What is the CHIA?
The Capital Investment Health Impact Assessment (CHIA) is an online resource which supports the assessment of health and equity impacts in capital investment projects. Step 1 of the CHIA process is to plan and run a screening workshop to identify potential positive, negative and uncertain health and equity impacts of proposed developments. The CHIA screening workshop is central to the CHIA process and is designed to bring together a range of people (including those impacted by the proposed investment and those developing it) to discuss potential positive, negative and uncertain impacts on different population groups and the wider economic, social and environmental determinants of health. If potential impacts are identified which will not be addressed by other impact assessments, then project teams can proceed to Step 2 where they identify the scope of the health impact assessment (HIA) required and commission this out. The CHIA resources support all the steps in the process that project teams have to undertake internally.
What is the purpose of the CHIA?
The CHIA's main purpose is to maximise the health, wellbeing and economic benefits from capital investment. The CHIA supports project officers to maximise the population health and wellbeing outcomes and mitigate inequalities in capital investment decisions.
Who is the CHIA for?
The CHIA is intended to be used by those working on capital investment infrastructure projects.
It will be relevant for the following:
- project officers writing business cases
- equality and diversity officers coordinating or overseeing Equality Impact Assessments
- procurement officers writing procurement strategies
- planning officers and community benefits officers advocating for the community impact of investment
and many others, depending on the needs of a project.
How has the CHIA been developed?
The CHIA has been developed by Glasgow City Region and Public Health Scotland with input from a range of people involved in, or impacted by, capital investment projects in Glasgow City Region. The CHIA development covered:
Current position and needs:Sessions were held with different groups to understand existing tools and processes and what the CHIA should provide to support business case development. Sessions included local authority equality officers, those working in the transport and housing sectors where capital investment is often focused, and officers working in procurement and community benefits.
A community panel:A community panel was brought together by the Scottish Community Development Centre (SCDC), specifically to support the development of CHIA. The Panel included representatives from a range of groups and organisations across Glasgow, representing those who experience inequality and/or who are seldom heard in decision-making processes.SCDC in collaboration with the community panel have written 'Community Engagement in Capital Investment' which is a guide to community engagement throughout the capital investment project lifecycle, and provided feedback on the CHIA as it has been developed.
User group feedback:Throughout the development of the CHIA, local authority officers have provided further information on existing integrated impact assessment processes and new processes being introduced. Officers also provided feedback on each draft of the CHIA to ensure it is useful to future users.
What does the CHIA screening workshop involve?
Step 1 of the CHIA process involves undertaking a screening workshop with those developing the project, and those impacted by the proposal. A health and equity impact checklist is used as a prompt for systematic consideration and discussion to identify a wide range of potential impacts. This process may help to gather and identify the information needed for other impact assessments required for the project.
What are the wider determinants of health?
The wider determinants of health are the economic, social and environmental factors which influence physical and mental health, and outcomes from illness. Structural inequality in society, for example in access to the building blocks of health such as education and good quality employment, being able to afford secure housing, and having strong social and community links, are important determinants of health. Inequalities in these building blocks lead to inequalities in health and life expectancy. Ultimately, unequal distribution of money, wealth and power, also known as the fundamental causes of inequality (see priority 1 in the linked article), underlie health inequalities.
Is health, wellbeing and equity not covered by other impact assessments?
No. The impact assessments typically completed by capital projects are Equality Impact Assessment, Strategic Environmental Assessment, Economic Impact Assessment, Sustainability Impact Assessment and UNCRC Children's Rights Impact Assessment. While some of these include elements of health, none of these assessments consider the wider social, economic and environmental determinants of health. The CHIA process also signposts to where elements of the health and equity impact checklist generates information to support the completion of other impact assessments.
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