Health Impact Assessments (HIAs) are increasingly being used across the US and in Massachusetts as a way to predict the health impacts of a proposed project, plan or policy.

A HIA is used to analyze the effects a proposed project, plan or policy would have on a population’s health. It also helps identify recommendations to prevent harmful health impacts and maximize positive health impacts.

HIAs identify health impacts by considering the social, environmental and economic health determinants of the proposal; which means the HIA will investigate how the proposal impacts everything from housing, air quality, educational opportunities and social networks, etc. HIAs follow a standard process as defined by the North American HIA Practice Standards Working Group (2010). As a fundamental principle, HIAs engage multiple stakeholders to help us best understand the different ways the proposal impacts health.

A HIA typically goes through the following stages:

  1. Screening: this stage determines the need and the value of conducting a HIA. It identifies whether the proposal is at the right stage in the decision-making process to be effected by a HIA and whether the proposal has potential health impacts.
  2. Scoping: this stage determines what the potential health impacts are and how those impacts will be analyzed. It also helps to develop a workplan for conducting the HIA.
  3. Assessment: this stage provides a profile of existing health conditions of the population that will be impacted by the proposal and an evaluation of potential health impacts. This is the stage where the HIA attempts to predict health impacts through either primary or secondary research or a combination of both.
  4. Recommendations: this stage uses the results of the assessment to provide recommendations that enhance positive health impacts while mitigating any adverse health impacts of the proposal.
  5. Reporting: this stage develops the report and engages stakeholders to disseminate the findings.
  6. Monitoring: this stage is ongoing and is used to track the effects of the HIA report on decision-makers and tracks the health impacts of the ultimate decision on the proposal.
  7. Evaluation: evaluation is used to understand if the HIA met its goals. Therefore each HIA should begin by including goals and objectives that can be evaluated.

View a list of Health Impact Assessments completed or underway in Massachusetts.

The following organizations provide detailed information on how to engage in a HIA:

For assessment resources, interested persons should look at both health outcome and health behavior related data as well information on the built environment and other health determinant data sources. A starting place could include:


This information is provided by the Department of Public Health.