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Health Impact Assessment Training. Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June 13, 2014. Acknowledgements.
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Health Impact Assessment Training • Kelly Muellman, AICP • MN Climate & Health Principal Planner • Linden Weiswerda • MN Climate & Health Principal Planner • June 13, 2014
Acknowledgements • This webinar/videoconference is supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. • The opinions expressed are those of the author(s) and do not necessarily reflect the views of the Health Impact Project, Robert Wood Johnson Foundation or The Pew Charitable Trusts.
Outline • What is HIA? • Why conduct an HIA? • What value does HIA add? • When is HIA appropriate? • HIA Examples • HIA Resources
What is Health Impact Assessment (HIA)? • 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.
2010 Avg Life Expectancy and Healthcare Spending US ranked 42ndin life expectancy for 2010 and 1stin health spending per capita. WHO and Global Health Expenditure Database http://www.gapminder.org/
Health Determinants Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Source: World Health Organization
Why Conduct an HIA? • Identify harms and benefits before decisions are made • Identify evidence-based strategies and recommendations to promote health and prevent disease • Support inclusive and democratic decision-making and increase transparency in the decision-making process • Support community engagement in the decision-making process and foster community empowerment • Advance equity and justice Note: There are many ways to insert health into decision-making. HIA is one way.
Types of Decisions Influenced by HIA • Policy Decisions (bills by state legislature, city council decision, local school board on district-wide policy) • Policy Implementation (weigh various implementation options for a policy once it is passed) • Project Specific (siting, permitting, construction, design) • Comprehensive Plans (neighborhood plan, regional growth plans, master planning documents) Provided by Health Impact Project http://www.healthimpactproject.org/
What topics have HIAs addressed? Provided by Health Impact Project http://www.healthimpactproject.org/
Value of HIA • HIAs directly contributed to decision outcomes—the way projects, plans, and policies were developed or implemented • HIAs influenced changes beyond the decision under consideration • HIAs showed key stakeholders the health effects of non-health policies and programs. • HIAs built consensus • HIAs amplified community member voices in the decision-making process • HIAs built cross-sector relationships Bourcier, E., Charbonneau, D., Cahill, C., & Dannenberg, A. (2014). Do health impact assessments make a difference? A national evaluation of HIAs in the United States. Seattle: Center for Community Health and Evaluation.
Concerns about HIA Source: Wisconsin Department of Health Services, Health Impact Assessment: A Tool to Increase Health Equity in Decision-Making, Great Lakes Intertribal Council, April 23, 2012
Six Steps of HIA • 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
When is HIA appropriate? Consider: • Decision-point • Potential health impacts • Timing • Resources (money, staff, expertise) • Political will
Types of HIAs Modified from Harris et al. 2007. Health impact assessment: A practical guide, Centre for Health Equity, Training, Research and Evaluation (CHETRE), Part of the UNSW Research Centre for Primary Health Care and Equity, UNSW: (http://www.hiaconnect.edu.au/hia_a_practical_guide.htm)
When not to do an HIA • 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 • Insufficient time to complete HIA for drafts • Stakeholders (DOT) not open to considering health Source: Wisconsin Department of Health Services, Health Impact Assessment: A Tool to Increase Health Equity in Decision-Making, Great Lakes Intertribal Council, April 23, 2012
Gary/New Duluth HIA • Small Area Plan • Parallel process • Health concerns: • Social Cohesion • Physical Activity • Access to Healthy Food
Healthy Corridor for All • Zoning ordinance (urban) • Lead by ISAIAH, Take Action MN, and PolicyLink • Community driven • 3 Areas of Assessment: • Healthy Economy • Healthy, Affordable Housing • Safe and Sustainable Transportation http://www.policylink.org/atf/cf/{97c6d565-bb43-406d-a6d5-eca3bbf35af0}/HEALTHYCORRIDOR_SUMMARY_FINAL_20120111.PDF
Goodhue County Zoning Districts HIA • Zoning ordinance (rural) • Lead by Goodhue County Health and Human Services and Land Use Management Department • Areas of Assessment: • Housing; Living conditions; Air, water, and soil quality changes; Access to natural resources, respiratory health, mental well being, physical activity; and Economic health.
Farm to School and School Garden Policy • Oregon Bill 2800 (HB 2800), the Farm to School and School Garden legislation (2011) • Led by Upstream Public Health • Areas of Assessment: • Employment • Diet & Nutrition • Farm to School & School Garden Education • Environmental Health • Social Capital 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
Additional HIA Examples • Paid Sick Days HIA (national, state, local) • Treatment Instead of Prison HIA (WI) • School Integration Strategies HIA (MN) • Federal Farm Bill HIA (national) • HIA for proposed coal mine at Wishbone Hill (AK) • Lower Duwamish Waterway Superfund Site (WA) • HIA for open burning enforcement in La Crosse county (WI)
Evaluations of HIA • Quigley & Taylor. 2004. Evaluating health impact assessment. Public Health. 2004 Dec; 118(8):544-52. • EPA. 2013. A Review of Health Impact Assessments in the U.S.: Current State-of-Science, Best Practices, and Areas for Improvement. • Center for community Health and Evaluation (CCHE). 2014. Do health impact assessments make a difference? A national evaluation of HIAs in the United States. • John Hopkins School of Public Health (Keisha Pollack ), Health Impact Project and CDC, 2011
HIA at the National Level • Two major national funders • Centers for Disease Control & Prevention (CDC) (directly funds granteesand professional organizations) • Health Impact Project (PEW and RWJF) • SOPHIA (Society of Practitioners of HIA): http://www.hiasociety.org/ • Two conferences: • HIA of the Americas Workshop (Oakland, CA) • National Health Impact Assessment Meeting (WDC) • Local Funder: Blue Cross Blue Shield of MN Foundation
Completed and in progress HIAs Provided by Health Impact Project & CDC http://www.healthimpactproject.org/hia/us
MDH’s Role in Promoting HIA • Leading/performing HIAs: • Douglas County Comprehensive Plan; St. Louis Park Comprehensive Plan; Duluth 6th Ave Redesign Plan; Divine Mercy HIA; Gary/New Duluth Small Area Plan HIA; Winona County Active Living Plan HIA; Lincoln Park Small Area Plan HIA • Providing technical assistance: • Healthy Corridor for All HIA; Bottineau Transitway HIA; HIA on the Fort DuPont Redevelopment Project DE; Second Street Redevelopment Plan GA; Emerald Ash Borer HIA; MN School Location & Design HIA • Providing HIA training
MDH’s Role in Promoting HIA (II) (http://www.health.state.mn.us/divs/hia/) • Promoting Health in All Policies • EAW & Comprehensive Plans • Tool Development (EAW, comp planning, brownfields, climate change) • Sharing information on HIA:website & listserv (500+) • Promoting HIA through Collaboration
Collaboration: Get Involved HIA Interagency Workgroup: (12 agencies) MN HIA Coalition: (70+ members) (http://www.health.state.mn.us/divs/hia/coalition.html)
HIA Reports • Improving Health in the United States: The Role of Health Impact Assessment (http://www.nap.edu/catalog.php?record_id=13229) • Minimum Elements and Practice Standards for Health Impact Assessment (http://www.humanimpact.org/doc-lib/finish/11/9) • Guidance and Best Practices for Stakeholder Participation in Health Impact Assessments (http://www.hiasociety.org/documents/guide-for-stakeholder-participation.pdf) • Promoting Equity through the Practice of Health Impact Assessment: (http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5-eca3bbf35af0%7D/PROMOTINGEQUITYHIA_FINAL.PDF)
Resources: HIA Websites • MDH HIA webpage (http://www.health.state.mn.us/divs/hia/) • CDC Healthy Places webpage (http://www.cdc.gov/healthyplaces/hia.htm) • World Health Organization HIA webpage (http://www.who.int/hia/en/) • HIA Gateway – Public Health England (http://www.apho.org.uk/default.aspx?QN=P_HIA) • UCLA – HIA Guide web (http://www.hiaguide.org/) • Health Impact Project website (http://www.healthimpactproject.org/) • Design for Health website (http://www.designforhealth.net/resources/healthimpact.html) • Healthy Development Measurement Tool website (http://www.thehdmt.org/) Source: http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5-eca3bbf35af0%7D/PROMOTINGEQUITYHIA_FINAL.PDF
Contact Information • Linden Weiswerda Principal Planner MN Climate & Health Program Minnesota Department of Health 651.201.4924 Linden.Weiswerda@state.mn.us • Kelly Muellman, AICP Principal Planner MN Climate & Health Program Minnesota Department of Health 651.201.5637 Kelly.Muellman@state.mn.us Please complete the online evaluation: https://survey.vovici.com/se.ashx?s=56206EE33D67C4D2 *We will send all participants links to today’s slides and the webinar evaluation*