title: Advancing efforts to achieve health equity: equity metrics for health impact assessment practice.
abstract: Equity is a core value of Health Impact Assessment (HIA). Many compelling moral, economic, and health arguments exist for prioritizing and incorporating equity considerations in HIA practice. Decision-makers, stakeholders, and HIA practitioners see the value of HIAs in uncovering the impacts of policy and planning decisions on various population subgroups, developing and prioritizing specific actions that promote or protect health equity, and using the process to empower marginalized communities. There have been several HIA frameworks developed to guide the inclusion of equity considerations. However, the field lacks clear indicators for measuring whether an HIA advanced equity. This article describes the development of a set of equity metrics that aim to guide and evaluate progress toward equity in HIA practice. These metrics also intend to further push the field to deepen its practice and commitment to equity in each phase of an HIA. Over the course of a year, the Society of Practitioners of Health Impact Assessment (SOPHIA) Equity Working Group took part in a consensus process to develop these process and outcome metrics. The metrics were piloted, reviewed, and refined based on feedback from reviewers. The Equity Metrics are comprised of 23 measures of equity organized into four outcomes: (1) the HIA process and products focused on equity; (2) the HIA process built the capacity and ability of communities facing health inequities to engage in future HIAs and in decision-making more generally; (3) the HIA resulted in a shift in power benefiting communities facing inequities; and (4) the HIA contributed to changes that reduced health inequities and inequities in the social and environmental determinants of health. The metrics are comprised of a measurement scale, examples of high scoring activities, potential data sources, and example interview questions to gather data and guide evaluators on scoring each metric.
authors.affiliation: Human Impact Partners, 304 12th Street, #2B, Oakland, CA 94607, USA. jch@humanimpact.org.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Heller
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53726, USA. mgivens@wisc.edu.
authors.forename: Marjory L
authors.initials: ML
authors.lastname: Givens
authors.affiliation: National Association of County and City Health Officials, 1100 17th Street NW, Seventh Floor, Washington, DC 20036, USA. tyuen@naccho.org.
authors.forename: Tina K
authors.initials: TK
authors.lastname: Yuen
authors.affiliation: School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720, USA. solange.g@icloud.com.
authors.forename: Solange
authors.initials: S
authors.lastname: Gould
authors.affiliation: Institute of Population Health, University of Ottawa, 1 Stewart Street, Room 300, Ottawa, ON K1N 6N5, Canada. maria.benkhalti.jandu@uottawa.ca.
authors.forename: Maria Benkhalti
authors.initials: MB
authors.lastname: Jandu
authors.affiliation: Center for Community Health and Evaluation, Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. bourcier.e@ghc.org.
authors.forename: Emily
authors.initials: E
authors.lastname: Bourcier
authors.affiliation: Solano County Health and Social Services Department, 275 Beck Avenue, MS 5-240, Fairfield, CA 94533, USA. tmchoi@solanocounty.com.
authors.forename: Tim
authors.initials: T
authors.lastname: Choi
mesh_terms: D002140:California; D062489:Health Impact Assessment; D006801:Humans; D015397:Program Evaluation / Q000379:methods*