Centre for Primary Health Care and Equity

Popular or Political?Trade-offs in HIA

Ben Harris-RoxasConsultant, Harris-Roxas Health

Conjoint Lecturer, University of New South Wales, Sydney

Health Section Co-Chair, International Association for Impact Assessment

Draws on the findings of the first phase of the

Australia-New Zealand HIA effectiveness study

Harris E, Baum F, Harris-Roxas B, Kemp L, Spickett J, Keleher H, HarrisM, Morgan R,

Dannenberg A, Sukkumnoed D, Wendel A. The effectiveness of health impact

assessments conducted in Australia and New Zealand; Australian Research Council

Discovery Project Grants; 2010-2011. [DP1096211]

Harris E, Baum F, Harris-Roxas B, Kemp L, Spickett J, Keleher H, HarrisM, Morgan R, Dannenberg A, Sukkumnoed D, Wendel A. The effectiveness of health impact assessments conducted in Australia and New Zealand; Australian Research Council Discovery Project Grants; 2010-2011. [DP1096211]

Was there community involvement in the HIA?

Yes n = 33 (73%)

No n = 12 (27%)

Was there any controversy and/or opposition to

the proposal?

Yes n = 26 (58%)

No n = 19 (42%)

If yes, what was the level of controversy? (n = 30)

Low Some Medium High0123456789

109

6 6

9

Column1

Comparing community involvement and controversy (n = 45)

Community In-volvement No Community

Involvement

0

5

10

15

20

25

Controversy

No Controversy

21

5

12

7

Low Some Medium High0

1

2

3

4

5

6

7

8

98

3

5

8

Community Involvement No Community Involvement

Comparing community involvement and

level of controversy (n = 30)

Plan Policy Program Project0

2

4

6

8

10

12

14

16 15

43

4

Controversy No Controversy

Comparing controversy by proposal type (n = 45)

Source: Wismar M, Blau J, Ernst K, Figueras J (Eds.) (2007) The Effectiveness of Health Impact Assessment: Scope and limitations of supporting decision-making in Europe, European Observatory on Health Systems and Policies, World Health Organization: Copenhagen. ISBN 978 92 890 7295 3

Modification of pending decisionsYes No

Health adequa

tely ackno

wledged

Yes

Direct Effectiveness

HIA-related changes in the decision

Due to the HIA the project was dropped

Decision was postponed

General Effectiveness

Reasons provided for not following HIA recommendations

Health consequences are negligible or positive

HIA has raised awareness among policy-makers

No

Opportunistic Effectiveness

The decision would have been made anyway

No effectiveness

The HIA was ignored The HIA was dismissed

Direct General Opportunistic No0

5

10

15

20

25

20

5

01

Controversy No Controversy

Comparing controversy by

type of effectiveness (n = 45)

Murky picture

Does community involvement lead to controversy,

or vice versa

And does it matter?

An example of trade-offs: Lithgow

Some important trade-offs are never public

ben@harrisroxashealth.com

@ben_hr or @hiablog

healthimpactassessment.blogspot.com

linkedin.com/in/benharrisroxas

These slides are available at

www.slideshare.net/benharrisroxas