Cost Benefit Analysis of HIA

The UK Department of Health has published a cost benefit analsysis of HIA. From the abstract:

"The report sets out the findings of the cost benefit evaluation of Health Impact Assessment. York Health Economics Consortium followed 16 HIAs looking at the process, impact, outcomes and costs and benefits of HIA. The findings show the benefits outweigh the costs, although it was a small sample. The report will be subject to further consideration and comments are welcome."

Many of the issues identified in the report will be familiar to HIA practitioners. What is perhaps most interesting is the large variation in the amounts spent on conducting the HIAs - ranging from £1,107 to £65,240.

Where does HIA fit best within the policy and planning cycle?

I’d like to stimulate some debate about where people see HIA best fitting within the planning cycle (following on from the interesting recent blog discussion on HIA as a scientific tool).

In New South Wales, HIA is seen as adding most value as a prospective tool at a specific point in the planning cycle; after a draft proposal has been developed but before implementation.

However, recently we’ve been approached to use HIA as a tool to assist with planning for health earlier in the cycle. This raises a number of issues:

First, should or can HIA be a substitute for good needs assessment and problem identification? Or can HIA become a useful needs assessment / problem identification tool? Work with communities on regeneration projects in Victoria has indicated this may be the case.

Second, developing a draft proposal takes time and effort. How can HIA be integrated with this time and effort while planning decisions are being made rather than afterward as a check on those decisions? Would this be a better way of ensuring health impacts are considered? At a recent training course Ben and I attended in Thailand, it was suggested that HIA can stretch itself earlier in the planning cycle to assist with developing different options and their potential impacts before the proposal is drafted.

Third, what are some other approaches and methods the HIA can use or add to earlier on in the planning cycle? For example, at a recent meeting we had with Urban Planners, it was suggested that as Health professionals we need to understand how private sector developers plan and develop proposals (i.e. through market analysis).

Finally, while I am open to HIA being used earlier in the planning cycle, I would take more convincing concerning the use of HIA as a retrospective tool that replaces evaluation.

What do others think?

Will the HIA wiki replace existing HIA websites?

There's an interesting debate taking place over at the HIA Wiki at the moment about the future of HIA websites around the world. Take a look at the discussion and take a few moments to add your point of view.