An adaptable Health Impact Assessment (HIA) framework for assessing health within Environmental Assessment (EA): Canadian context, international application

Figures & data

Figure 1. Steps of the EA and HIA processes (Ross et al. 2014; CEAA 2016).

Table 1. Definitions for characterizing effects.

Magnitude: what is the severity of the effect on human health?
Low	The effect is minor and does not pose a hazard/benefit to health; health status will not change from baseline
Medium	The effect is detectable and poses a minor to moderate hazard/benefit to health; health status could change from baseline
High	The effect is severe and poses a major hazard/benefit to health; health status will change from baseline
Reversibility (and/or Adaptability): is the effect reversible; how resilient is the community to this type of change; are they able to adapt?
Reversible	The effect is reversible (effect stops once exposure removed) and people will be able to recover or adapt to the change with relative ease, may require support. For positive effects, the improvement is temporary
Irreversible	The effect is not reversible (effect continues once exposure is removed) people are not likely to recover or adapt to the changes, even with additional support. For positive effects, the improvement is permanent
Frequency: how often is the effect expected to occur?
Low	The effect occurs rarely, if ever
Medium	The effect may occur occasionally
High	The effect occurs on a continuous basis
Duration: what would be the duration of the effect, if it were to occur?
Short-Term	A short-term (acute) effect, lasting from days to weeks
Long-Term	A long-term (chronic) effect, lasting from months to years
Geographic Extent: what area will be affected and/or what is the geographic boundary of assessment?
Varies	The geographic extent is a site-specific determination of the amount of area that is anticipated to be impacted. It can include a specific study area (e.g. 5 km radius around the proposed project), a political boundary (e.g. city limits), or be based on topological or ecological features (e.g. watershed)
Timing
Varies	Timing involves temporal fluctuations that can potentially impact health and well-being outcomes (e.g. seasonal changes affecting land/resource use)

Figure 2. Decision matrix I: characterizing effects.

Table 2. Definitions for characterizing likelihood.

Likelihood: What is the probability of the impact occurring?
Unlikely	The impact is anticipated to occur rarely, if ever. This classification is appropriate for those situations where impacts are not zero but they are limited to very rare occurrences, catastrophic events, or highly unlikely system failures
Possible	The impact may occur, but the probability is less than 50%
Probable	The impact will likely occur, the probability is greater than 50%

Figure 3. Decision matrix II: determining significance.

Table 3. Definitions for characterizing uncertainty.

Uncertainty: what is the level of uncertainty associated with the evaluation of health impacts and determination of significance for each of the health determinants?
Very High	A very high level of uncertainty (i.e. very low level of confidence) is associated with the determination of significance as a result of major data or information gaps and/or a very low level of confidence associated with the assessment methods and approach
High	A high level of uncertainty (i.e. low level of confidence) is associated with the determination of significance as a result of moderate data or information gaps and/or a low level of confidence associated with the assessment methods and approach
Medium	A medium level of uncertainty (i.e. moderate level of confidence) is associated with the determination of significance as a result of minor data or information gaps and/or a moderate confidence associated with the assessment methods and approach
Low	A low level of uncertainty (i.e. high level of confidence) is associated with the determination of significance as a result of negligible data or information gaps and/or a high level of confidence associated with the assessment methods and approach
Very Low	A very low level of uncertainty (i.e. very high level of confidence) is associated with the determination of significance as a result of no data or information gaps and/or a very high level of confidence associated with the assessment methods and approach

Figure 4. Revised HIA framework (Step 5): overall determination.

Ross CL, Orenstein M, Botchwey N. 2014. Health impact assessment in the United States. New York (NY): Springer. ISBN 978-1-4614-7302-2.10.1007/978-1-4614-7303-9

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CEAA. 2016. Basics of environmental assessment. Canadian Environmental Assessment Agency. http://www.ceaa.gc.ca/default.asp?lang=En&n=B053F859-1#gen01

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