An Introduction to Health Impact Assessment

1. An Introduction to Health Impact Assessment Paul J. Anderson, MD, MPH HIA Program Manager Section of Epidemiology Division of Public Health Department of Health and Social Services

2. What is HIA? • Preventive health report • Anticipates human health effects • New or current • Projects • Policies • Programs • Minimize adverse health effects • Maximize health benefits

3. Definition “HIA is 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 (WHO), 1999

4. HIA and NEPA

5. Who does the HIA? Federal Lead Agency N E P A • Proponents • Corporations • State Government • Cities • Boroughs • Others • Federal Cooperating Agencies • EPA • MMS • BLM • USACE • Others • State Cooperating Agencies • DNR (LEAD) • DHSS* • DEC • ADF&G • DOT • Others Produces EIS • Local Cooperating Entities • Municipalities • Tribal Governments • Boroughs • Cities • Counties • Others • Contractors • Environmental • Socioeconomic • Human health • NEPA specific • Others

6. Project Timeline and HIA Intent to File Permit Permit Application Project Permit Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation

7. Project Timeline and HIA Intent to File Permit Permit Application Project Permit Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation • Screening • Scoping meetings • Site visits • Existing data gathered • New data collected • Literature review • Summary Report • Data synthesis • Data Analysis • Updated site visits • Risk Assessment • Health Action Plan • Standalone HIA • Ongoing monitoring • Evaluate Action Plan

8. Participating in HIA Intent to File Permit Permit Application Project Permit Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation • Request an HIA • Educational meetings • Letters of invitation • Host HIA team visits • Share information • Participate in studies • Community comments • Scoping meetings • Formal comments • Draft reviews • Study participation • Help suggest mitigation • Assist monitoring

9. HIA Concepts

10. Mitigation Types in HIA High Control (Direct Impacts) Low Control (Indirect Impacts) Regulatory Negotiated Voluntary

11. Respect, Protect, Remedy Corporation/Applicant Respect Do no harm Do good when able Protect autonomy Seek justice Governments Protect People Remedy ~John Ruggie – UN Secretary General’s Special Representative on Human Rights

12. Health Effects Categories • Social Determinants of Health • Accidents and Injuries • Hazardous Substances • Food, Nutrition, Subsistence • Infectious Diseases • Chronic Diseases • Water and Sanitation • Health Care Delivery

13. Key Activities • Ask for an HIA • Participate in scoping meetings • Give health comments • Share local and traditional information

14. HIA Elements

15. Project Features and Health • Linear features (roads, pipelines) • Construction camps (size, location) • Influx (worker housing) • Resettlement or relocation • Large projects, rural settings • Engineering footprints • Health footprint

16. HIA Funding under NEPA APPLICANT Federal Agency • Federal agency requests HIA

17. HIA Funding under NEPA $ HIA Contractor APPLICANT $ Department of Natural Resources (OPMP/LMPT) Federal Agency • Federal agency requests HIA • Applicant asks OPMP for HIA OR Applicant hires contractor

18. HIA Funding under NEPA $ HIA Contractor APPLICANT $ $ Department of Natural Resources (OPMP/LMPT) Federal Agency AK HIA Program • Federal agency requests HIA • Applicant asks OPMP for HIA • OR Applicant hires contractor • OPMP uses state HIA program • OPMP provides contract help to HIA program

19. HIA Funding under NEPA $ HIA Contractor Independent HIA APPLICANT $ $ $ Department of Natural Resources (OPMP/LMPT) Federal Agency AK HIA Program State HIA • Federal agency requests HIA • Applicant asks OPMP for HIA • OR Applicant hires contractor • OPMP uses state HIA program • OPMP provides contract help to HIA program