The Health Equity Impact Assessment tool is a practical and effective approach to analyzing the potential impact of service, program or policy changes on health disparities and/or health disadvantaged populations. It can help to plan new services or initiatives or assess and re-align existing programs. Using it has proven valuable to building awareness of and embedding equity within organizations. It can be used both within the health sector and in numerous other fields that impact the social determinants of health.
Increasingly, these assessments are being used by policymakers to understand and influence how policies, projects, plans and programs affect health inequities. Equity issues are often overlooked, especially outside of health policy, so applying an equity lens can generate discussion and improve decision making.
Health Equity Impact Assessment Primer
Wellesley Institute published a primer in 2011 that introduced the potential and practice of the Health Equity Impact Assessment.
Health Equity Impact Assessment in Ontario
The Health Equity Impact Assessment tool aims to support improved health equity, including the reduction of avoidable health disparities between population groups. The tool has a template and a workbook.
Health Equity Impact Assessment History
Wellesley Institute partnered with the Ministry of Health and Long-Term Care and Toronto Central LHIN to consult practitioners and refine the Health Equity Impact Assessment (HEIA) tool. Consultations were held with a range of GTA-area health service providers and clients, the template was revised and a new step-by-step workbook developed. The HEIA was pilot tested in 2009 in the Toronto Central LHIN and subsequently piloted further in several LHINs.
The HEIA came out of broader health impact assessments (HIA), which have been increasingly used in many jurisdictions in the past. The more specific focus of HEIA arose as increasing policy attention to social determinants of health and health disparities highlighted the need to incorporate an equity focus into planning. At the same time, the need for shorter and more focused processes – sometimes called Rapid HIA – had been recognized.
There has also been growing recognition that mental health and well-being has to be better addressed in impact assessments. Innovative tools and resources for mental well-being impact assessments have been developed.
Related resources
- The Canadian National Collaborating Centre on Healthy Public Policy has a paper on HIA and inequities. Its paper, Health Impact Assessment In Québec: When The Law Becomes A Lever For Action, examines the implications of Québec’s Public Health Act and its influence on HIA. The paper also introduces a framework for understanding the creation and adoption of public policies.
- The Health Impact Project in the U.S. encouraged local, state and national organizations to include health considerations in policy decisions across multiple sectors, such as housing, transportation and education.
- HIA Connect in New South Wales, Australia provides various resources, including HIA practice standards and case studies, information about healthy public policy, and reports from leading jurisdictions.