Health Impact Assessment in Canada – Frequently Asked Questions Answered

Blog Overview

The following blog provides a concise, practical introduction to Health Impact Assessments (HIAs) and their growing role in project planning and decision-making across Canada. It explains how HIAs offer a systematic, evidence-based approach to evaluating both the positive and negative effects of projects, policies, and developments on community health, while also considering how those impacts are distributed across different populations.

The article clarifies key concepts, including how HIAs differ from Human Health Risk Assessments (HHRAs) by taking a broader, population-level perspective that incorporates social, environmental, economic, and cultural determinants of health. It also outlines when HIAs should be conducted, ideally early in the planning process, to better inform design, mitigation, and stakeholder engagement, including meaningful collaboration with Indigenous communities and the integration of Indigenous knowledge and worldviews.

Readers will gain insight into the benefits of HIAs, such as improved project outcomes, stronger stakeholder trust, enhanced health equity, and reduced long-term risks. The blog also addresses common practical questions, including regulatory expectations, typical project types requiring HIAs, timelines, assessment methodologies, and how equity and vulnerable populations are considered.

Finally, the blog highlights the key deliverables of an HIA, from baseline health assessments to mitigation and monitoring strategies.

Graphical Blog Summary

What is a health impact assessment?

An HIA is a systematic, evidence‑based process used to evaluate the potential positive and negative health effects of a proposed project, policy, plan, or development on communities, as well as the distribution of those impacts within the communities. HIAs consider a broad range of social, environmental, economic, and cultural determinants of health to support informed decision‑making and promote healthier, more equitable outcomes for communities. The HIA process is complementary to existing Human Health Risk Assessment (HHRA) and Environmental Assessment (EA) protocols; however, it is uniquely able to identify and assess project benefits to provide a more balanced perspective of overall impact.

HIAs conducted for and by Indigenous communities focus on Indigenous determinants of health that are holistic and grounded in the relationship between the ecosystem and people. Indigenous-led HIAs reflect Indigenous worldviews that understand health is a balance of physical, mental, emotional, and spiritual well‑being.

Intrinsik’s HIA services integrate public health expertise with planning and impact assessment best practices to help organizations understand and manage how their decisions may affect human health and well‑being.

Is an HIA the same as an HHRA?

No. While both consider health, HIAs take a broader, population‑level approach. An HIA examines a wide range of health determinants (such as housing, employment, access to services, food security, air quality, and social conditions) and considers both positive and negative effects of projects, programs or policies. An HHRA relates to the environmental determinants of health and in doing so focuses on chemical exposures and related risks.

When should an HIA be conducted?

An HIA is most effective when conducted early in project or policy planning, before key decisions are finalized. Early application allows health considerations to be integrated into design, mitigation, and decision‑making rather than addressed after issues arise. Early engagement with Indigenous communities, Rights holders and stakeholders allows for Indigenous- or community-led HIAs that scope into the assessment those determinants of health most valued by communities. This leads to more meaningful HIAs that are grounded in community concerns.

What are the benefits of an HIA?

A well designed HIA helps organizations:

• Proactively identify and reduce potential health impacts before they occur
• Enhance potential positive health outcomes and community well being
• Support regulatory compliance and approval processes
• Strengthen Rights holder / stakeholder and community trust
• Improve project design through early, informed decision making
• Address health equity and impacts to vulnerable populations
• Reduce long term health, social, operational, and reputational risks

Ultimately, HIAs help bridge the gap between development objectives and public health priorities.

Are HIAs required by regulation?

HIAs are not always mandated, but they are increasingly recommended by regulators, public health authorities, municipalities, and Indigenous communities. They are often required or recommended as part of environmental/impact assessments, land‑use planning, or major development approvals.

What types of projects typically require an HIA?

HIAs are commonly applied to:

• Infrastructure and transportation projects
• Industrial and resource development projects
• Urban development and land‑use planning initiatives
• Energy, utility, and renewable projects
• Policies or programs with potential community‑level effects

How long does an HIA take?

Timelines vary depending on the size, complexity, and regulatory context of the project. HIAs conducted by Intrinsik range from rapid, high‑level assessments that require little time (weeks) and resources to comprehensive evaluations aligned with environmental/impact assessment processes (months).

How are health impacts assessed?

HIAs can use a combination of:

• Existing health and community data
• Indigenous knowledge and worldviews (for Indigenous-led HIAs)
• Literature and best‑practice evidence
• Qualitative and quantitative analysis
• Rights holder, stakeholder and community input via surveys, key person interviews, focus groups, etc.

The goal is to clearly identify health pathways, potential impacts, and practical mitigation or enhancement measures.

How are equity and vulnerable populations considered?

A core part of an HIA is identifying how different populations may experience impacts differently. This includes consideration of how different vulnerable or priority groups, such as children, seniors, Indigenous peoples, or communities with existing health or social challenges, are impacted differently, and tailoring mitigation measures specifically to these priority groups. Intrinsik has developed Guidelines for Health Canada on Integrating Gender-Based Analysis Plus into HIA as part of Federal Impact Assessments. These guidelines are essentially a blueprint on considering how health impacts to varied groups of people can vary and identifying appropriate mitigation and enhancement measures.

What deliverables does an HIA typically include?

An HIA may include:

• A health and community baseline summary
• Identification of community- and project-specific health determinants and pathways of effects
• Health impact characterization and interpretation
• Mitigation and enhancement recommendations
• Monitoring and follow‑up measures

Deliverables are tailored to project needs and regulatory requirements.

Why partner with Intrinsik for your HIA project?

Intrinsik brings a practical, solutions‑focused approach to HIAs. We work closely with clients and communities to tailor the scope and level of analysis to the project, regulatory context, and community setting.

Intrinsik developed the initial HIA Guidance for Health Canada for application to federal Impact Assessment projects, as well as the Guidelines for Integrating Gender-Based Analysis Plus in HIA for Federal Impact Assessment projects. Provincially, Intrinsik developed the Human Health Implications Study guidance for the Ministry of Transportation of Ontario that integrates the HHRA and HIA frameworks into a single process to be applied to major transportation projects to assess impacts to population health.

Our team:

• Integrates health, environmental, and socio‑economic data into clear, actionable findings
• Collaborates with planners, engineers, regulators, and Indigenous Rights holders and community stakeholders
• Applies best‑practice guidance while remaining flexible and proportionate
• Translates complex health information into clear insights for decision‑makers
• Focuses on both mitigation and enhancement strategies as well as actionable monitoring solutions and indicators

Clients choose Intrinsik for our deep understanding of impact assessment frameworks, our ability to work across disciplines, and our commitment to delivering assessments that are both technically robust and practical to implement.