Ministry of Health and Long-Term Care (2012).
. Toronto, ON: Ministry of Health and Long-Term Care. Available at:
Relevance for Public Health
This tool can be used to assess programs prospectively and retrospectively, and to inform organization-wide change to incorporate an equity lens in decision making.
This Health Equity Impact Assessment (HEIA) tool was developed by the Ontario Ministry of Health and Long-Term Care (MOHLTC) in partnership with Public Health Ontario (PHO), Public Health Units (PHUs) and Local Health Integration Networks (LHINs). This tool can help decision-makers consider equity issues in planning decisions.
Health Equity Impact Assessment (HEIA) is a specialized form of Health Impact Assessment (HIA) that evaluates the impact of a program, policy or initiative on the health of a population (National Collaborating Centre for Healthy Public Policy). HEIA analyzes a program or policy's impact on health inequities and/or disadvantaged populations (Haber, 2011). For more equity resources, see NCCDH's Resource Library.
HEIA can be used in the following ways:
- To identify potential unintended health impacts of a planned initiative on vulnerable groups
- To develop recommendations for adjusting initiatives in ways to mitigate negative impacts and optimize positive impacts on the health of vulnerable groups
- To embed equity across an organization's decision-making processes
- To support equity-based improvements in service delivery
- To raise awareness of health equity to support change within an organization
The following resources can be accessed from MOHLTC to conduct an HEIA:
Accessing the Method/Tool
Implementing the Method/Tool
Time for Participation/Completion
Information not available
Additional Resources and/or Skills Needed for Implementation
Steps for Using Method/Tool
The Health Equity Impact Assessment (HEIA) tool includes a template with guiding questions for each step in the process. There are five steps in conducting a health equity impact assessment:
- Scoping: identify affected populations and potential unintended health impacts on those groups of the planned policy, program or initiative.
- Potential impacts: use available data or evidence to prospectively assess the unintended impacts of the planned policy, program or initiative on the identified groups in relation to the broader population.
- Mitigation: develop evidence-based recommendations to minimize or eliminate negative impacts and maximize positive impacts on identified vulnerable groups.
- Monitoring: determine how implementation of the initiative will be monitored to determine its impact on vulnerable groups related to other subpopulations or the broader target population.
- Dissemination: share results and recommendations for addressing equity.
The Public Health Unit Supplement specifies the links between the HEIA tool and the Ontario Public Health Standards (OPHS) Foundational Standards and the Population Health Assessment and Surveillance (PHAS) Protocol.
Who is involved
Health equity impact assessment (HEIA) is conducted by planning staff, and decision-makers use the results to inform planning decisions.
Conditions for Use
Evaluation and Measurement Characteristics
Information not available
The Health Equity Impact Assessment (HEIA) tool was developed by the following groups:
- Ontario Ministry of Health and Long-Term Care (MOHLTC)
- Public Health Ontario (PHO)
- Public Health Units (PHUs)
- MOHLTC's Public Health Division
- many other contributers
Method of Development
The Ontario Health Equity Impact Assessment (HEIA) Tool was developed by the Ministry of Health and Long-Term Care in collaboration with the province's Local Health Integration Networks (LHINs), with a second edition recently being launched with Public Health Ontarion (PHO). It incorporates international evidence as well as input gathered during regional pilots and conversations with health service providers.
The HEIA Team
Ministry of Health and Long-Term Care
These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.