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The Health Impact Assessment: an Opportunity for Community Engagement

Clare Delmar, Listen to Locals

Many of us see the pandemic as a reset opportunity for the development of local communities, with many lessons learned about place and public health begging to be considered and applied to future planning decisions.

So it’s bewildering when we then encounter discussion and documentation about planning proposals with little or no reference to the pandemic – almost like it never happened, and it’s business as usual.

Its absence is understandable in technical documents, but in the one document that you’d expect this discussion – the Health Impact Assessment – I have yet to see it addressed.

Good HIAs are de facto forums for understanding local health needs now and in future and analysing how a proposed development will impact these, and they should be an opportunity to engage local residents and community groups around their hopes and aspirations for their community.

The Pew Research Centre, did extensive research on HIAs and their role in promoting community engagement, published just before the pandemic. The research revealed close links between community engagement and overall health in the community:

“Increased community engagement and strengthened relationships with decision-makers may yield health benefits. Research shows that excluding community members from decision-making or failing to consider the impacts of a policy change on residents can lead to uncertainty and a perceived loss of control, cultural identity, and sense of belonging among affected populations”

It went on to point out

“The resulting distrust can decrease the effectiveness of health promotion campaigns and reduce participation in treatment and prevention services, which in turn can negatively affect health outcomes and increase inequities, especially among historically disadvantaged communities”

And concluded

“The Health Impact Assessment can be an influential tool for strengthening community engagement, building trust between residents and decision-makers, and enhancing the decision-making process. HIAs can contribute to more equitable access to health-promoting resources and protection from environmental risks. By engaging community members in the process and identifying their concerns, HIAs help uncover health risks to residents that may otherwise be masked. Similarly, by sorting the collected data by geographic area, socioeconomic status, and racial or ethnic groups, HIAs can identify opportunities to increase equity and help practitioners develop evidence-based recommendations to address differences in distribution of health risks.”

If only. My experience with the HIA for the planning application to redevelop the Stag Brewery in SW London, now under the planning authority of the London Mayor, is anything but an exercise in community engagement.:

· Production/ownership

The report was produced by consultants Hatch Regeneris, who did not consult with local community groups Mortlake Brewery Community Group or Mortlake Community Association, nor our local GP Surgery. The CCG, representing a wider area and broader spread of health services, was asked to comment and a spokesperson there told me their comments emphasised a need for more resources to support the proposed population increase (which at that time, in the original application, included a care home). These were not reflected in the HIA .

· Access

The GLA website provides all documentation for the Stag Brewery application – but good luck finding anything specific with no clear document titles in no particular order, and no search capability or navigation aid to help. It took an iron will to locate the HIA.

· Currency

The HIA was updated in July 2020 following the application’s mayoral call-in and subsequent changes to the scale and scope of the development, including increased density and building heights. There is no mention of the pandemic, much less its current and future impact on the local community, and the assessment of the impact of the scaled-up proposed development on local health remained unchanged from the original HIA.

Fortunately, there is some discussion and practice emerging here in the UK around linking public health and planning. Hopefully, this will begin to inform a rethink of the HIA and lead to a process that is inclusive, meaningful and IMPACTFUL for all communities affected by proposed redevelopment.

· New Local is currently undertaking an investigation into community involvement and the NHS

· Public Health England runs a programme on Healthy Places that is looking at how best to design and develop local areas to promote public health.

· The Kings Fund has recently published a report on the role of communities and public health

· A petition has been launched this week demanding that local NHS authorities consent to proposed large-scale developments

Let’s hope these become meaningful steps toward reforming the HIA ,and communicating its importance to local communities as they undergo change to their built environment in our post-pandemic world.


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