The Wellesley Institute promotes community engagement in various areas, as it is essential for effective reform of public policy. It is crucial that community engagement reflect the diversity of the population, including marginalized groups. HIA could benefit enormously from a community engagement component since the purpose of HIA is to consider how policies and programs impact the health of the community.
The Welsh Health Impact Assessment Support Unit (WHIASU) believes that members of the public should be actively involved in the process of HIA. Their knowledge and personal experience is valuable in evaluating the potential impacts of existing or developing policies and programs. In Wales, members of the community have been given the opportunity to conduct HIAs with support from the WHIASU. There are some potential risks associated with engaging the community in HIA, such as raised expectations and possibility of the public as a barrier to innovation, but overall the public’s role in HIA has been a positive one. Consultation with the community has been extremely useful at local, regional and national levels. Empowering the community has led to increased capacity on both the statutory and the public sides, as well as improved relationships between these two groups.
The WHIASU recommends that future HIA processes emphasize communication with the participants, to ensure that they understand their role and the objective of the HIA. In addition, further investigation into how to include hard-to-reach groups is needed so that the community is fairly represented throughout the HIA consultation process. It is also crucial to adapt HIA workshops to the unique needs of the participating population, specifically in groups that have low literacy rates or limited knowledge of the related terminology. Involving The Public In HIA: An Evaluation Of Current Practice In Wales explores these issues in more detail.
There are several examples of community groups involved in HIA. In Australia, residents of the remote community of Goodooga conducted their own Equity-Focused HIA in response to proposed cutbacks to local health services. One participant noted that the HIA gave the community a platform from which to speak to the health system. Closer to home in Nova Scotia, People Assessing Their Health (PATH) has been working on Community Health Impact Assessment, where community members use storytelling and dialogue to develop their own HIA tool that reflects the values, priorities, and unique determinants of health of their community. Community-driven assessments have been carried out on a variety of policies from a proposed recreation centre to a tax increase in the Nova Scotia budget. This presentation gives more detail on the PATH process and some cases where it’s been used.