6. Health Impact Assessments

Question 1

health

Answer 1

complete physical, mental, social well-being beyond absence of disease

Question 2

determinants of health

Answer 2

enviro conditions (impacting physical and mental health), social factors, economic factors

Question 3

broad impact on well-being

Answer 3

interplay of determinants shapes individual and community-level health outcomes

Question 4

HIA

Answer 4

evaluates health impacts of diverse policies, plans and projects systematically

aims to promote health equity and ensure vulnerable populations benefit from inclusive decision-making processes

integrates health considerations across sectors (enviro, social services, econ development) for cohesive policies

centers on the potential impacts on public health, addressing broad range of health outcomes including indirect factors (housing, service access, social cohesion, equity)

Question 5

equality vs equity

Answer 5

equality; everyone same to produce equal outcomes

equity; what is right, fair, moral. interventions adjusted in ways attentive to unique needs to produce fairer health outcomes

Question 6

HIA steps

Answer 6

1. screening; HIA necessary based on potential health impacts?
   –> identify significant effects= HIA
2. scoping; key health issues, data sources, affected populations, HIA objectives/framework
3. assessment; baseline, predict outcomes, assess impacts on vulnerable populations
   –> ensure communicated to stakeholders
   –> ensure integration of health considerations in EIA
4. recommendations; actions to enhance health benefits, reduce risk, mitigate impacts through design changes/project modifications
5. reporting; stand alone report or integrated into EIA
6. follow-up/monitoring/evaluation; track implementation, monitor health outcomes, assess HIA effectiveness to inform future assessments, make needed adjustments

Question 7

HIA = diverse methodologies

Answer 7

quantitative
qualitative
participatory research techniques

enhance prospective and retrospective evaluations
–> not just about predictions based on project, but understanding legacy effects

Question 8

HIA = engagement

Answer 8

engage public, stakeholders throughout process to support comprehensive understanding of health impacts and community’s concerns.

–> communication
–> strong learning function

Question 9

4 types of HIA

Answer 9

1. mandated; legally required conducted within formal assessments to meet statutory health requirements
2. decision-support; voluntary evaluations to improve decision-making, provide health insights
3. advocacy; conducted by individuals/orgs seeking to influence decision-making process of specific project for fairer/better outcomes
4. community-led; initiatives of local communities seeking to influence decision-making process of specific project for fairer/better outcomes

Question 10

HIA in BC

Answer 10

mandates HIAs for new projects to embed health considerations into EIAs

health now identified pillar of EIA legislation in BC (standalone HIA = rare, often commisioned independent of EIAs)

–> evolving health policy landscape trends indicating policies increasingly focus on social determinants, emphasizing comprehensive health impact evaluations

Question 11

HIA in canada (federal)

IAAC = interim guidance on HIA

Answer 11

IAAC = practioner guidelines for social and health IAs, strong focus on upstream determinants across multiple life cycles and contexts

strong interest in evaluating pathways of effects from project development through decommissioning + health impacts

HIA recognized, not mandated

Question 12

HIA includes both… effects on populations

Answer 12

direct effects

indirect effects
–> benefits; enhanced social cohesion or mental health
–>potential negative indirect impact: increased housing insecurity

Question 13

HIA challenges

Answer 13

1. equity assessment gaps
   –> limited methodologies hindering effective equity assessments = insufficient connections between health determinants across time
2. methodological limitations; exisiting HIA frameworks overlook CEs of health impacts, linking past, present, future stressors
3. data limitations; data to understand context, impacts, outcomes, pathways
4. advancements; need to integrate equity considerations systematically in better way (need innovative methods)

–> how define well-being?

5. integration with EIA; (defined later)

Question 14

HIAs demonstrate the necessity of integrating health within enviro. assessments for effectiveness and improved socio-enviro. outcomes.

Answer 14

Integrative approach

Question 15

effective HIAs acknowledge cumulative and legacy effects, contribute directly to promoting health equity by addressing social determinants, connect project impacts on well-being and are woven into EIA and decision-making

Answer 15

promoting health equity

Question 16

exposure pathways in HIA

Answer 16

1. health impact pathways:
   toxic exposures, ecosystem changes, behavioural modifications, workplace conditions affecting health equity
   –> common, preferred by proponents/regulators
2. significance for equity:
   pathways can emphasize need for equitable policy and decision-making addressing social determinants of health disparities
   –> challenge in EIA
3. environmental justice considerations: how impacts important to ensure enviro. justice and promote fair health outomes for all
   –> challenge in EIA

Question 17

Many environmental health challenges now have been unfolding across broad geographic areas over period decade/centuries. These enviro. challenges are drivers of…

Answer 17

health inequities

Question 18

integrated assessment approaches offer significant potential to understanding multiple drivers of … (4) to ecosystem communities and human health. they can strengthen the social license to operate. making linkages means better understanding of …(2)

Answer 18

change, pressures, exposures and impacts

impacts + how to mitigate them

Question 19

challenge of integration

Answer 19

social ecological systems = complexities need to be integrated assessment methodologies to address interconnected challenges.

–> means connecting different types of information

–> improved mitigation tools = essential for integrating health assessments, ensuring comprehensive understanding of cumulative impacts

Question 20

Federal Impact Assessment Act:

“effects means, unless the context requires otherwise, changes to …. and the positive and negative consequences of these changes

• effects within federal jurisdiction means, with respect to a physical activity or a designated project
  …. (2)
• sustainability means the ability to protect the environment, contribute to the social and
  economic well-being of the people of Canada and preserve their …..

Answer 20

the environment or to health, social or economic conditions

– any change occurring in Canada to the health, social or economic conditions of the Indigenous peoples of Canada;

– any change to a health, social or economic matter that is within the legislative authority of Parliament that is set
out in Schedule 3.

health in a manner that
benefits present and future generations”