Health Equity Impact Assessments in Action

By Andrea Bodkin, Health Promotion Specialist

This week I got to do one of my favourite things: moderate a panel discussion at a conference. The Ontario Public Health Association asked me to help design and then moderate a session at their Fall Forum, Health For All: Closing the Equity Divide. I was thrilled to work with four amazing panelists on a session called “Health Equity Impact Assessments (HEIAs) in Action”. Public Health Nurses from the Middlesex-London Health Unit, Deborah Fenlon, Erica Zarins and Kristin Heard joined Chetna Pandya, Senior Public Health Inspector from the Regional Municipality of York to share their experiences in conducting HEIAs. Participants who attended the session heard about three very different programs and three very different HEIAs. We then had a discussion on the challenges, benefits and innovations that resulted from the HEIA process.

One of the things that I really appreciate about the HEIA tool developed by the Ministry of Health and Long Term Care is its simplicity: it’s a five step process that can be easily adapted to meet the needs and timelines of your organization.  The stories shared by the panelists easily demonstrated this point:

•    Middlesex-London Health Unit used an evidence-based approach, with support from the National Collaborating Centre for Methods and Tools, to develop a “tandem approach” to planning at the downstream, midstream and upstream levels. The HEIA was conducted on an existing program with the intention of identifying how long term impacts of the program could be improved.
•    In York Region, key informant interviews and partnerships with community organizations provided data for the HEIA. The HEIA was conducted to inform the adaptation of an existing curriculum for adults with intellectual disabilities.
•    The second HEIA conducted by Middlesex-London was embedded into existing program development and evaluation processes. As in the York Region example, key informant interviews and strong relationships with community organizations informed both the HEIA and the development of the program.

Step 3 of the HEIA process is to identify the unintended impacts that the program, service, initiative or policy may have. Similarly, conducting an HEIA can itself have unintended consequences! The panelists shared these benefits:

•    The HEIA provided an opportunity to gather community partners and strengthen relationships that lasted into program delivery and beyond
•    The HEIA started a conversation about health equity and generated evidence as to the needs of equity-seeking groups
•    The “tandem approach” to planning was an efficiency way to plan at three levels concurrently

All of the panelists and I have found that conducting HEIAs can yield beneficial results for our programs, our organizations, our partnerships and our own capacities. We all join together to encourage you to conduct HEIAs often!

Want to learn more about HEIAs or need support in conducting one?

Visit the Health Nexus HEIA page to watch an introductory video and read a series of Tip Sheets on HEIA. You can also watch a recording of a short webinar I delivered called Preparing for your HEIA.

Check out this NEW infographic on HEIA, download the HEIA Workbook from the Ministry of Health and Long Term Care and the recently developed Immigrant Supplement.

Join the HEIA Community of Interest to learn about their webinar series, resources and discussions.