HIA CASE STUDY

Health Impact Assessment of the Regional Policy Statement: Regional Form and Energy Draft Provisions

April 2008

Background

This rapid Health Impact Assessment (HIA) was conducted to assess the impact of two sections of the draft provisions of the Regional Policy Statement (dpRPS) on health and well-being within the community. It was conducted by Regional Public Health (RPH) in partnership with Greater Wellington Regional Council (GRWC).

The dpRPS is a large document containing twelve resource management topics. The two topics that this HIA assessed were the Regional Form and Energy provisions.

There were several resource constraints, particularly around time and people. Initial time frames for the HIA were 6-8 weeks. However, these were extended after associated deadlines for GWRC were extended. Input to the workshops was almost exclusively from RPH, GWRC and other city and district councils. Although invitations were sent to several other stakeholders (e.g.Ministry of Health HIA support unit, local iwi, Primary Health Organisations, local and regional community, and academic organisations), many were unable to attend. This was possibly due to the initial tight timeframes with minimal warning of the upcoming workshops.

By assessing the health impacts of the dpRPS, the HIA aimed to improve the health of the community and reduce inequalities throughout the greater Wellington region. This was to be achieved by feeding into the policy development process and by informing submissions on the draft RPS.

Rationale for HIA

The dpRPS was considered a suitable proposal for an HIA as:

  • it affects many health determinants
  • it affects many people, including future generations
  • there are obligations to address health and wellbeing under the Resource Management Act
  • the HIA process promotes cross-sectoral work between RPH and GWRC

Carrying out the HIA

Scoping Workshop

The half day scoping workshop was held to identify the health determinants and the population the HIA would focus on. The workshop identified access to services, physical activity, housing, and a change in emissions of greenhouse gases as the important health determinants. There were other considerations recognised at the scoping workshop including identifying important vulnerable populations, parts of the dpRPS to consider and the temporal scale of the HIA.

Some useful resources to bring to the scoping workshop included a list of selected health determinants (photocopied from the HIA guidebook), a presentation summarising HIA and its importance to the dpRPS, and some scoping workshop discussion questions.

Literature Review

This was conducted between the two workshops in order to inform the appraisal workshop. Evidence linking the four selected health determinants to Regional Form and Energy and their effect on health and wellbeing was written in an 8-9 page document. This entailed a search of online databases (e.g. Medline) and the internet, but no focus groups or key informant interviews.

Appraisal Workshop

There was another half day workshop that aimed to identify the potential health impacts of the dpRPS. The policy was not compared to a ‘status quo’ or ‘alternative policy’. Some useful resources for the workshop were the health evidence review (results from the literature review) and a list of questions to guide and aid discussion (generally taken from the HIA guidebook).

Workshop members were divided into groups of about 5-6 members. Open discussions were then held with ideas being written on large pieces of paper.

After the workshops

Findings from the appraisal workshop were circulated among the attendees for confirmation and/or correction. After this, the HIA was written with drafts circulated among stakeholders for review and comment. The final HIA was used to inform RPH’s submission on the dpRPS and was disseminated to stakeholders with the intention that it would inform their submissions also.

Main Findings and Recommendations

Key Findings

In the workshop there was repeated emphasis on the need to incorporate effective and meaningful collaboration and consultation in the implementation of the RPS. This included collaboration not only between key stakeholders but also to linking the RPS to other important documents (such as the Regional Land Transport Strategy).

There were several aspects identified that have clear potential to benefit health and well-being in the community. These included the focus on principles of the New Zealand Urban Design Protocol (e.g. connectivity and compact form), open spaces network policy and many of the energy policies (in particular, sustainable energy and small-scale renewable energy).

Housing was identified at the workshop as a significant issue with major health implications: the housing policy could have the most impact on health compared to the other policies. It was recommended that the housing policy be maintained and strengthened.

Key recommendations

Some of the major recommendations included:

  • Both the Regional Form and Energy provisions should have explicit recognition of the necessity for collaboration and consultation by GWRC and local councils with: other councils; iwi; Pacific peoples groups; community organisations; private developers; and any other key stakeholders.
  • Regional Form provisions that aim to create high connectivity, maintain compact form and limit urban sprawl within the region should be maintained, strongly supported and encouraged.
  • There should be greater emphasis on housing affordability and quality within the policy and an explicit recognition of the importance of housing to health and well-being.
  • The Regional Form provisions should encourage and promote the development of a coherent housing policy framework.
  • Both the Regional Form and Energy provisions should have a focus on maintaining or enhancing equity in the community.
  • Both the Regional Form and Energy provisions need to ensure that vulnerable populations are prioritised within the community.

Proposed process for monitoring and evaluation

Due to time, resource constraints and personnel moving elsewhere there was no planned evaluation for this HIA. At the time of writing this case study, GWRC had not yet released its proposed RPS, therefore, it is unknown whether the recommendations from the HIA have been adopted.

Key learning points for practitioners of HIA

Workshops

Invites to attendees for the workshops should be sent early. Probably 3-4 weeks prior to workshop with a reminder closer to the time. Consider using various media (e.g. emails, phone calls, etc).

Consider the time allocated to the workshops. The half day appraisal workshop was not long enough for this HIA, but getting people to attend a full day workshop will be more difficult.

Disseminate important information prior to workshop. This is particularly relevant for the health evidence review. This allows attendees to read it prior to the workshop and to start formulating ideas and thoughts.

Stakeholder Engagement

Stakeholder engagement is vital to the HIA process but can be very difficult to achieve. Some tips for achieving improved engagement could include:

  • engaging stakeholders early in the process
  • emphasising the relevance of the HIA to their work
  • stating how stakeholders could benefit from the process
  • confirming that time commitments outside the workshops are not necessarily huge

Dissemination

Depending on the HIA, dissemination of the final product can be essential for its success. For example, sending this HIA to stakeholders who were likely to submit on the draft RPS was important in order to inform their submission. Obviously, dissemination needs to be timely.

Other points

Use the Ministry of Health’s HIA Support Unit. They can provide helpful input to the process and the workshops.

Conduct the HIA early in the policy/programme development process. It is not so useful to conduct HIA on a policy/programme that is not going to change following the recommendations. It is also important to define at the start how the HIA will feed into the policy/programme development process.

Conclusions

  • This HIA was conducted with limited experience, time and resources. It is a process that can be led by as few as one or two people if necessary.
  • Stakeholder engagement is vital. Unfortunately, it is not always easy to get or maintain this engagement.
  • Ideally the HIA should be conducted very early in the policy/programme development process. This allows for the HIA to have greatest effect on the final policy/programme.
  • Use the HIA Support Unit.
  • Remain flexible. Expect that resources, timelines, personnel and the policy/programme itself may change during the process, and be prepared to change your processes as a result. The HIA Guidebook is a fantastic resource but does not necessarily need to be followed to the word. You may find parts of the guidebook do not fit well with the policy or programme being assessed.Adapt the guidebook around the policy/programme as necessary.

Richard Jaine

Public Health Medicine Registrar

September 2008