Using health impact assessments as both a research and community coalition-building tool

Health Impact Assessments (HIAs) are gaining popularity as a research approach for prospectively evaluating the likely health impact of non-health sector policies and plans. HIAs also provide an excellent opportunity to incorporate cumulative risk assessments, which can difficult to incorporate in many research methodologies. Little attention also has been given to the potential of the tool for building coalitions, generating consensus, and supporting coordinated responses among community members. By designing HIAs to explicitly incorporate community engagement at multiple points in the process, researchers can engender trust, elicit information on community concerns and local knowledge, build capacity for understanding the relationship between policies or plans and health, and contribute to the development of recommendations for mitigating potential harms and maximizing positive community health impacts. However, although the formal HIA may end at this point, community members that have been fully engaged in the process are more likely to monitor adoption of recommendations and apply further pressure, themselves becoming agents of change and not merely research participants.