Types of HIAs and the HIA Process

A bicycle and a bicycle image on a sidewalk

There are many approaches to using HIA. These approaches are outlined below and can help you determine what type of process may work for you. 
Read more about HIA and see more HIA resources at the bottom of this page.

A comprehensive HIA examines as much evidence as possible, using:

  • An extensive search of the literature and other existing information
  • In-depth interviews
  • Community surveys
  • Some original research if appropriate
  • Input from experts and agencies

This type of HIA can take six months or more, and can require a team to conduct it.1

See Minimum Elements and Practice Standards for Health Impact Assessment published by the North American HIA Practice Standards Working Group.

An intermediate HIA may combine a workshop with key stakeholders followed by desk-based work to build up a more detailed picture of the potential health impacts than would typically be identified during a rapid or "mini" HIA. It may involve a limited literature search, usually non-systematic, and relies mainly on surveillance or routine, readily available data.2
A rapid HIA uses both existing research and rapid assessment techniques, so it includes some fieldwork. Although it could be carried out by one or two researchers, it may also involve more and can take up to three months.3
See the Rapid HIA Toolkit from LA County for additional guidance.

As the name implies, this HIA focuses mainly on existing research and remote contact with a few stakeholders. It would probably be carried out by one or two people, and may take between two to six weeks.4


Steps of HIA

HIA has a general framework involving six key steps:5

  1. Screening: Determine whether or not a HIA is needed and likely to be useful.
  2. Scoping: In consultation with stakeholders, develop a plan for the HIA, including the identification of potential health risks and benefits.
  3. Assessment: Analyze and describe the baseline health conditions of the affected communities and determine the potential impacts of the decision.
  4. Recommendations: Develop practical solutions that can be implemented within the political, economic, or technical limitations of the project or policy being assessed.
  5. Reporting: Disseminate the findings to decision makers, affected communities, and other stakeholders.
  6. Monitoring and Evaluation: Monitor the changes in health outcomes and health risk factors to evaluate the effectiveness of the measures that are implemented, including the HIA process as a whole.
HIA has broad relevance to wide-ranging policies, plans, and projects, making it a practical tool for informing decision makers. 
For more detailed information about the steps of a health impact assessment, please visit the links below.


NEXT: HIA Case Studies

1. Adapted from: KU Work Group for Community Health and Development. (n.d.). Community Tool Box Chapter 2 Section 11. Health Impact Assessment. Retrieved from http://ctb.ku.edu/en/table-of-contents/overview/models-for-community-health-and-development/health-impact-assessment/main
2. Adapted from: UCLA Health Impact Assessment Project. (n.d.). Glossary. Retrieved from http://www.hiaguide.org/glossary 
3. KU Work Group.
4. KU Work Group.
5. Adapted from: The Pew Charitable Trusts. (2014, August 26). Retrieved from http://www.pewtrusts.org/en/research-and-analysis/analysis/2014/08/28/the-hia-process