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This Project has received funding from the European Commission
The European network of health promotion agencies Bundeszentrale für gesundheitliche Aufklärung National Institute of Public Health, NIPH Finnish Centre for Health Promotion (FCHP) The Institute of Public Health in Ireland National Social Marketing Centre International Union for Health Promotion and Education European Partners

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You are here: > DETERMINE Key Outcomes > Capacity Building > Tools and Resources

Tools and Resources

Tools

A Package of Tools & Guidelines* for addressing the Social Determinants of Health

As health is directly impacted by living and working conditions, the social and community networks and life-style related determinants of health, other sectors have an important responsibility and role in improving health. The present package has been developed as a response to the need to increase the skills and knowledge of the health sector to collaborate with other sectors, while strengthening organisational capacities, increasing workforce skills and building leadership. It comprises the most practical, flexible tools developed and identified at national level by partners from Wales, Scotland, Netherlands and Ireland. The present package was not intended 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.
The tools included in this package have been grouped based on their addressability and use in three main areas:

Practical guidelines and easy-to-use templates and tools

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. “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.
  6. 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.  

Sector specific tools&guidelines- greenspace, transport, housing

  1. “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.
  2. “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.  
  3. “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.

Groups specific tools&guidelines

  1. “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.
  2. 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.

The selection of tools and guidelines included in this package is the result of the consultation between DETERMINE Consortium partners from Ireland, Wales, Scotland and Netherlands. For a more extensive list of resource documents, tools and guidelines developed in other EU countries and by other international organisations, please consult the Menu for Capacity Building&Awareness Raising Actions available at www.health-inequalities.eu.

Comments or additions to this package can be addressed to Cristina Chiotan, at c.chiotan@eurohealthnet.eu.

Resources

Awareness Raising and Advocacy

This area refers to the ongoing process of informing and sensitizing key stakeholders and decision makers in effective ways to generate willingness and the ability to act on the social determinants of health.
The actions initiated by partners focused mainly on identifying the best communication tools and strong arguments for advancing work on the SDHI, to advance health equity.  Some partners are organizing conferences, workshops and seminars that aim to increase knowledge and to place SDH and health equity on the political agenda.  Partners are using DETERMINE outcomes and resources, or developing their own advocacy materials that are specifically relevant to their countries.
The most relevant resource documents identified for this area are as follows:

  1. DETERMINE action summary, WP reports, framework, materials developed by DETERMINE partners www.health-inequalities.eu;
  2. Report from the WHO Commission on the social determinants of health www.who.int/social_determinants/tools/en;
  3. WHA62.14 - Sixty-second World Health Assembly - 22 May 2009;
  4. The unnatural causes website: www.unnaturalcauses.org;
  5. JECH Online ‘Advocacy for public health: a primer' http://jech.bmj.com/cgi/content/abstract/58/5/36;
  6. Richard Sayers ‘Principles of Awareness Raising’ http://unesdoc.unesco.org/images/0014/001476/147637e.pdf;
  7. ‘The Equity Gauge - Concepts, Principles and guidelines’ http://www.gega.org.za/download/gega_guide.pdf.

The partners which are undertaken actions in this area are from Belgium, England (NWR), Hungary, Latvia, Finland, Romania.

Partnership Development

This area comprises the actions undertaken to stimulate and improve collaboration between people, organizations or institutions.
The actions initiated by partners focused mainly on developing collaborations and partnerships with other sectors. One of the aims is also to identify tools available at national level, to make them available to an international audience. The work being undertaken so far focuses on two main strands of action: engaging other sectors at both national level and local level and improving and disseminating existing tools, guidelines, HIA.
The most relevant resource documents identified for this area are as follows:

  1. K.E. Smith et al. ‘Partners in Health?’ A systematic review of the impact of organisations and partnerships on public health outcomes in England between1997-2008. Journal of Public Health, Jan 30,2009 pg.1-12;
  2. ‘Marmot Review’ of effective interventions to address the SDH in 9 areas: www.ucl.ac.uk;
  3. European Social Fund - Partnership Development Tool http://ec.europa.eu/employment_social/equal/data/document/pdtoolkit_en.pdf;
  4. ‘Crossing sectors - experiences in intersectoral action, public policy and health’ http://www.phac-aspc.gc.ca/publicat/2007/cro-sec/pdf/cro-sec_e.pdf.
  5. ‘Partnering for results - a user’s guide to intersectoral partnering’ http://www.usaid.gov/pubs/isp/handbook/PN-ACD-344.pdf;
  6. Conclusion of ‘Voices from other fields’ DETERMINE working document www.health-inequalities.eu; for identifying partners, policy , programme or project initiatives that are being planned or implemented in other sectors that affect health equity, and identify common objectives; prepare evidence base and approach actors involved in policy and programmes: www.health-inequalities.eu, DETERMINE Working doc ‘Voices from other fields’.
  7. Report from the WHO Commission on the social determinants of health www.who.int/social_determinants/tools/en.
  8. House of Commons - Health Committee, Third Report on Health Inequalities:  http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/286/28602.htm

The partners which are undertaken actions in this area are from Germany, Iceland, Ireland, Netherlands, Slovenia (Maribor), Slovenia (NIPH), Belgium (Flanders), Scotland, Norway, Czech Republic, Finland.

Skills Development

Capacity to address social determinants of health and improve health equity depends on the commitment and abilities of a wide range of people at the organizational, local, regional and national level. This area focuses on building a cadre of trained experts that can adopt and implement action on SDH. It also focuses on developing new techniques and strategies to disseminate knowledge about the SDH.
Partners are developing specific training curricula that are adapted to their professionals needs and can generate a targeted response based on their specific political context, taking into account existing resources and previous country experience in addressing SDH. Their actions aim to ensure further developments and sustainability by integrating the topics of SDH and health equity into the general training curricula for public health and health promotion professionals.
The most relevant resource documents suggested for this area are as follows:

  1. DETERMINE outcomes (e.g. Framework and WP 5, 6 and 7 Working Documents) www.health-inequalities.eu;
  2. Seminar on Health Inequalities by the London School of Economics and Political Science(LSE) and EC DG EMPL on 7 May 2009: http://www2.lse.ac.uk/LSEHealthAndSocialCare/LSEHealth/eventsAndSeminars/health_inequalities/health_inequalities__seminar_2009.aspx;
  3. HIA training material from the Institute of Public Health in Ireland www.publichealth.ie/hia;
  4. Training  and support for HIA in Scotland at http://www.healthscotland.com/resources/networks/HIAtraining.aspx;
  5. HIA Gateway: http://www.apho.org.uk/default.aspx?RID=40141;
  6. Improving Health and Reducing Inequalities. A practical guide to HIA. http://www.cieh-cymruwales.org/uploadedFiles/Core/Policy/Public_health/;
  7. National Social Marketing Centre: http://www.nsms.org.uk/public/default.aspx.
  8. Training Course Content - Identify the Training Topics - http://www.intulogy.com/training-course/ , http://www.stopvaw.org/Preparing_the_Training_Program_Structure_and_Content.html?Type=B_BASIC&SEC={DBBA8050-B91C-46DF-96B0-E6A60F4DE0D2} ;
  9. PAHO/WHO self-instructional courses on the SDH www.who.int/social_determinants/tools/en;
  10. ‘Health inequalities - Understanding the essentials’ - London Health Observatory LHO - Association of Public Health Observatories (APHO) www.lho.org.uk .

The partners which are undertaken actions in this area are from Belgium (Flanders), Wales, Italy (Perugia), Poland, France, Estonia, Norway, Spain (Canary Islands), Denmark.

Paris Meeting
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Workshops took place have been focused on the main areas addressed by partners within their capacity building activities: awareness raising and advocacy, partnership development (at national and local level, tools and resources)and skills development. One workshop provided also the opportunity for further discussions on data and information available and accessible for monitoring SDH and health equity.
+WS handouts (revise to include purpose of the handout) .

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