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THE HEALTH IMPACT PROJECT: Promoting the use of Health Impact Assessment in the U.S. HIA in the Americas March, 2010. Aaron Wernham, M.D., M.S. Director | The Health Impact Project 901 E Street, NW, Washington, D.C. 2004 p: 202.540.6346 e: awernham@pewtrusts.org www.healthimpactproject.org.
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THE HEALTH IMPACT PROJECT:Promoting the use of Health Impact Assessment in the U.S.HIA in the AmericasMarch, 2010 Aaron Wernham, M.D., M.S.Director | The Health Impact Project 901 E Street, NW, Washington, D.C. 2004 p: 202.540.6346 e:awernham@pewtrusts.org www.healthimpactproject.org
Completed HIAs in the United States 1999–2009 (N = 54) WA 4 MT 1 MN 5 OR 2 MI 1 MA 2 PA 1 OH 1 NJ 1 CO 2 CA 25 MD 1 GA 4 FL 1 AK 3 Courtesy A. Dannenberg, A. Wendel, CDC NCEH
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts www.healthimpactproject.org Overall Objective: To promote and support the use of HIA as a tool to ensure that decisions in non-health sectors, whether at the local, state, tribal, or federal level, are made with health in mind.
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts • 1. A national Center to support the field: • A website with resources, case studies, policy briefs • Forming a community of practice: both online and in-person forums • Convening trainings, meetings, and policy-oriented discussions • Collaborating with and supporting current centers with established expertise in the field • Supporting agencies new to HIA
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts • 2. Building the case for HIA: • Funding a series of demonstration projects that address real-time decisions on proposed policies, programs, and projects at the local, state, and tribal level: see the CFP at www.healthimpactproject.org • Building a technical assistance network to support new HIA practitioners • A “rapid response” fund to support rapid HIAs or provide key resources to allow an HIA to go ahead (training, TA, research expertise, etc).
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts • 3.Federal Policy HIAs
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts • 4. Review of existing legal constructs that may support the inclusion of health – zoning laws, growth plans, regulatory impact analysis, administrative procedures, etc.
The Health Impact Project:A collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts • 5. Advocating for new policies that support HIA: • Guidance for implementing HIA within existing laws and policies • Research to determine the best governance structures and incentives to promote HIA wherever it adds value • Providing evidence to support legislation or administrative efforts to build HIA into public decision-making.
Finding good ideas for an HIA:Proposals we’ve received suggest no shortage! • State Budget Process: state budget decisions -- weigh the relative consequences of cuts/spending in various sectors • BRAC Redevelopment: a Public Health Institute would do an HIA to shape redevelopment plans for a closed military base. • Prison Reform: A university-based policy institute would address a state legislative package of 6 bills on prisoner reentry • Agriculture Policy: A non-profit will help develop a county agricultural plan that will shape the local economy, land use patterns, and diet. • State immigration legislation: a university would examine proposed state legislation to restrict access to public services
Finding good ideas for an HIA:and on and on… • 7. Regional passenger and freight rail policy: a university would partner with regional transit planners on a large rail plan • 8. City planning decisions on use of vacant lots: a coalition of faith-based groups would weigh options including community gardens, commercial farming, and new industry in an economically devastated urban area • 9. CAFO Regulation: an environmental organization would attempt to introduce health and social welfare considerations into the state permitting process. • 10. State energy policy: an environmental group would address a comprehensive energy plan in a coal-belt state • 11. Foreclosure mitigation: a university would address state legislation seeking to prevent foreclosures
Why is there so much interest in HIA? • Is there more to it than predicting impacts, making recommendations, and writing a report? • A new way to engage: brings public health professionals, community stakeholders, planners, developers, and decision-makers to the table, with a focus on practical, realistic solutions. • Address public concerns early and directly • Develop public health • input and recommendations • sensitive to the political, • regulatory, and economic • context.