Health Impact Assessment

Health impact assessments (HIA) bring together scientific data, health expertise and public input to identify potential health effects of proposed new laws, regulations, policies, projects and programs.

Benefits & Problems Addressed

Spotting unintended health impacts: Like other impacts (environmental, traffic), projects can have adverse impacts such as increase exposure to contaminants, lower access to care, 

Elevating health among factors: HIAs place health concerns in the context of other important factors when making a decision, allowing 

Solving local health problems: HIAs seek improved plan and project design to address pressing local health challenges (and their costs) such as obesity.

Tips & Techniques

Types of Health impact Assessments:  Assessments can be (1) Desktop, (2) Rapid and (3) Comprehensive with varying level of analysis for direct, indirect and cumulative impacts, both positive and negative. HIAs can also be conducted alongside Environmental Impact assessments required for larger projects.

Health categories: Assessments are flexible (and often voluntary) and mostly address (1) hazardous materials, (2) air quality, (3) water resources, (4) subsistence resources, (5) social and mental health impacts, (6) relocation. Increasingly assessments focus on physical activity and equity related to positive/negative impacts.

Types of projects triggering HIAs: (1) transportation projects, (2) large footprint facilities, (3) high impact construction projects, (4) displacement/resettlement, (5) post-disaster and recovery plans and projects, (6) Groups of disproportionately affected, vulnerable populations.

Main Steps: (1) Screening of project to see if it has any impacts, (2) Scoping for plausible impacts and data gaps, (3) Ranking of hazards identified in scoping, (4) Health Action Plan to minimize hazards and/or build in benefits, (5) Implementation & Monitoring

Types of hazards addressed: (1) reducing airborne pollutants to prevent additional asthma, (2) improved street redesign to add walk/bike paths to improve activity & reduce obesity; (3) use of green infrastructure to clean water flowing into waterways used for recreation.

Key Performance Indicators (KPIs): Effective plans rely on key indicators of measurable progress and include (1) Institutional indicators like facilities, equipment, infrastructure, personnel, money, and partnerships; (2) Process indicators such as executable plan steps, schedules, training rates, access, weight assigned to prevention versus reduction; (3) Outcome indicators – Death, disease metrics such as weight & blood test results and 

Hot Buttons: (1) Trade-offs between minimizing adverse effects and project costs; (2) responsibility for poor outcomes, (3) who pays.


Health Impact Project; Pew Trust and Robert Wood Foundation 

The State of Health Impact Assessment in Planning (July 2016): American Planning Association

Alaska Health Impact Assessment (HIA) Program