Equity-focused health impact assessment framework

Background to the Development of the Equity-Focused HIA Framework
The equity focused health impact assessment (EFHIA) framework arises out of a two year research project funded for the most part by the Australian Government’s Public Health Education Research Program (PHERP) Innovations Grants (Round 2) scheme. This project had as its primary objective the development of a framework for health inequalities impact assessment, subsequently renamed equity focused health impact assessment. A partnership between the University of Newcastle, Deakin University and the University of New South Wales (the Project Management Steering Committee) received the funding and the Australasian Collaboration for Health Equity Impact Assessment (ACHEIA) was formed to undertake appropriate background research and to develop, pilot test, modify and disseminate the framework. The work commenced in September 2002 and concluded in October 2004. Part of the funding included a capacity building workshop in August 2004. ACT Health and the Division of Medicine at the John Hunter Hospital, Newcastle, also provided financial support for the project. The August 2004 Workshop was supported by NSW Health. All participants and organisations involved in the project gave extensive in-kind support.
The aims of the workshop were to bring together an international collaboration of multidisciplinary investigators, public health experts, and key senior health managers working in national, state and local settings, to inform the further development of the framework and to provide training in its application. The initial goals of the project were to work collaboratively to develop a strategic framework to assess the health inequalities of public health-related policies, plans, strategies, decisions, programs and services. The EFHIA framework as presented at the August workshop was developed through:
1. an extensive review of the relevant literature
2. formal and informal consultation with members of ACHEIA (the international
reference group), members of the Project Management Steering Committee and
other relevant experts; and
3. testing of the draft EFHIA framework with the 5 case study partners – who applied the draft framework in a range of health settings (see
Acknowledgements).
The result of this work has been the development of an equity focused health impact assessment framework that can be used to determine the unanticipated and systemic health inequities that may exist within the decision making processes or activities of a range of organisations and sectors. The EFHIA framework provides one approach that can be used to assist decision makers to put equity and health on their agenda in a more obvious and systematic way. The framework represents a ‘moment in time’ rather than a definitive statement or ‘toolkit’ on the best way to proceed. Further practice, refinement and adjustment will be needed over many years to consolidate both HIA and EFHIA. As well as this guide to the framework, additional outputs from the project team include:
- A literature review
- A position paper
- A report on the five case studies
- An evaluation report.
With the consent of the Australian Government, a monograph will be made available to workshop participants at the end of October which contains the framework and the appropriate background papers.

Health impact assessment in Australia

A recently published paper which describes the status of health impact assessment (HIA) in Australia in 2003 provides a vantage point from which to see how rapidly HIA is developing across the country. When the report Health impact assessment: a tool for policy development in Australia was released in 2002 there was little use of HIA beyond environmental management applications. By late 2005, most states and territories are undertaking a variety of HIA activities either routinely or experimentally. Traditional divisions between environmental project-level applications that focus on health protection and public health policy-level applications that focus on health promotion, are largely disappearing. These are being replaced by a growing understanding of the need for complementarity in approach and cross-sectoral working. This is not to say that there are high levels of activity, but both awareness and action are increasing.

Exploring the application of Health Impact Assessment in neighbourhood renewal

This thesis explores the role that Health Impact Assessment can play in social exclusion policy contexts focusing specifically on Victoria's Neighbourhood Renewal Scheme. The findings demonstrate that it can play an important role if due attention is given to contextual and procedural factors both within community settings and within government.

Imperatives for policy health impact assessment : perspectives, positions, power relation

The thesis disturbs the seeming secure foundations of the dominant realist tales about the imperatives for the development of Health Impact Assessment, a relatively new policy device used within governments to consider the effects of policies on health. Foucauldian genealogical approaches are used to provide alternative, non-linear and non-definitive accounts.