Health Impact Assessment (HIA) is a structured approach that allows decision makers to consider how a policy, program or project could affect health. HIAs are often carried out as part of other assessment processes (e.g., environment, transportation, planning) but may be conducted on a stand-alone basis. The findings of an HIA may be used to inform recommendations on whether to approve or defer a proposal or to require modifications to mitigate adverse impacts or maximize benefits for affected individuals, communities or sub-groups. Up to six steps may be included: screening, scoping, assessment, recommendation, reporting, and monitoring and evaluation.
Incorporating health criteria in assessment processes has been advocated by agencies such as Health Canada and the Canadian Environmental Assessment Agency (CEAA). Some provinces, territories, regions and municipalities require or promote the use of HIA. However, until 2019, federal regulations did not require HIA or the involvement of the public health sector in environmental and other types of assessments.
With the passage of the Impact Assessment Act (IA Act) in 2019, and the replacement of the CEAA with the Impact Assessment Agency of Canada (IAAC), the role of human health within federally mandated impact assessments has been strengthened. The practitioner’s guide related to this Act requires the consideration of health criteria, including indigenous health as well as the employment of best practices in HIA. The use of the Public Health Agency of Canada’s recommendations in applying the
social determinants of health approach is also required. Proponents must demonstrate that all aspects of the assessment, including health, have been conducted by qualified individuals.
Although the scope for health has been expanded under the IA Act, the role of the public health sector is not specified. The IA Act also empowers cabinet ministers or the IAAC to narrow factors included and to substitute provincial environmental assessment (EA) processes for the federal process. This means that certain health criteria could be excluded and a health assessment might not be conducted if it is not required by provincial regulation.
Canadian Public Health Professionals (PHPs) participate in HIAs within a variety of contexts, but capacities and practices vary, and this has created concern that important dimensions of human health and well-being may be overlooked. To begin addressing this concern, in March 2019, the National Collaborating Centre for Environmental Health (NCCEH) conducted a national scan in order to characterize HIA capacities within health units. This document uses the insights gained from the scan to outline
options for addressing challenges for the public health ector in improving HIA practice.
About this report
This report presents the results from the first national scan related to the involvement of Canadian Public Health Professional s in HIA. The findings from an online survey and key informant interviews are summarized; the gaps in practice and challenges faced are reviewed; and recommendations for improving practice are made.