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Health Impact Assessment: A Tool for Informed Decision Making

This article discusses the use of Health Impact Assessments (HIA) in informing decisions about the health implications of shale gas extraction. It explains the six-step process of conducting an HIA and highlights the differences between HIA and Environmental Impact Assessments. The article also explores the growth of HIAs in the United States, with a focus on Pennsylvania and natural resources/energy projects. It concludes by discussing the challenges and opportunities for using HIA in gas drilling projects.

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Health Impact Assessment: A Tool for Informed Decision Making

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  1. Health Impact Assessment: A Tool for Informed Decision Making Professor Pamela Ko, The Sage Colleges Dean Patricia Salkin, Touro Law Center September 27, 2013

  2. Drilling and Health Impact Assessment • One tool that can be used to inform decisions about the health implications of shale gas extraction by: • Identifying potential positive and negative health impacts of drilling • Identifying alternatives to maximize benefits of proposed actions • Mitigating negative effects of changes to the built environment • Promoting and/or improving the health of a given “target” population in line with environmental justice objectives

  3. What is HIA? • “[A] combination of procedures, methods, and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.” – World Health Organization

  4. HIA – Six Step Process

  5. Health Issues Source: State of Alaska HIA Program, Department of Health and Social Services, Technical Guidance for Health Impact Assessment (HIA) in Alaska 29-30 (July 2011)

  6. EIA vs. HIA • Intent of the National Environmental Policy Act of 1969 • Environmental Impact Assessments (EIA) • Any consideration of health dealt with environment/biomedical impacts and limited “health” focus to chemical hazards, toxins, disease or other “risk assessments” based on a medical model of health and environment. • Inattention to Human Health Concerns • lead agency focused solely on physical environment • Many EIAs conducted made no mention of human health • No expectation/mechanism to obtain health input • Lack of guidance for including health in EIA • HIA was developed to address the neglected health considerations in conventional EIAs.

  7. Project-based HIA (“HIA in EIA”) • EIAs originally only considered biophysical impacts related to the environment • Air • Water • Land • Toxins, hazardous chemicals • EIAs have begun to evolve to include certain, limited health considerations • Human Health • Culture • Social • EIA framework may offer institutional legitimacy for HIA in project development. This has been the method analyzed and used in several HIAs in Alaska relating to oil and gas projects on federal lands.

  8. Growth of Health Impact Assessments in the United States • National Environmental Policy Act of 1969 • Environmental Impact Assessments • “Mini-NEPAs” • 1999: Gothenburg Consensus Paper (World Health Organization) • Rapidly Increasing Usage in U.S. • 1997-2007: 27 HIAs completed • As of 2010: 79 HIAs completed (40 in progress) • Several states have begun to incorporate HIA requirements in legislation for future development projects such as hydrofracking

  9. HIA and Natural Resources/Energy Projects Today • 2 HIAs have been completed in Pennsylvania • 1 HIA has been completed that related to the health impacts of hydrofracking specifically • 19 HIAs have been completed that focused on health impacts related to the natural resources/energy sector (with 6 of these HIAs being conducted in Alaska) • 19 HIAs that focus on the health impacts related to the natural resources/energy sector are in progress (with 12 of these HIAs being conducted in Alaska)

  10. HIAs in Pennsylvania SugarHouse Casino (completed by the Center for Health Equity, Drexel University School of Public Health in 2010) Lower South District HIA (completed by Philadelphia Department of Public Health and the Philadelphia Planning Commission in 2012)

  11. Source: Jonathan Purtle, MPH, MSc, Drexel University School of Public Health, Gambling on the Health of the Public: A Rapid Health Impact Assessment for an Urban Casino

  12. Battlement Mesa, Colorado HIA • Only HIA on the health impacts of fracking • Community of 5000 people • Plans to develop 200 natural gas wells (some of which would be approximately 500 feet from homes

  13. New York State • Legislation, Outcome, Current Status

  14. Regulatory HIA: The North Slope Borough (Alaska) • EIA for Oil & Gas Leasing Rights • North Slope Borough joined as “cooperating agency” • Convinced federal lead agency to focus more on health considerations during EIA • HIA integrated into final EIS • Identified a number of risks and benefits • Withheld certain lands from leasing • New Pollution Monitoring requirements

  15. Challenges to HIA Use in Gas Drilling • Typically not required by law • Projects can be polarizing and political • Limited funding • Limited access to HIA education and training

  16. Continuing the Dialogue • HIA presents many opportunities…this is a beginning • Encourage dialogue between environmental and public health communities • Better ensure proposed projects/policies are sustainable • Slowly being incorporated into legislation in other states • Access to data

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