Step 1: Screening

The first step in the HIA process is the screening stage. The goal of this stage is to determine whether it is appropriate and feasible to conduct an HIA. The main question to answer with respect to appropriateness is whether the policy or intervention is likely to impact population health considerably or one of the determinants of population health. If it is likely that there are significant health impacts, an HIA should be considered. Feasibility aspects, such as available resources and organizational capacity should also be considered in the decision to carry out a health impact assessment.

Potential equity-focused questions (Gunther, 2011) that can be asked during the screening step are “Which populations are currently relatively disadvantaged in the context of this policy or intervention?” and “Does the policy enhance equity or increase inequity e.g. by affecting different population sub-groups differently because of what the policy targets are, how the policy is implemented or how it works with/against existing policy?” (Download here).

The model by Dahlgren and Whitehead (1993) (Figure 27) provides an overview of the wider determinants of health and can therefore assist in determining whether the policy or intervention is likely to influence health via one of these wider determinants of health. In addition, the information from the needs assessment phase can be used in this step of the HIA.

Next: Step 2: Scoping