1. 9 th International HIA Conference A framework for public health officials to integrate HIA considerations in municipal project undertakings for the City of Toronto Siobhan Sutherland, Ronald Macfarlane, Dr. Lesbia Smith, Bob Kearse, Norm Lee, and Christopher Ollson, PhD. Liverpool, 9-10 October 2008

2. Presentation Overview 9 th International HIA Conference (Liverpool: 9-10 October 2008) 1 Acknowledgements: Siobhan Sutherland, Jacques Whitford Limited, Ontario, Canada Christopher Ollson, PhD, Jacques Whitford Limited, Ontario, Canada Dr. Lesbia Smith, EOH+Plus, Toronto, Ontario, Canada Bob Kearse, City of Toronto Solid Waste Management Services Norm Lee, City of Toronto Solid Waste Management Services Project Advisory Committee Angela Li-Muller & Kitty Ma, Health Canada Gloria Rachamin, Ontario Ministry of Health and Long-term Care Kathleen Anderson & Paul Celsie, Ontario Ministry of the Environment Lee Doran & Kathleen Reil, Community Environmental Assessment Team Dr. Rick Edwards, University of Toronto Dr. David McKeown, Medical Officer of Health, Toronto

3. Presentation Overview 9 th International HIA Conference (Liverpool: 9-10 October 2008) 1 HIA in Toronto The HIA framework document Residual Waste Planning Study pilot HIA

4. The Context of HIA in Toronto 9 th International HIA Conference (Liverpool: 9-10 October 2008) 2 The Medical Officer of Health (MOH) for Toronto has a long history of initiating and advocating for healthy public policy at all three levels of government The MOH is often asked to comment on municipal decisions which have the potential to affect health Toward a Healthy City – TPH Strategic Plan 2005-2009 Improve the health of the city’s diverse population Champion public health for Toronto TPH will remain vigilant in urging other governments to enact laws and regulations that reduce health hazards and promote health pro-actively influence decision-making in the business, community and public sectors

5. Genesis of HIA in Toronto July 2004: Board of Health requests HIAs for 2 transportation projects February 2005: Staff report on urban health identifies HIA as a tool to assist in the adoption of healthy public policy in Toronto November 2005: Report to the Board of Health on HIA February 2007: City Council approves the development of an HIA framework for the EA on residual municipal solid waste February 2008: Framework document completed September 2008: Planning study, incorporating a screening level HIA starts 9 th International HIA Conference (Liverpool: 9-10 October 2008) 3

6. Elements of the Framework What does the framework contain? Guiding Principles Equity considerations Steps in HIA Screening Scoping The assessment Monitoring and evaluation Modelled after the New Zealand Guide to Health Impact Assessment 9 th International HIA Conference (Liverpool: 9-10 October 2008) 4

7. Proposed TPH HIA process 9 th International HIA Conference (Liverpool: 9-10 October 2008) 5

8. Outcome of the screening process 9 th International HIA Conference (Liverpool: 9-10 October 2008) 6 Triggered at planning stage of municipal projects Three possible outcomes: Judged not to warrant an HIA – screening report outlines basis for this decision Further investigation is required and scoping identifies project likely to have positive health impacts and negligible or readily addressed negative health impacts – Limited-scope HIA report outlines basis for this decision Further investigation is required and scoping identifies project likely to have potentially large negative health impacts – In- depth HIA report provides basis for this decision Possible to start with limited-scope and move to in-depth assessment

9. Public Participation 9 th International HIA Conference (Liverpool: 9-10 October 2008) 7 Some form of public and stakeholder participation needs to occur throughout the process Not specified in the framework The degree and scope of stakeholder or public participation will depend on scope of HIA

10. Screening 9 th International HIA Conference (Liverpool: 9-10 October 2008) 8 Triggering the HIA No criteria have been set until now Suggested that project that is subject to an Environmental Assessment would go through screening It is anticipated that Toronto Public Health will direct or undertake the screening Need of a multi-disciplinary team to do the screening Public comment on the screening report

11. HIA Screening Tool 9 th International HIA Conference (Liverpool: 9-10 October 2008) 9 Based on Greater London Authority Screening Tool Qualitative tool Determinants of health Populations affected

12. HIA Screening Report 9 th International HIA Conference (Liverpool: 9-10 October 2008) 10

13. Scoping 9 th International HIA Conference (Liverpool: 9-10 October 2008) 11 Scoping determines if HIA will be limited or in-depth in scope Likely to involve a Steering or Project Advisory Committee: Various stakeholders Multi-disciplinary team Public input: At minimum comments on a draft report More inclusive or extensive participation possible Scoping may result in a limited-scope assessment

14. Conducting the Assessment 9 th International HIA Conference (Liverpool: 9-10 October 2008) 12 Scoping will determine the approach and depth of the assessment or appraisal Likely to involve a Steering or Project Advisory Committee Public participation will be necessary An initial assessment may identify need for more in- depth analysis Final report will make recommendations to minimise negative health impacts Assessment of multiple options is favoured Limited scope HIA on various alternatives More in-depth HIA on preferred options

15. Monitoring and Evaluation 9 th International HIA Conference (Liverpool: 9-10 October 2008) 13 At minimum – evaluation of the HIA process should be undertaken HIA report could make recommendations for on-going monitoring and other evaluation processes

16. Residual Waste Planning Study 9 th International HIA Conference (Liverpool: 9-10 October 2008) 14 March 2007: Province of Ontario enacts new regulation which changes the EA requirements for waste management June 2007: Staff recommend that Toronto instead carry out a comprehensive residual waste planning study Principles for residual waste planning study: protection of human health and the environment conservation of natural resources consideration of a wide range of alternative technologies rigorous evaluation methodology that includes a health impact assessment meaningful public consultation Residual Waste Working Group provides guidance

17. Planning Study Appraisal Approach 9 th International HIA Conference (Liverpool: 9-10 October 2008) 15 Screening HIA

18. Summary 9 th International HIA Conference (Liverpool: 9-10 October 2008) 16 HIA allows Medical Officer of Health to make informed judgement Assessment of options allows us to compare a range of proposals and identify the one that has least overall negative impact Health is only one factor to be considered in decision-making The current framework is flexible The pilot HIA in the Residual Waste Planning Study will help make recommendations for more a formal process in future

19. For more information 2005 HIA report is available at: http://www.toronto.ca/health/hphe/environmental_health/ environmental.htm The framework report is available at: http://www.toronto.ca/garbage/rwwg/meetings.htm Thank you!