Health Equity Impact Assessment

The Ministry of Health and Long-Term Care (MOHLTC) has identified equity as a key component of quality care. MOHLTC has developed HEIA to support improved health equity, including the reduction of avoidable health disparities between population groups. HEIA also supports improved targeting of health care investments—the right care, at the right place, at the right time.

What is HEIA?

HEIA is a decision support tool which walks users through the steps of identifying how a program, policy or similar initiative will impact population groups in different ways. HEIA surfaces unintended potential impacts. The end goal is to maximize positive impacts and reduce negative impacts that could potentially widen health disparities between population groups—in short, more equitable delivery of the program, service, policy etc. Effective use of HEIA is dependent on good evidence.

Why use HEIA?

The HEIA tool that has been developed by MOHLTC has four key objectives :

  1. Help identify unintended potential health equity impacts of decision-making (positive and negative) on specific population groups
  2. Support equity-based improvements in policy, planning, program or service design
  3. Embed equity in an organization’s decision-making processes
  4. Build capacity and raise awareness about health equity throughout the organization

What does the HEIA tool look like?

The HEIA tool includes a template and a workbook that provide users with step by step instruction on how to conduct an HEIA. The workbook walks users through five steps: 1) Scoping, 2) Potential Impacts, 3) Mitigation, 4) Monitoring, and 5) Dissemination. The results are recorded in the HEIA template.

There is also a French Language Services Supplement that has been developed for MOHLTC and Local Health Integration Network (LHIN) staff who have distinct responsibilities under the French Language Services Act, and a Public Health Unit Supplement that has been developed for Public Health Units (PHUs).

Who can use HEIA?

The tool is not only intended for use by organizations across the Ontario health care system, such MOHLTC, LHINs, PHUs, and health service providers; but also by organizations outside the health care system whose work can have an impact on health outcomes. HEIA is intended to be completed by the planning, program or policy development team—not an external third party.

Who else is using HEIA?

HEIA tools have been adopted in a number of international jurisdictions including Australia, New Zealand, the United Kingdom and Wales. HEIA is also used and advocated by the World Health Organization (WHO). The Ontario HEIA tool was developed by MOHLTC in collaboration with LHINs. It incorporates international evidence as well as input gathered during regional pilots and conversations with health service providers.

Download the HEIA Tool

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