Further information about HIIA

You can use our guides and resources to help you carry out an HIIA. Our answers to frequently asked questions resource provides more information about why and how to conduct a health inequalities impact assessment (HIIA).

Background to HIIA

HIIA is a process which offers an integrated approach to impact assessment. It was developed following a recommendation in Scottish Government’s Equally Well report (external website) and has been used in the Scottish Government, local and national health boards and some third sector agencies since its launch in 2011.

It draws on methodology from the World Health Organization’s (WHO) Health Impact Assessment (HIA) (external website), which includes consideration of the social determinants of health. HIA has been used to influence policies in a wide range of sectors, such as housing, environment and transport. For more information, download WHO’s report on The Effectiveness of Health Impact Assessment (external website).

HIIA also incorporates Equality Impact Assessment (EqIA) which focusses on impacts on people covered by the nine protected characteristics included in the Equality Act 2010. These are

  • age
  • sex
  • race
  • disability
  • religion or belief
  • sexual orientation
  • gender reassignment
  • pregnancy and maternity
  • marriage and civil partnership.

HIIA includes consideration of these protected characteristics, but also considers other population groups who are vulnerable to unfair differences in health outcomes such as

  • those living in remote/rural locations
  • people in different socio-economic groups
  • those involved in the criminal justice system.

HIIA also considers potential impacts on human rights, which is not usually included in EqIA. It draws on methodology from the Scottish Human Rights Commission's (SHRC) Human Rights Impact Assessment. You may wish to download SHRC’s Impact Assessment Guidance for Future Assessments (external website).

Human rights based approach

Including human rights in the assessment prompts consideration of how a plan or policy might drive up standards of services and enhance positive impacts for all people.

Scotland’s National Action Plan on Human Rights (SNAP) promotes a human rights based approach known as PANEL (external website), which stands for

Participation

  • Does your impact assessment involve the right people?
  • Have those affected by the policy or plans had a say in shaping it?
  • Everyone has the right to participate in decisions which affect them.

Accountability

  • Who is responsible for taking action on the HIIA findings?
  • How will the organisation be held to account for embedding equality and human rights into its plans and policies?

Non-discrimination and equality

  • Does the policy ensure everyone can realise their human rights?
  • Has the HIIA considered how it can demonstrate non-discriminatory practice and advance equality?

Empowerment

  • How does the plan/policy build understanding or affirmation of human rights?

Legality

  • Has the policy respected, protected and fulfilled the full range of legally protected human rights?

Embedding a human rights based approach into existing impact assessment processes can help mainstream human rights into the work of public authorities. You can find more information about a human rights based approach on our Right to Health page.

You can read more information on equality and human rights impact assessment on the SHRC's website (external website).

The legal duty for impact assessments

Not all decisions by organisations need to be impact assessed. Public bodies have a legal duty to conduct an equality impact assessment where a plan, policy or decision has the potential to impact upon people and to the extent necessary to demonstrate that due regard has been paid to the requirements of the Public Sector Equality Duty of the Equality Act 2010 (external website).

HIIA includes equality impact assessment and therefore satisfies this legal requirement if it considers how a new or revised policy will

  • eliminate unlawful discrimination, harassment and victimisation and other prohibited conduct
  • foster good relations between people who share a protected characteristic and those who do not
  • advance equality of opportunity between people who share a relevant protected characteristic and those who do not

Further support

Members of the Learning and Improvement team in the NHS Health Scotland are available to discuss any part of the process and share examples of practice. They can also provide copies of any NHS Health Scotland HIIA report.

The Equality and Human Rights Commission (EHRC) can provide advice on an impact assessment (external website) and guidance on rights, responsibilities and good practice, based on equality law and human rights. 

The Scottish Human Rights Commission (SHRC) (external website) is dedicated to helping everyone understand their rights and the shared responsibilities we have to each other and to communities. The commission is independent of the UK and Scottish parliaments and governments.

Our resources include answers to frequently asked questions giving details of peer networks that can support you with your HIIA.