This HIA training is supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.
This HIA training is supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.
Welcome & Introductions
Welcome & Introductions
Connections between health and the environment
Introduction to HIA
Haila Maze, AICP, City of Mpls—Introduction to ATF Plan
Step 1: Screening & Exercise
Step 2: Scoping & Exercises
Step 3: Assessment
Jared Erdmann, MPH, City of Mpls—Reflections on ATF HIA
Step 4-6: Recommendations, Reporting &Monitoring and Evaluation
Training Evaluation
Think “Health”
Think “Health”
The purpose of an HIA: to provide health information to decision-makers before important decisions are made, so they can make a more informed decision
The purpose of an HIA: to provide health information to decision-makers before important decisions are made, so they can make a more informed decision
Six HIA steps and HIA process
Leading causes of death in Minnesota: 2010
Leading causes of death in Minnesota: 2010
Cancer 9,599 166.9
Heart Disease 7,144 118.7
Unintentional Injury 2,087 36.4
Stroke 2,154 35.8
Chronic Lower Respiratory Disease 2,012 35.1
Definition: A systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects.
Definition: A systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects.
National Research Council, Improving Health in the United States: The Role of Health Impact Assessment, 2011.
HIA aims to advance the values of
HIA aims to advance the values of
democracy
equity
sustainable development
the ethical use of evidence
a comprehensive approach to health
North American HIA Practice Standards Working Group (Bhatia R, Branscomb J, Farhang L, Lee M, Orenstein M, Richardson M). Minimum Elements and Practice Standards for Health Impact Assessment, Version 2. North American HIA Practice Standards Working Group. Oakland, CA: November 2010.
Identify harms and benefits before decisions are made
Identify harms and benefits before decisions are made
Identify evidence-based strategies and recommendations to promote health and prevent disease
Recommended specific language and policy statements
Recommendations adopted into plan
Desktop HIA
Desktop HIA
Mixed use development, 181 acres, near Faribault
Church campus, school, low-density residential, senior living, townhomes, commercial
10 Health Categories: Air Quality, Land Development, Parks, Trees & Vegetation, Transportation, Housing, Food, Water, Noise, and Safety
26 health indicators
Results shared with developer
1st Comprehensive HIA in MN
1st Comprehensive HIA in MN
Community driven: ISAIAH, Take Action MN, PolicyLink
3 Areas of Assessment:
Healthy Economy
Healthy, Affordable Housing
Safe and Sustainable Transportation
Screening - to determine if an HIA is useful for a specific project or policy
Screening - to determine if an HIA is useful for a specific project or policy
Scoping - identify which health effects to consider
Assessment - determine which people may be affected and how they may be affected
Recommendations - suggest changes to proposal to promote positive or mitigate adverse health effects
Reporting - present the results to decision-makers
Monitoring and evaluating - determine the affect of the HIA on the decision process
Presentation on the Above the Falls Master Plan by Haila Maze, AICP, City of Minneapolis
Presentation on the Above the Falls Master Plan by Haila Maze, AICP, City of Minneapolis
What is HIA Screening?
What is HIA Screening?
The Screening process helps determine if:
… the HIA is feasible
Is there sufficient information about the decision?
Is there available resources to conduct the HIA?
… the HIA can be done in a timely manner
Can the HIA fit within the decision-making time frame?
… the HIA would add value to the decision making process
Is health already at the table?
Will the proposed project benefit from an HIA and promote health and influence positive change to the community?
No added value
No added value
Chula Vista Plan to Improve Walkability
Plan was already considering health
Health advocates involved in design
Resources better focused elsewhere
No influence on decision
Milwaukee Zoo Interchange Project
Time: insufficient time to complete HIA for drafts
Stakeholders: DOT was not open to considering health (recommendations seen as another obstacle or more red tape)
How to start the screening process:
How to start the screening process:
Define the decision
What is being proposed?
What is the timeline for the decision?
2. Decide who will be involved in the screening process
2. Decide who will be involved in the screening process
Identify the stakeholders (i.e., residents, business owners, regional agencies, local organizations, elected officials)
3. Determine if potential partners are ready to work on the HIA
Do they have the resources available to conduct an HIA?
4. Evaluate the program, plan, or policy based on screening criteria (including will the program have a significant impact on health)
4. Evaluate the program, plan, or policy based on screening criteria (including will the program have a significant impact on health)
Utilize a Screening Worksheet or a Checklist
There are a number of worksheets to choose from
Use the worksheet that best meets your needs
Has a project, plan or policy been proposed?
Has a project, plan or policy been proposed?
Is there time to conduct HIA before decision is made?
Will the project, plan or policy affect health?
Would health inequities be impacts? How?
Are health impacts likely to be significant in terms of number of people impacted (magnitude), severity of impact, or immediacy or permanence of impacts?
Is there expertise, evidence and/or research methods available to analyze health impacts?
Is health already being considered?
Is health already being considered?
Are there clear links between the proposal and health?
Are decision-makers open to considering HIA findings?
Will the HIA process have potential health impacts?
Do stakeholders have the interest and capacity/resources to participate in the HIA?
Discuss HIA plan, timeline and the decision and alternatives
Ground rules
Goals of HIA & screening
Communications plan—is everyone at the table?
Geographic area
Population(s) and subpopulations to be studied
Scoping* next meetings:
Scoping* next meetings:
Examine the range of possible health issues
Come to agreement on priority health issues
Discuss pathways
Determine research questions, data sources & methods+
*scoping flows into assessment
+data sources & methods-discussed in assessment
Bill 2800 (HB 2800), the Farm to School and School Garden legislation, as introduced in January of 2011:
Bill 2800 (HB 2800), the Farm to School and School Garden legislation, as introduced in January of 2011:
(1) allocate $19.6 million in state funds, equivalent to 15 cents per lunch and 7 cents per breakfast, to reimburse schools for purchasing Oregon food products, and
(2) provide $3 million in competitive education grants to support food, garden and agriculture activities, up to 150 school teaching gardens each fiscal year.
Source: Henderson, T., Rader, M., Sorte, B., Ratcliffe, M. M., Lawrence, A., Lucky, J., and Harris, C. (2011) Health Impact Assessment: Farm to School and School Garden Policy, HB 2800, Upstream Public Health and the Health Impact Project. http://www.upstreampublichealth.org/sites/default/files/F2SHIA_FINAL.pdf
Employment
Employment
Diet & Nutrition
Farm to School & School Garden Education
Environmental Health
Social Capital
Determined land-use decisions to evaluate
Determined land-use decisions to evaluate
Health issues:
Obesity
Mental Health
Environmental Quality (air, noise and water quality)
Safety and Security
Neighborhood Cohesion
Neighborhood Livability
Employment
Pathways can be direct:
Pathways can be direct:
Or indirect:
and can be fairly complicated…
HIA land use decision alternatives to be investigated:
HIA land use decision alternatives to be investigated:
To add 108 acres of parkland;
To extend existing Riverfront biking and walking trails by 4.2 miles.
To add over the long term 3000 jobs; and
To add over the long term 1000 new housing units.
Come to agreement on priority health issues
Come to agreement on priority health issues
Prioritization Criteria
Health impacts with the greatest potential significance, magnitude, severity, certainty, permanence
Stakeholder/community priorities
Equity
Available resources: time, existing data/research, ability to collect new data for gaps in data/research
Determine research questions, data sources & methods
Healthy Corridor For All (MN)
Healthy Corridor For All (MN)
HB 2800: Farm to School and School Garden Policy (OR)
HB 2800: Farm to School and School Garden Policy (OR)
Screening - determine if HIA is useful for specific project or policy
Screening - determine if HIA is useful for specific project or policy
Scoping - identify health effects to consider
Assessment – perform research, determine populations affected & how
Recommendations - suggest changes to proposal to promote positive or mitigate adverse health effects
Reporting - present results to decision-makers
Monitoring and evaluating - determine effect of HIA on decision process
Main goals:
Main goals:
Profile baseline conditions, characteristics of target populations
Analyze potential health effects of decisions
U.S. Census
U.S. Census
Hospital-discharge records
Disease registries
Behavioral Risk Factor Surveillance Survey
Scale discrepancies
Scale discrepancies
Qualitative
Qualitative
Mixed methods
Mixed methods
Qualitative: literature review, public meetings
Quantitative: extensive use of existing data for summary statistics and predicting impacts
Mixed methods
Mixed methods
Qualitative: literature review, interviews, community forums
Quantitative: secondary data analysis, economic procurement analysis (IMPLAN)
You don’t have to predict everything with absolute certainty
Look at all the evidence available and make an informed judgment based on
analysis of data
expertise
experience
Validity = Transparency
Use results from assessment to develop recommendations and mitigations to address any negative health impacts and maximize health benefits
Use results from assessment to develop recommendations and mitigations to address any negative health impacts and maximize health benefits
Recommendations -- alternative ways to design a project, plan, or policy including its location or timing to benefit health
Mitigations -- management strategies to lessen anticipated adverse health effects of a decision
Recommendations can focus on Process and/or Outcomes
Recommendations can focus on Process and/or Outcomes
Recommendations and mitigations should be:
Recommendations and mitigations should be:
Responsive to predicted impacts
Specific and actionable
Best practices or evidence-based
Experience-based and effective
Technically feasible
Politically feasible
Economically efficient
Work with existing businesses; they will likely continue to be located in the ATF area. Explore ways of effectively engaging businesses to assist in achieving the ATF plan objectives, for example by promoting environmentally safe or greener practices and increasing job density.
Work with existing businesses; they will likely continue to be located in the ATF area. Explore ways of effectively engaging businesses to assist in achieving the ATF plan objectives, for example by promoting environmentally safe or greener practices and increasing job density.
Focus on improving already existing residential areas and housing along Riverway streets that may have been hit hard by the recession and the housing and foreclosure crisis to help mitigate crime and safety concerns and promote health through well-maintained neighborhoods.
Focus on improving already existing residential areas and housing along Riverway streets that may have been hit hard by the recession and the housing and foreclosure crisis to help mitigate crime and safety concerns and promote health through well-maintained neighborhoods.
Explore alternatives for youth, elderly, people with disabilities and other vulnerable populations to access the Riverfront such as planning for off-road trails to accommodate biking and walking traffic and public transit.
Explore alternatives for youth, elderly, people with disabilities and other vulnerable populations to access the Riverfront such as planning for off-road trails to accommodate biking and walking traffic and public transit.
Farm to School HIA:
Farm to School HIA:
Recommendations to legislation (HB 2800)
Reimburse schools only for purchased foods “produced” or “processed” in Oregon so as to increase economic activity in our state.
Agriculture and Garden education grants will be preferentially given to schools serving:
a low-income student population
schools with a racially diverse student population
schools in rural or urban areas with limited food access
Ensure grants support schools developing multiple-component programs that increase child health benefits
Healthy Corridor for All HIA:
Healthy Corridor for All HIA:
Five Policy Recommendations for Moving Forward
Community Equity Program
Codifying the Commitment to Affordable Housing
Density Bonus Program
Relieving the Lack of Commercial Parking
First Source Hiring
Two main products:
Two main products:
Develop full HIA report and communicate findings and recommendations
Offer opportunity for meaningful feedback on report
Update report or address substantive criticism through a formal written response
Implement communications plan
Intro/Project Background
Intro/Project Background
Screening
Scoping
Stakeholder Engagement
Assessment
Recommendations
Reporting
Monitoring & Evaluation
Bottineau HIA
Bottineau HIA
Released draft HIA report
Published summary in 5 languages: English, Hmong, Laotian, Somali, and Spanish
Advertised 2 month public comment period (July 15 – Sept 15)
Will incorporate feedback from stakeholders and the public into final HIA report
Letters to proponents and decision-makers
Letters to proponents and decision-makers
Comment letters on or reports included in draft Environmental Impact Assessment
Formal report
Presentations
Peer-reviewed publications
Monitoring—What happened?
Monitoring—What happened?
Monitor recommendations & implementation
Were the HIA recommendations adopted?
Has the policy, program or plan been implemented?
Monitor health determinants and outcomes
Were there changes in exposures, health outcomes/determinants & any unexpected consequences
Develop a monitoring plan
Develop a monitoring plan
The monitoring plan should include:
goals for short- and long-term monitoring;
outcomes and indicators for monitoring;
lead individuals or organizations to conduct monitoring;
a mechanism to report monitoring outcomes to decision-makers and HIA stakeholders;
triggers or thresholds that may lead to review and adaptation in decision implementation; and
identified resources to conduct, complete, and report the monitoring.
Process evaluation—Considers whether the HIA was carried out according to the plan and HIA standards
Process evaluation—Considers whether the HIA was carried out according to the plan and HIA standards
Impact evaluation—Seeks to understand the impact of the HIA itself on the decision-making process or on other factors outside the specific decision being considered
Outcome evaluation—Focuses on the changes in health status/health indicators resulting from implementation of the recommendations
Process evaluation of the HIA:
Process evaluation of the HIA:
What were the successes?
What were the challenges?
What worked?
Who should we include next time?
What data sources will you need in the future?
Did the HIA meet the HIA minimum standards?
Report on evaluation so that new HIA practitioners can learn from your successes and challenges
Performed a self-evaluation.
Performed a self-evaluation.
Answered key questions:
What was accomplished during the various steps of the HIA process and how was it accomplished?
What were some of the major successes and challenges during each step of the process?
What changes happened to the Above the Falls Plan because of the HIA?
What partnerships have formed from the HIA process? How do you see these partnerships working in the future?
How has health data been useful in the process?
Some see evaluation as a separate process—objectivity, funding, timeframe
Some see evaluation as a separate process—objectivity, funding, timeframe
Lack of attention to evaluation is a barrier that will need to be overcome if HIA practice is to be advanced in the US
Screening - to determine if an HIA is useful for a specific project or policy
Screening - to determine if an HIA is useful for a specific project or policy
Scoping - identify which health effects to consider
Assessment - determine which people may be affected and how they may be affected
Recommendations - suggest changes to proposal to promote positive or mitigate adverse health effects
Reporting - present the results to decision-makers
Monitoring & Evaluating - determine the affect of the HIA on the decision process
Improving Health in the United States: The Role of Health Impact Assessment
Improving Health in the United States: The Role of Health Impact Assessment
Minimum Elements and Practice Standards for Health Impact Assessment
Guidance and Best Practices for Stakeholder Participation in Health Impact Assessments
