

10%

Physical Environment

25%

Illness Care System

Source: Canadian Institute for a Advanced Research

Estimated Health Impact of ‘Determinants Of Health’ on Population Health Status

An individuals life circumstances contribute more to health

improvement than health care services

…Absolutely!

Four aspects of the reality of HIA in local government

Why HIA at the local level

How HIA at the local level

Drivers/broader agenda

Organisational context

That’s us – who are you?

AND

Why do you think local government should use HIA?

1.Social networks and the scale of operations within communities are such that the ties between policy makers and those affected are stronger

2.Policy makers live where they work so are identifiable and affected by their own policies

3.The bureaucracies of communities are relatively small and there is a greater chance of inter-sectoral cooperation

Hancock’s rationale for using HIA in LG

The Workshop Bit – sharing your experiences

Drivers/broader agenda

Organisational context

Workshop Task 1

• From your experience in your organisation identify CONTEXTUAL FEATURES IN YOUR ORGANISATION that could – create barriers to positioning or applying HIA – enable the positioning or application of HIA

• As a group, decide if there are there any generic features that are common to many organisations. Rank the features…

Workshop Task 2

• From your experience in your local region or your country identify EXTERNAL DRIVERS or AGENDAS that could – create barriers to positioning or applying HIA – enable the positioning or application of HIA

• Write these on sticky note paper and place on wall – clearly label BARRIER or ENABLER

Examples of ‘how’ in Welsh LG

• School Health Review - Pembrokeshire

• Screening linked to LA ‘Quality of Life’ checklist

– against a proposal of NO school health service

• Two ‘rapid assessment’ workshops

– against 11 aims for a reshaped service

• Systematic gathering of evidence to inform decision on reshaping service

Examples of ‘how’ in Welsh LG

• Highways Maintenance Policy Wrexham CBC– Policy being re-drafting/HIA profile raiser– Police, community reps, disability groups and insurers– driven monthly > walked weekly– More sharing of data to inform policy

• Maesincla Integrated Children’s Centre– Community engagement ‘vehicle’ – Parents, consultants, LA officers and community reps – Renamed by community and daily timetable changed– Report on www.WHIASU.cf.ac.uk

Examples from Victoria

• HIA of Family Violence Strategy– HIA identified increased perceptions of fear

amongst community because strategy raised awareness of incidence of family violence

• HIA of Drought Social Recovery Strategy– Currently impact identification stage– Consecutive short term funding for rural

counselling services may have increased mental health problems

Examples from you!

???

So, what’s changed as a result of the HIA?

Workshop Task 3

• When you leave this workshop today what action do YOU plan to take that will

– reduce the barriers to the positioning or application of HIA in your organisation?

– take advantage of the enablers?

Whys & Hows Drivers &

Contexts

Ashley Gouldashley.gould@wlga.gov.uk

Applying HIA in Local Government:

Exploring the Reality

Grace Blaugraceb@deakin.edu.au

Inclusive decisions > ownership

Exploration of what’s

already known

Focuses on the ‘better life’ contribution

Achieve ‘healthier’ results

Structured yet flexible

Community development

Evaluation & shared learning

Open process > justifiable results

cynicism = resistanceraising unrealistic expectationsresource (time & £) constraints

“used” to support controversial issues

A Few disadvantages or weaknesses:

7th International Health Impact Assessment

Conference

Health Impact Assessment: Making the Difference

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