Course
Health in SEA
Overview of Course
Notes on sessions for independent
learners
Introduction aims and objectives
for each session
Health in SEA
Introduction to the course for self learners
Introduction
The SEA EU Directive 2001/42/eu requires the consideration of the likely significant effects of
plans and Programmes on human health. To support non-health professionals to address health
in Strategic Environmental Assessment (SEA) the Department of Health (PHAST)
commissioned the West Midlands Public Health Observatory to develop a web based training
course, Health in SEA, for both training organisations and self-learners.
The course is designed for SEA and Sustainability Appraisal (SA) practitioners, planners and
those in local authorities who carry out and contribute to SEAs/SAs and who need to consider
health within these assessments. The materials for the 1 day Health in SEA course have been
adapted to be used by self learners to work through at their own pace either on their own or with
a self selected peer group. The materials provide opportunities for self learners to apply their
own skills and knowledge to realistic SEAs, a local transport plan and a core strategy, to be
used in the exercises accompanying the different sessions.
The course contains 9 sessions 8 of which have audio commentaries and there are 6 exercises
to work through to consolidate the learning in the sessions. Five handouts provide further
information on the two scenarios, the following sessions: „What is health‟, „Health baselines‟ and
„Working with health authorities‟, and where to get further information on health in SEA on the
HIA Gateway.
Course aims
The aims are for participants to build on their own knowledge of SEA/SA to:
Develop an understanding of health in SEA/SA
How health can be addressed within the SEA/SA process
Learning objectives and learning outcomes
By the end of this course participants should be able to:
Understand the drivers to include health within SEA
Understand the importance of using a broader definition of health, the link with health
determinants and the need to address health inequalities
Write health objectives for SEAs/SAs
Recognise the different types of evidence used in Impact Assessment and differential
strengths of these
Identify sources for health baseline data and know where health information can be
obtained
Understand and draw causal pathways and understand the limitations of predicting
health impacts
Identify the health issues to be considered in a draft scoping report and how and where
these can be addressed in the Scoping and Environmental Reports
Identify mitigation and enhancement measures and propose recommendations to
enhance health performance
Understand the legislative basis to monitoring of impacts and identify and describe
indicators for a monitoring strategy in SEA/SA
Course content
1. Introduction to health in SEA
2. Experience of health in SEA
3. Meaning of health
4. SEA scenarios and scoping for health issues
5. Prediction and causal pathways
6. Health baselines
7. Working with Health Authorities
8. Reporting and magnitude of impacts
9. Mitigation, enhancement and monitoring of health impacts
Time
This course has been designed to be delivered by a trainer in one day. Obviously if you are
working through it by yourself you can take as much time as you want.
Facilitator’s notes
After each exercise we suggest that you read the facilitator‟s notes. You will find these on the
Trainers front page.
Positional Map
Introduction, Aims and Objectives
Introduction
Complete the Positional Map before you start the course and complete it again at the end of the
course before completing the evaluation form. Comparing the maps you completed at the start
and end of the course will provide an opportunity for you to consider how you think about health
(in bio-physical and/or social economic terms) and if you thinking has changed after following
the course.
Aims
The aims are to:
Encourage you to reflect on what you think health means prior to the course and at the
end of the course
Consider if your thinking has changed as a result of the course
Objectives and Learning Outcomes
By the end of this session and end of the course you should be able to:
Complete both Positional Map questionnaires
Assess if your thinking about health has changed from the beginning to the end of the
course
Evaluate how you think about health (e.g. in biophysical terms or covering the wider
determinants of health)
Instructions
Print off and complete a copy of the positional map. Keep the map you complete at the start of
the course and compare it with the one you complete at the end of the course.
Session 1 (S1) Health in SEA
Introduction, Aims and Objectives
Introduction
The session explores the reasons for covering health in SEA (the legal requirement is described
in the additional materials for participants less familiar with SEA and the SEA Directive) and
introduces the Draft Guidance on Health in SEA. Setting of health objectives, identifying
indicators and setting targets are integral to this process. Getting health into the SEA brief is
important and some of the barriers to getting commissioners to address this are outlined.
Aims
The aims are to:
Summarise the legal basis for covering health in SEA and other reasons for doing so
Explains why health needs to be covered in SEAs
Highlight the need for consistency in all impact assessments
Introduce the Draft Guidance on Health in SEA (DH 2007)
Identify health objectives in SEA and links with indicators and targets
Explore the barriers to addressing health in SEA and how to get health into the SEA brief
Describe relevant National Health Policies
Objectives and Learning Outcomes
By the end of this session you should be able to:
Know the reasons for covering health in SEA including the legal requirement
Know of the existence of the Draft Guidance on Health in SEA (if not already aware of
this)
Relate health objectives in SEA to indicators and targets
Recognise that health coverage is required from SEA commissioners
Understand the barriers of getting health into the SEA brief
Know potential sources of health (also covered in Sessions 6 and 7)
Know the range of relevant national policies
Instructions
Work through Powerpoint slides: S1 Health in SEA
Read the background Guidance Notes
Additional material available
Session 2 (S2) Experience of SEA
Introduction, Aims and Objectives
Introduction
This is an introductory session to encourage you to get to think about your own experiences of
SEA, and then move onto considering how health was covered within these SEAs. If you have
never been involved with an SEA this exercise is unlikely to be meaningful.
Aims
The aims are to:
Encourage you to think about your experiences and knowledge of SEAs (or your
involvement with some of the process)
Identify the health issues they raised within these SEAs
Objectives and Learning Outcomes
By the end of this session you should have:
Described your own experience of SEA
Identified how health was covered in these SEAs
Instructions
Look at Exercise A participants notes and follow the instructions – Rather than recording on a
flip chart make your own working notes.
When you have done the exercise look at Exercise A Facilitator‟s notes
Finally work through Powerpoint slides S2 Experience of SEA
Session 3 (S3) What is health, WHO definition of health,
determinants, inequalities in health
Introduction, Aims and Objectives
Introduction
This session explores your own views on health working from what this may mean to you
personally and then thinking about this in the wider context of what health may mean at the level
of a city, town or rural community.
Aims
The aims are to:
Explore the WHO definition of health (1948) and encourage you to reflect on a broader
definition of health and how this is linked to an understanding of the determinants of
health
Introduce you to health inequalities and extend understanding of health and inequalities
to application in SEAs
Objectives and Learning Outcomes
By the end of this session you should be able to:
Recall the WHO definition of health
Recognise that this is a broad definition of health
Compare this with the narrow definition of health sometimes used in SEA
Identify the wider determinants of health underpinning their own understanding of health
Recognise the importance of addressing health inequalities and differential impact of
Plans and Programmes on population health
Recognise the need to address both the wider determinants of health and health
inequalities within SEAs to improve population health
Instructions
Look at Exercise B participants‟ notes and follow the instructions – Rather than recording on a
flip chart make your own working notes.
When you have done the exercise look at Exercise B facilitator‟s notes
Finally work through Powerpoint slides: S3 What is health
Session 4 (S4) Scenarios
Exercises C, E and F
Introduction
There are 2 scenarios presented, a Local Transport Plan (LTP) and a Core Strategy (CS).
Chose one of these to work on. When you have done the three exercises based on the one
scenario you may like to go to the other scenario and repeat the exercises using that scenario.
1. The three exercises are: scoping the proposed plans to identify health issues that are
considered significant (Exercise C); forecasting of likely health impacts (Exercise E); and
mitigating and monitoring of the significant health effects (Exercise F).
2. Each exercise involves a review and discussion of the evidence provided to provide a
recommendation on the way forward. Owing to the time available the materials are brief
and do not represent the information that might normally be made available. In addition,
the locations have been made anonymous to exclude any prior knowledge that you may
bring.
3. The materials presented are based on a real local transport plan and core strategy, but
they have been adapted for the purposes of the exercises.
4. We have deliberately provided only a small amount of information to promote a wide
consideration of the potentially significant effects, the data required, the forecasting and
assessment as well as mitigation and monitoring.
5. You may wish to use your own scenarios.
Instructions
First read and familiarise yourself with your chosen scenario.
Read the participants notes for Exercise C and follow the instructions.
When you have completed the exercise look at facilitators notes for Exercise C for the scenario
on which you are working.
You may also do exercises E and F at this point or you may prefer to do exercise E after
completing session 7 and exercise F after completing session 9.
Aims, Objectives and Learning Outcomes are covered separately for each exercise.
Session 4 (S4) Scenarios
Exercises C Scoping Report
Time: 60 minutes
Introduction
There are 2 scenarios for this exercise, the Local transport Plan and Core Strategy. Choose
which you would like to work on. You are asked to identify what health issues should be covered
in a draft scoping report and how these should be assessed.
Aims
The aims are to:
Encourage you to focus upon what health issues might be significant to the SEA and
plan rather than to provide a long list of issues.
Consider what health issues should be covered within the draft scoping report and how
these can be addressed. (The focus is on what you wish to see covered and not to
review the draft scoping document to identify omissions and seek clarification).
Objectives and Learning Outcomes
By the end of this exercise you should be able to:
Identify clearly the health issues that ought to be examined in relation to the strategy
objectives and consider whether the impacts are localised upon a particular area/corridor
(in abstract terms) or on a particular community when considering health inequalities.
Identify and describe the health baseline information relevant to the plan that ought to be
examined
Summarise the significant health issues to be examined in the SEA
Identify the data sets/knowledge that ought to be explored
Describe the health objective(s) that ought to be set
Identify and describe the different methods to be employed to assess the health effects
Instructions
You will need:
Exercise C1 (LTP) or C2 (CS):
Session 5 (S5) Prediction, Evidence and Causal Pathways
Introduction, Aims and Objectives
Introduction
The session explores: the SEA Directive‟s coverage of prediction and evidence; the techniques
used in predicting health impacts; the role of evidence within prediction; consultation and
participation as sources of evidence; use of causal pathways; and what constitutes evidence.
Aims
The aims are to:
Explore the reasoning that contributes to prediction in SEA and the limitations of
prediction both in SEA and other Impact Assessments
Explore what constitutes evidence and strength of evidence in SEA
Encourage you to think about what you mean by the term evidence
Understand that the “expert scientific” view is only part of what constitutes evidence.
Clarify the criteria used to assess evidence
Objectives and Learning Outcomes
By the end of this session you should be able to:
Know the SEA Directive‟s requirements for predicting impacts
Recognise the limitations of prediction and related use of evidence in SEA
Explain some prediction techniques used in SEA
Recognise the role of participation and consultation as sources of evidence and the
differences between these
Know that some causal pathways are more difficult to predict (e.g. those relating to
impacts on employment, income) than others (e.g. those relating to air quality, noise)
List different types of evidence.
Recognise that people‟s fears, hopes are important items of evidence.
Recognise the criteria that you may use to attach weight to different items of
evidence.
Instructions
Start to work through Powerpoint slides S5 Prediction and evidence
Look at Exercise D participants‟ notes and follow the instructions – Rather than recording on a flip chart
make your own working notes.
Session 6 (S6) Health Baselines
Introduction, Aims and Objectives
Introduction
The session introduces you to health baseline information; sources of health baseline data; and
how to access it and other health related data relevant to SEA. Limitations with the
information/data are discussed and health baselines for some vulnerable groups are suggested.
The session is supported by the Background Guidance handout.
Aims
The aims are to:
Introduce health baselines and describe the different sources of health baseline
information
Describe the limitations of health baseline data
Provide information on where these can be obtained
Objectives and Learning Objectives
By the end of this session you should be able to:
Know where to find health baseline data using the Background Information handout
Identify the different sources of health baseline information
Identify some of the problems/limitations in using health baselines information
List some vulnerable groups and identify which health baseline data could be used to
address these
Instructions
Work through Powerpoint slides S6 Health baselines
Look at the handout Health baselines and working with health authorities
Session 7 (S7) Working with Health Authorities
Introduction, Aims and Objectives
Introduction
This session introduces you to how Health Authorities and health related organisations are
organised at National, Regional and Local Levels and the type of information they provide.
Other sources of information are also highlighted. The session is supported by the Background
Guidance and you are expected to apply some of their understanding in Exercise F (Mitigation,
Enhancement and Monitoring).
Aims
The aims are to:
Introduce participants to the organisation of Health Authorities and related organisations
Indicate where further information and advice can be sought
Build on the Health Baselines session (Session 6)
Objectives and Learning Objectives
By the end of this session participants should be able to:
Identify the organisation (at National, Regional or Local level) and the possible
professional(s) who could be contacted for health information and advice
Identify sources of information using web links available in the Background Information
Handout
Recall the 3 questions when accessing and using health information
Instructions
Work through Powerpoint slides S6 Health baselines
Look at the handout Health baselines and working with health authorities
EXERCISE E: CAUSAL PATHWAYS AND IMPACTS
Introduction, Aims and Objectives
Introduction
The exercise focuses upon potential health effects by considering the causal pathways.
Aims
The aims are to:
Explore the variety of potential health effects (or health impacts) that can arise from the
range of polices across the LTP or Core Strategy.
Objectives
By the end of this exercise you should be able to:
Identify the determinants of health that may be affected by the strategy/policy
Identify the measures/ key policies with potential health effects both positive and
negative
Draw the causal pathways
Identify those which may be significant and those that ought to be ignored
Assess whether any of the significant effects are likely to be disproportionately
represented on particular population subgroups (geographic, ethnic, age, disability,
socioeconomic).
Assess the potential for significant cumulative plan wide effects in the context of other
(likely) plans and programmes in the area
Assess whether any measures might have been missed or not addressed in the plan
Instructions
Refresh your memory on the scenario on which you are working.
Read the participants‟ notes for Exercise E and follow the instructions.
When you have completed the exercise look at facilitators notes for Exercise E for the scenario
on which you are working.
Session 8 (S8) Reporting and Magnitude of Impacts
Introduction, Aims and Objectives
Introduction
The session considers how impacts and health impacts are reported in the Environmental
Report and how they are analysed of health impacts. Particular attention is given to how
magnitude of impacts is assessed and the different dimensions used to describe this.
Aims
The aims are to:
Consider where health can be covered in the Environmental Report
Explore how health impacts can be described
Discuss some of the problems with measuring the magnitude of health impacts
Understand how assessing magnitude of health impacts (as with other impacts) is
subjective
Objectives and Learning Outcomes
By the end of this session you should be able to:
Identify where health impacts can be covered in the Environmental Report
Know how the magnitude of health impacts are described, the problems in describing
magnitude, and understand the different dimensions to magnitude
Recognise that describing magnitude of health impacts is subjective
Exercise X
Rate and rank the health impacts provided from the worst to the least “nastiest”
Discuss the reasoning behind the ranking and negotiate an agreement with the group (if
possible)
Evaluate the magnitude of 2 impacts against each other
Instructions
Work through Powerpoint slides S8 Reporting and magnitude of impacts
Read the participants notes for Exercise X and follow the instructions.
When you have completed the exercise look at facilitators notes for Exercise X.
Session 9 (S9) Mitigation, Enhancement and Monitoring
Introduction, Aims and Objectives
Introduction
SEA guidance and regulations on mitigation, enhancement and monitoring are outlined. The
purpose of these procedures and what needs to be included are described. A Monitoring
Framework is discussed and consideration is given to the role of the Annual Monitoring Report
in this process. You are asked to apply this understanding to their own scenarios in Exercise F.
If working on the Core Strategy (B) group it is suggested you consider only 1 or 2 policies within
the Core Strategy for the exercise.
Aims
The aims are to:
Understand how Plans and Programmes can be written to mitigate against negative
health impacts and enhance positive impacts
Understand the regulatory basis and purpose of mitigation, enhancement and monitoring
Recognise the Annual Monitoring Report as an important part of this process
Outline a monitoring strategy based on significant health effects and using indicators and
other sources of information
Objectives and Learning Outcomes
By the end of this session you should be able to:
Explain the SEA Directive‟s guidance on Mitigation, Enhancement and Monitoring
Describe the purpose of Mitigation, Enhancement and Monitoring in SEA
Identify a series of Mitigation measures that are expected to be relevant to the plan and
its subsequent development proposals
Propose a series of recommendations to mitigate or enhance the health performance of
the strategy/plan
Identify a small set of key topics from the Scenarios to be Monitored
Describe the indicators to be used
Decide how often this data should be assembled
Identify what data has already been collected (links to likely existing monitoring regimes)
Assess the costs and resource implications for establishing monitoring measures
Instructions
Work through Powerpoint slides S9 Mitigation, Enhancement and Monitoring
Refresh your memory on the scenario on which you are working.
Read the participants notes for Exercise F and follow the instructions.
When you have completed the exercise look at facilitators notes for Exercise F for the scenario
on which you are working.
Positional Map: 2
When you have completed the exercise fill in the positional map once again.
Has it changed since you started the doing the course?
Evaluation
Have you found this course helpful?
If you have any comments or suggestions as to how it can be improved please use the
evaluation form to send us your comments.
.