Health Impact Assessment
A Health Impact Assessment evaluates the potential health effects of a proposed development on the local population and identifies measures to maximise health benefits while mitigating any adverse impacts. With the growing recognition that the built environment fundamentally shapes public health outcomes, Health Impact Assessments have become an increasingly common requirement in UK planning, particularly for major developments and in areas with significant health inequalities.
Typical Cost
£300 – £5,000+
Turnaround
1 – 6 weeks
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What is a Health Impact Assessment?
A Health Impact Assessment (HIA) is a systematic process that uses a combination of evidence, stakeholder engagement, and professional judgement to evaluate the potential health consequences of a proposed development. It examines how the design, construction, and operation of a scheme may affect the physical health, mental health, and wellbeing of existing and future residents and the wider community. The assessment goes beyond clinical health to consider the wider determinants of health including housing quality, access to green space, air quality, active travel opportunities, social cohesion, and access to health services.
When is a Health Impact Assessment required?
Health Impact Assessments are increasingly required by London boroughs under the London Plan, which mandates HIAs for developments subject to Environmental Impact Assessment and encourages them for other major schemes. Outside London, a growing number of local authorities include HIA requirements in their local plans or supplementary planning documents, often setting thresholds such as 100 or more residential units, 10,000 square metres or more of commercial floorspace, or developments in areas of high health deprivation. The NPPF supports healthy places through paragraphs 96 and 97, which require planning decisions to promote healthy and safe communities.
What does a Health Impact Assessment include?
A thorough Health Impact Assessment includes a community health profile establishing the baseline health characteristics of the local population, a systematic assessment of the development's potential impacts across a range of health determinants including housing quality and affordability, access to healthcare facilities, open space and physical activity opportunities, air quality and noise exposure, access to healthy food options and avoidance of hot food takeaway clustering, active travel infrastructure and public transport, social infrastructure and community facilities, employment and training opportunities, social cohesion and community safety, and construction phase impacts. For each determinant, the assessment identifies affected populations, evaluates the direction and magnitude of impact, and proposes design measures and mitigation to optimise health outcomes.
How much does a Health Impact Assessment cost?
A desktop Health Impact Assessment for a mid-sized development typically costs between £3,000 and £8,000. A comprehensive HIA involving community engagement, stakeholder workshops, and detailed modelling of health outcomes for a large-scale development can cost £10,000 to £25,000. Rapid HIAs or health statements for smaller schemes that require a proportionate assessment may be prepared for £1,500 to £3,000.
Who can prepare a Health Impact Assessment?
Health Impact Assessments are prepared by public health consultants, planning consultants with health specialisms, or specialist HIA practitioners. The author should have expertise in public health, health promotion, or environmental health, and be familiar with the HIA methodology set out in guidance from the Wales Health Impact Assessment Support Unit (WHIASU), Public Health England, or the London Healthy Urban Development Unit (HUDU). Many local authority public health teams can provide advice on scope and methodology.
How long does a Health Impact Assessment take?
A desktop HIA can typically be completed within 3 to 5 weeks. Comprehensive HIAs involving community health profiling, stakeholder engagement workshops, and detailed analysis of multiple health determinants may take 8 to 12 weeks. Where the HIA forms part of an Environmental Impact Assessment, timescales will align with the broader EIA programme.
Frequently Asked Questions
Is a Health Impact Assessment legally required?
There is no national legislation mandating HIAs for planning applications. However, many local authorities include HIA requirements in their adopted local plans, making them a validation requirement for qualifying developments. The London Plan requires HIAs for EIA developments, and the NPPF supports healthy place-making. Where an HIA is included on the council's validation checklist, failing to submit one will prevent your application from being registered.
What is the HUDU Healthy Urban Planning Checklist?
The Healthy Urban Development Unit (HUDU) Rapid Health Impact Assessment Tool is widely used in London and beyond as a framework for assessing health impacts. It provides a structured checklist covering 11 broad themes aligned with the wider determinants of health, against which the development is scored. Many London boroughs require applicants to complete the HUDU checklist as part of their HIA submission.
Does a Health Impact Assessment replace other health-related reports?
No. An HIA provides a strategic overview of health impacts but does not replace specialist assessments such as air quality assessments, noise impact assessments, or contaminated land investigations. Instead, it draws on the findings of these specialist reports and synthesises them into an overall assessment of health effects. The HIA adds value by considering the wider determinants of health that individual technical reports do not address.
How does the HIA consider mental health and wellbeing?
A good HIA assesses factors that affect mental health and wellbeing including access to daylight and sunlight, provision of private and communal amenity space, noise and air quality within homes, opportunities for social interaction and community building, access to nature and green space, safety and security in the public realm, and the availability of social support services. These factors are particularly important for developments in areas of high deprivation.
What is a community health profile?
A community health profile establishes the baseline health characteristics of the population in the area around the development site. It draws on data from Public Health England's Fingertips database, the Office for National Statistics, and the Indices of Multiple Deprivation to describe life expectancy, disease prevalence, mental health indicators, deprivation levels, and health risk factors. This baseline enables the assessment to identify populations that are particularly vulnerable to health impacts from the development.
Can an HIA strengthen a planning application?
Absolutely. A well-prepared HIA demonstrates that the developer has considered the health implications of the scheme from the outset and has designed the development to promote health and wellbeing. This is increasingly valued by planning committees and can help differentiate your scheme from competing proposals. An HIA that shows genuine health benefits can also help justify the development in policy terms under the NPPF's healthy communities objectives.
Do I need to consult with the local public health team?
It is strongly recommended. Many local authority public health teams are consulted on major planning applications and may provide formal comments on health impacts. Early engagement helps you understand their priorities and concerns, and can inform the scope of your HIA. Some councils have established protocols for public health input into planning decisions, and their support can carry significant weight at planning committee.
How does the HIA address hot food takeaway clustering?
Many local planning authorities have adopted policies restricting the proliferation of hot food takeaways, particularly near schools. The HIA should assess the existing density of takeaways in the area and evaluate whether the development contributes to an oversupply that could negatively impact dietary health, particularly for children. For mixed-use schemes proposing food and drink uses, the HIA should consider the types of food outlets and their potential health effects.
What is a healthy streets approach?
Healthy Streets is a framework developed by Lucy Saunders and adopted in the London Plan that assesses how street design affects health outcomes. It evaluates 10 indicators including whether people feel relaxed, whether the environment is clean and pleasant, and whether active travel is prioritised. The HIA may reference Healthy Streets principles when assessing the development's impact on the surrounding walking and cycling environment and the quality of public realm within the scheme.
How are health impacts monitored after development is complete?
For major developments, the HIA may recommend a health monitoring framework that tracks health outcomes during and after construction. This might include monitoring air quality and noise levels, tracking usage of open spaces and active travel routes, conducting resident satisfaction surveys, and liaising with local health services to identify any emerging health concerns. Monitoring requirements can be secured through planning conditions or Section 106 agreements.