The American-based Prevention Institute made a presentation to recent National Research Council deliberations on HIA. They argued that HIA aligns well with primary prevention or upstream action on the roots of ill health and health disparities, and with healthy community planning approaches to addressing the underlying determinants of health.
They stressed that HIA needs to more explicitly define equity as a fundamental principle and goal and “must elevate equity – both by highlighting existing inequities in policies and programs in specific communities and by focussing on and demonstrating the importance of investing in communities with greatest need.” (This emphasis has been one of the drivers behind the emergence of specific Health Equity Impact Assessment tools.)
They argued further that HIA needs to be part of a broader shift to comprehensive ‘health in all policies’ approaches. HIA must take a similarly broad view of the evidence it uses: peer-reviewed literature tends to focus on medical interventions and provides very little on innovative and cross-cutting community-based initiatives and on the impact of comprehensive community strategies, and needs to be supplemented by community-based research and the insight of practitioners. Finally, they highlight the potential of HIA, when combined with other tools to enhance cross-sectoral collaboration, to institutionalize a new progressive approach to health and health reform across all policies and sectors.