How can HIA address inequalities?

Definition of health

Health Impact Assessment (HIA) uses the World Health Organization (WHO)’s definition of health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’.

Health is partly determined by biological factors like age, sex and genetic makeup and by lifestyle choices such as diet, physical activity, smoking, alcohol consumption and sexual behaviour.

But health is also determined by social and economic factors such as income, poverty, employment and social exclusion, and by aspects of the physical environment, such as housing, transport, noise, air and water quality. HIA addresses this wide range of health determinants.

Health inequalities

People in higher socioeconomic groups are more likely to live longer and enjoy more years of good health than those in lower socioeconomic groups.  There are also notable differences in the health experiences of men and women.  As health inequalities often mirror social inequalities, addressing the social determinants of health can impact positively on health inequalities.

HIA aims to tackle such health inequalities by informing policy-makers of the potential health impacts of a proposal on different population groups. Further information on health inequalities may be found at the health inequalities section.

All stages and methods of the HIA should consider the implications for health inequalities. For example, a profile of the population should assess how the vulnerable sections of a population are adversely affected by the policy. Recommendations of the HIA should aim at reducing the steepness of the social gradient in health, focusing on a universal approach with a scale and intensity that is proportionate to the level of disadvantage.