Step 3: Impact assessment

The third step in the HIA process is the core step of the whole process and actual impact assessment. The goal is to assess the health benefits and health hazards and to consider evidence of impact. This stage involves the collection and analysis of quantitative and/or qualitative data and should result in information about the expected health impact, the direction of the impact (positive or negative), the likelihood and magnitude of these health impacts, and what the time frame is in which these health impacts can be expected to occur. All of these elements should be considered in an equity perspective.

Potential equity-related questions (Gunther, 2011) to be answered in this phase are “What health equity impacts (positive and negative) have been identified as likely to arise from the policy or intervention?” or “Does the intervention or policy introduce new health equity impacts?” (Download here).

The data necessary to estimate the potential impacts of the action on health and health inequalities can be obtained from literature review, quantitative modelling (see step 3c), and qualitative analysis, such as expert consultations, interviews and focus groups. A combination of these methods often results in the most comprehensive information.

The impact assessment can further be split up into three sub-activities: 3a. policy analysis, 3b. description of the baseline situation, and finally 3c. estimation of the health impact.

Next: Step 3a: Policy analysis