As noted above, all participants should have details of the proposal in advance of the screening workshop in an accessible format, as well as a link to, or a copy of the Health and Equity Impact Checklist (Word doc, 56 KB)(opens new window). The checklist can be used by the facilitator as prompts to guide the discussion and is roughly structured in two parts (Figure 4).
Part 1: Population Groups
Q1. What population groups might be affected by the proposal?
The group first jointly identifies the different population groups who may be affected by the policy, plan or strategy. These may include people in different roles, for example a housing development will affect people who gain new housing, people living near the development, people who work there.
Q2. How might people in the population groups be affected by the proposal? Will these impacts be positive, negative or uncertain?
The group should then systematically discuss the groups of people listed on the checklist and identify if each of these may be differentially affected by the proposal, and how.Population groups may not be mutually exclusive - for example, many people will have one or more protected characteristic and also be living in, or at risk of, poverty (intersectionality).
When working through the checklist to identify the population groups, consider whether any of the following apply:
- Groups who may be affected unintentionally (positively or negatively)
- Groups who are excluded from benefiting from the proposal
- Groups who could benefit from the proposal with some changes to the proposal
- Groups missing from either the health and equity impact checklist or the discussion where the impact (positive or negative) is not clear.
Part 2: Health Determinants
Q3: What positive, negative or uncertain impacts do you think there may be on the following health determinants? Which population groups will be affected by these impacts? Consider each of the sections below.
Workshop participants should then consider possible impacts on health, equity and wellbeing. The health and equity impact checklist is intended to help people think broadly about the indirect and unintended effects of the proposal as well as the direct and/or intended effects. Impacts do not have to be limited to the categories included in the checklist, there may be others not covered by the checklist. Participants should identify both positive and negative impacts, as well as any uncertain impacts.
The group should try to identify which population groups will be affected by each impact. Sometimes impacts are positive for some populations but negative for others. Some members of the group may think an impact will be positive but others think it will be negative. In these situations, the group may be able to identify actions to promote a positive impact.
Impacts may last for a short time or continue for a longer period. Some impacts may be negative in the short-term but neutral or positive later on. Timescales should therefore be mentioned if they are relevant to the proposal and potential impacts.
The person(s) recording the session should try to capture the group's understanding of how each impact will arise, as well as documenting the impacts. Often the same underlying impact will be identified at different points in the checklist. For example, a proposal may bring employment and so also impact on income. In this case the underlying issue to identify in the exercise is the potential employment - further assessment might focus on the quality of the employment, who would benefit etc.
At the end of this stage, it is helpful for the facilitator to summarise the impacts identified. This helps to highlight the impacts that the group thinks are most significant and lead discussion about further evidence and actions needed after the workshop.
Adapting the process
The process can be adapted for use in other situations. For example, different groups of participants, such as community groups, can each use the checklist to identify impacts and results from these can then be combined. It can be useful to involve groups that consist of different affected populations to gain a range of different perspectives. Information gained in CHIA screening workshops can also be fed into any HIA that is commissioned.
For larger developments with multiple components, workshop participants can be divided into smaller groups to use the checklist to assess a specific part of the development; or to consider impacts on particular specified populations. Whole day events could be used to go through the checklist in the morning and prioritise impacts or define them in more detail in the afternoon.
Workshops may need to be conducted several times during business case development, depending on the nature of the project and potential impacts identified.
It is best practice to carry out a workshop as early as possible, once there is a detailed project outline to discuss.
The earlier the health and equity implications of the project are considered, the better the final business case will be as there will be greater scope to make changes at an earlier stage and maximise community benefits by involving a wider range of people impacted by the project.
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