CDE Appendix 1 Literature Review - Central East Local Health ...

The Culture, Diversity and Equity Project: Literature Review
HIA methodologies involve both community/stakeholder consultation and more ‘expert’-based and derived
assessments of the research evidence.
Among the many benefits of Health Equity Impact Assessment are:
• Its heightening of awareness and reflexivity among policymakers as to the impact of their policies on different
social groups and the value-ladenness of the policymaking process.
• Its proactivity - health-disparity-prevention and health-promotion potential - in enabling assessments of
unintended health impacts of proposed policies on health disparities prospectively. It also enables the
consideration of ways to enhance health equity promoting factors when weighing or revising policy options.
• Its mainstreaming of health equity considerations as part and parcel of all policymaking processes
• Its evidence-basis and emphasis on the rigorous use of evidence regarding actual or potential health equity
impact. It also generates data for future program/service reform and strategic development and policymaking.
• Its emphasis on consultation with affected stakeholders and empowerment of marginalized groups in the
assessment process (which also facilitates knowledge-exchange).
• Its potential to increase the transparency and public accountability of decision-making processes through public
involvement and public reporting of results of impact assessments (as is the practice in the UK).
The scope of health equity impact assessments have been expanded in some jurisdictions to include an assessment of
not only policies, but also programs, services, projects, and budgeting and allocation processes. The City of Toronto
has for instance developed an ‘equity lens’ and requires that equity impact statements be included in City Reports
and budget allocation processes.
Health impact assessments have also been used in Sweden, England, and the Netherlands to screen and assess
legislation, policies and initiatives in other sectors that are likely to have a direct or indirect effect on health and
health inequalities (see for instance WHO, 2008, p.115 and London Health Commission, 2008 for examples of such
broader uses of health impact assessments by the London Health Commission across policy sectors). HIAs have also
been commended for their potential to promote intersectoral collaboration through such intersectoral evaluation
processes.
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