How To Conduct An HIR

How To Conduct An HIR

The Health Impact Review (HIR) process consists of the 5 steps explained below.


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Step 1 - Screening

The object of the initial screening step is to determine if conducting an HIR is warranted and will be useful to the decision-making process. Factors considered during this process are: 

  • Potential effects on public health as a result of the plan, project or policy 
  • Potential for impacts on vulnerable populations 
  • Potential for the HIR to add value to the decision-making process 
  • Availability of data, methods, resources and capacity to conduct analysis 
  • Buy in from decision-makers 

Potential questions to consider when reviewing the drafted proposal during the screening step: 

  • Will this proposal impact the public’s health? 
  • Will the impacts reduce health inequity? 
  • What vulnerable groups (e.g. children, older people, people with low incomes) may be affected? 
  • Is the project or plan occurring in a place where other local health problems have been identified? 
  • How will the HIR be used? 
  • Assessing time and budget needs, which HIR type will work best?
Step 2 - Scoping

During the scoping step, determine which health impacts to evaluate. Collaborate with subject matter experts or community stakeholders to examine community health concerns or potential benefits the plan, policy or project raises. Develop causal diagrams to outline how the plan, policy or project could directly or indirectly affect specific health issues. The diagram will assist in prioritizing which health effects to include in the assessment and in the development of research questions. Data needs will also be identified in this step. 

As a result of the scoping process, a plan will be developed that describes the health effects that will be considered in the assessment phase, outlines the research questions and methods that will be used to answer those questions, and describes the roles and responsibilities of the team conducting the HIR and the stakeholders.

Step 3 - Assessment

Once the focal issue(s) of the HIR have been identified, the next step is to describe the current conditions using quantitative and/or qualitative data related to the health issues identified during the scoping step. The assessment activities are dependent on the HIR process selected, tasks range from limited data collection to comprehensive community and stakeholder engagement. See the timeline in the drop-down menus above for more details.

A mixed method approach can be utilized to evaluate the potential risk factors and health outcomes of the drafted plan, policy or project. This approach can include some or all of the following, depending on the given timeframe and funding:

  1. A systemic literature review
  2. Primary and secondary data collection
  3. An analysis of existing health data
  4. Spatial analysis; and
  5. Stakeholder and community engagement

A variety of existing data, as well as, local data for descriptive and analytical purposes is used throughout the report to best represent the health conditions of the affected population. Data is essential to describing the demographic and socioeconomic makeup, health status, health behaviors and health risks of a community. Data can also help to explain the built environment conditions. Guidance from experts, for example, transportation and/or planning, is utilized, as needed, to better understand certain components of the plan, policy or project. With the exception of Desktop Reviews, key-informant interviews and focus groups can be incorporated to understand local knowledge and expert opinions into the HIR process.

Step 4 - Reporting

A report for the Rapid Assessment and Complete HIR will be provided that documents the HIR process and methods, analysis, and major findings. The report can serve as a resource to the decision-makers, stakeholders and community members but does not include recommendations. A Desktop Review only allows time to complete a summary of research.

Step 5 - Monitoring and Evaluation

Evaluation and monitoring plans can be included for the future, but it is dependent on the HIR and project timeline as well as the allotted funding. The plan will involve assigning responsibilities for monitoring with the HIR team and partners, as well as creating a timeline and evaluation processes.