Health Impact Assessments

Health Impact Assessments

Juliet Clark is a Principal Planner at Bidwells

Juliet Clark, from Bidwells, considers the effect of Health Impact Assessments.

Health Impact Assessments (HIA) are not widely required by Local Planning Authorities, but there is growing uptake of the process. HIA deliver the health and wellbeing objectives of the National Planning Policy Framework and reflect wider government commitment to developing healthy, successful places for people to live and work in.

HIA are a means of increasing the health benefits generated by a development and reducing negative health impacts, with a particular requirement to consider impacts to vulnerable groups. The overall objective is desirable: we would all rather live in a healthy environment than a life threatening one.

However, the HIA process has a number of uncertainties and inefficiencies. There are no national guidelines on what an HIA should cover, nor how an assessment should be carried out, leading to widespread variation in HIA requirements by Local Planning Authorities. Some authorities set low housing thresholds for when an HIA is required: 20 dwellings in South Cambridgeshire, 25 in South Worcestershire, while in Bristol 100 dwellings is the starting point.

Evolving methodology
HIA methodology is evolving. There is currently no national or industry standard guidance on what level of health improvements are desirable or acceptable. There is a lack of standards or benchmarks for how much benefit a scheme should bring or what level of negative impact is acceptable. In the worst case, the whole process can be reduced to a tick- box compliance exercise.

More needs to be done to define how health benefits are assessed and weight the assessment process towards the demonstrable health impact rather than the reporting process. This said, we can never be too healthy and HIAs, in whatever form, raise awareness of the health agenda and ensure the development process contributes to improving the health of the nation.

“Small schemes have less ability to deliver opportunities for physical activity, green spaces, and social interaction”

Small schemes
However, HIA is not appropriate for all developments. Small schemes have less ability to deliver opportunities for physical activity, green spaces, and social interaction. HIA for such developments is often limited to analysis of general levels of accessibility by active modes or public transport or a review of housing mix and tenure along with wider environmental issues such as re-use of resources and impact on climate change.

Where open space is included there may be higher health benefits but the acceptability of these determinants of health are typically already covered by other policies in Local Plans. HIA in these cases is in danger of repeating the planning process, with limited added value.

Where policies with low thresholds persist, developers will do well to seek advice to screen out the need for HIA and scope out unnecessary aspects of the HIA so that it is focussed on real benefits and less costly to produce. Conversely, large schemes that provide community infrastructure, influence accessibility to services and facilities, provide open space and affect a greater number of people can greatly influence health and wellbeing. HIA in this instance provides a valuable tool for bringing together the wide-ranging health impacts into a simple format for evaluation of the scheme in its entirety.

Ensuring delivery
A third area for consideration by Local Authorities when formulating their HIA policies is the mechanism for ensuring that the HIA recommendations are incorporated into the current processes that control development.  Collaboration between developers, health officers, environmental heath, planning policy, planning control and enforcement is required to ensure the effort gone into considering health is delivered on.

Making HIA meaningful also requires monitoring of the mitigation and recommendations to ascertain if actions deliver the intended health consequences. All parties have a vested interest in engaging: local communities interested in a healthy environment, developers to deliver the highest quality scheme and avoiding unproductive conditions, and local authorities to know how best their policy objectives can be met.

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