The following selection of tools and guidelines addressing the social determinants of health and health equity were collected as part of the DETERMINE project (2007 – 2010). The list below comprises the most practical, flexible tools developed and identified at National level by four of the DETERMINE consortium partners: Public Health Wales (Wales), NHS Health Scotland (Scotland), the National Institute for Public Health and the Environment (Netherlands) and the Institute of Public Health (Ireland).
This selection of resources does not intend to be a comprehensive list of all the tools and guidelines available. Its aim is to provide guidance and support to public health and health promotion professionals that are addressing the social determinants of health and health inequalities and working with other sectors both at national and local level. For a more extensive list of resource documents, tools and guidelines developed in other EU countries and by other international organisations, please consult following publication, which can be found in the publications database:
“Menu of Awareness Raising and Capacity Building Actions to address the social determinants of health and to improve health equity”
Ingrid Stegeman, Caroline Costongs, Cristina Chiotan (EuroHealthNet) and Catherine Jones, Sara Bensaude de Castro Freire (IUHPE), DETERMINE project, September 2009
The tools and guidelines identified have been grouped into the following three categories:
I Practical guidelines and easy-to-use templates and tools
- Tools and Approaches for Assessing and Supporting Public Health Action on the Social Determinants of Health and Health Equity. A Collaborative Project by the National Collaborating Centre for Determinants of Health and the National Collaborating Centre for Healthy Public Policy, 2012. This document provides examples of the tools and approaches that have been adopted or applied by the public health and health sectors, with a focus on regions and authorities in Canada. Examples from outside of Canada have been included in cases where the approaches and tools are “foundational” or particularly relevant to the Canadian context. This document can be found at: http://www.ncchpp.ca/docs/Equity_Tools_NCCDH-NCCHPP.pdf
- Methodological Guide to integrate Equity into Health Strategies, Programmes and Activities. Ministry of Health, Social Services and Equality, 2012. This Guide has been drawn up by the Health Promotion Area of the Spanish Ministry of Health, Social Services and Equality, as a result of the training process for the “Integration of a focus on Social Determinants of Health and equity into Health SPAs” carried out during the period November 2010 to September 2011. It is based on the experience and the technical documentation of the Chilean Ministry of Health for the review and redesign of health programmes. The Spanish training process is framed within the National Strategy on Health Equity, and, moreover, within its strategic aim “to promote and develop knowledge and tools for intersectoral work, moving towards the concept of Equity and Health in all policies”. The English version of the Methodological Guide can be found at
- Owen Metcalfe, Claire Higgins, Teresa Lavin, ”Health Impact Assessment Guidance”. Institute of Public Health Ireland, Department of Health & Children, Investing for Health, 2009
This is a guidance manual which explains what Health Impact Assessment (HIA) is and the stages involved in conducting it. It provides a user friendly and practical framework to guide policy-makers and practitioners undertaking HIA. All HIA tools contained in this guidance and further information on HIA may be found at http://www.publichealth.ie/hia.
- Margaret Douglas, “How to do Health Impact assessment: a guide for practitioners”. Scottish HIA Network, March 2009
This document is a practical guide for people wishing to do health impact assessment. The guide covers the steps to take in doing a detailed HIA. It assumes an understanding of the basic principles informing HIA and also some basic public health knowledge.
- Margaret Douglas, “How to use the Rapid Impact assessment checklist for Health Impact Screening”. Scottish HIA Network, March 2009
The RIA Checklist is a screening tool that is intended to help identify potentially affected populations and potential health impacts of a proposed project, plan, programme or strategy.
- Malcom Ward, “Public Health Practitioner’s Public Engagement Toolkit”. National Public Health Service for Wales, 2009
This toolkit has been designed to support public health practitioners in identifying appropriate methods and techniques for public engagement. It could be useful for local project managers and in planning community level policies/programs, and also as guidance in developing training modules for public health and health promotion practitioners.
- “Developing a community profile: Guidelines. Community Health Impact Assessment”. Belfast Healthy Cities, Investing of Health, Eastern Health abd Social Services Board.
The purpose of this handbook is to provide a framework to identify priorities and needs at the community level, including a comprehensive panel of social determinants of health, such as: demography, health behavior, housing, employment, transport. The tool requires little adaptation, which mainly refers to the sources of data that can be used.
- Bro Taf Health Authority Wales, “Health inequalities impact assessment tools for use in Wales”
The four tools listed below have been developed for health inequalities assessment with a group of stakeholders from local level, when the aim is to develop or asses a policy/ project /intervention for specific groups. In the list presented by the authors the tools provide a good model to be used in the work at community/local level, while little adaptation to the specific contexts and situation is needed.1) HIIA Rapid Appraisal Guidelines
2) Policy Audit Checklist: guidance
3) Health Inequalities Impact Assessment Rapid Appraisal -tool
4) Health Inequalities Impact Assessment: planning for a positive impact
II Sector specific tools & guidelines: Green space, transport, and housing
- “Health Impact Assessment of greenspace. A Guide”. Health Scotland, Greenspace Scotland, Scottish Natural Heritage, Institute of Occupational Medicine, 2008
This guide has been written to help people conduct a health impact assessment (HIA) of greenspace, whether these are greenspace policies, strategies, plans, frameworks, programmes or projects. By bringing an innovative perspective on how to use greenspace evidence to do a HIA and on how greenspace relates to other aspects of the environment and to the health and well-being, it could be use as reference document, as well as support in working with environment/greenspace sector and decision makers involved in public policies.
- “Health Impact Assessment of Transport Initiatives. A Guide.” Health Scotland, MRC Social and Public Health Sciences Unit, Institute of Occupational Medicine, 2007
This guide has been written to help people doing a health impact assessment of a transport proposal. By providing brief summaries of completed of transport-related topics, it could be used as guidance for public health and health promotion professionals aiming to involve transportation sector in addressing the SDH.
- “Health Impact Assessment of Housing Improvements. A Guide.”NHS Scotland, Public Health Institute of Scotland, Medical Research Council, 2003
Although it is very much related to Scottish policy contexts and norms on housing improvements, the guide has been written to help people doing a health impact assessment (HIA) of a housing proposal. It could be used as a reference document for professionals aiming to address SDH in a cross-sectoral way, while working with urban development sector or other public policy decision makers in the community.
More information on sector specific HIA tools and guidelines, and e-learning courses on HIA, SDH and health equity could be found at http://www.healthscotland.com/resources/networks/shian.aspx.
III Group specific tools & guidelines
- “Guidelines for Poverty Impact Assessment”. Office for Social Inclusion, Ireland, 2008
Poverty impact assessment is described as the process by which government departments, local authorities assess policies/programmes at design, implementation and review stages in relation to the likely impact that they will have or have had on poverty and on inequalities which are likely to lead to poverty, with a view to poverty reduction. It is a useful guidance tool for both social and public health professionals and also for policy makers from national and community/local level.
- Community Calculator “How age friendly is my community?”. Age Cymru, Help the Aged in Wales.
(All rights reserved to the authors; requests for permission to use or translate should be addressed at : Mared.Williams@helptheagedwales.org.uk or Age Cymru at: Tŷ John Pathy, 13/14 Neptune Court, Vanguard Way, Cardiff, CF24 5PJ, Wales, UK, Tel: 029 2043 1555 Fax: 029 2047 1418)
This tool has been designed to facilitate gathering public opinion on a specific community in relation with the quality of life and facilities for elderly population. It could be used as a model for engaging with the elderly population in a community and involving them in the development of policies and projects addressing the social determinants of health and health inequities.
Please take into consideration that most of the tools and guidelines presented in this package have copyrights reserved – requests for permission to use or translate should be addressed to the authors or institution elaborating it, using the address and contact information inserted in each publication.
This online Crossing Bridges HiAP Capacity Building Training Module has been developed by:Yoline Kuipers, Ingrid Stegeman, Claudia Marinetti, Caroline Costongs
The Capacity Building Training Programme to promote “Health in All Policies”: Achieving the win-win for health and health equity has been developed by: Sharon Rawlinson, with special thanks to Dr. Susan Powell
We would also link to thank all the Crossing Bridges partners and Trainers who were involved in this work:
Charlotte Wirl (Gesundheit Österreich GmbH), and Gabrielle Sax
Bruno Buytaert (Flemish Institute for Health Promotion and Disease Prevention)
Pania Karnaki (PROLEPSIS) and Agoritsa Baka
Ágnes Taller, Júlia Kishegyi and József Solymosy (National Institute for Health Development)
Ruth Davis (Verona University Hospital) and Federica Michieletto
Marielle Schipperen (Netherlands Institute for Health Promotion) and Jessica Hoek
Justyna Car (National Institute of Public Health – National Institute of Hygiene) and Anna Debska
Mojca Garijelcic Blenkus (National Institute of Public Health)