Presentation Transcript

1. Strategic health impact assessment of housing tax credit programs
2. Today’s Session This session will review the Health Impact Assessment (HIA) as a tool for synthesizing research-based evidence regarding health determinants, and generating strategic policy recommendations that balance likely health impacts with stakeholder priorities and political context. The speakers will describe a multi-year HIA that is being conducted to provide information and recommendations to incorporate health considerations into the Georgia Qualified Allocation Plan (QAP).
3. THE ROOT CAUSES OF HEALTH Health Outcomes Behaviors/Exposures Environmental Contexts Policy Contexts
4. What is Health? Health is “a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.” Furthermore, health is the ability of an individual or group “to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.” 1948 World Health Organization Constitution and the 1986 Ottawa Charter for Health Promotion
5. Health in All Policies
6. What is Health in All Policies?(HiAP) A strategy that strengthens the link between health and other policies, creating a supportive environment that enables people to lead healthy lives.
7. Health in All Policies Considers the intentional or unintentional impact of non-health policies on individual or population health Non-health sectors can include Education, Housing, Transportation, Economics, etc.
8. HiAP EXAMPLE: HUD
9. Health in All Policies Can Occur at Different Levels Information-sharing Collaboration Integration
10. HiAP & HIA Health impact assessment (HIA) is one of the key strategies for moving toward a health in all policies perspective.
11. Definition of 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. Source: “Improving Health in the United States: The Role of Health Impact Assessments” by the National Research Council, September 2011
12. What HIA is not . . . What HIA is HIA is used during a time when a proposed policy, program, or project is under active consideration. It’s the sweet spot – it’s proactive! HIA is not used before a policy, program, or project has even been considered. It’s not used to make the case for why a policy, program or project should be proposed. HIA is not used after a policy, program, or project has been completed. It’s not an assessment to understand the impacts of a program or policy once it has been implemented.
13. STAGES OF HIA Screening, to determine whether a proposal is likely to have health effects and whether the HIA will provide useful information Scoping, to establish the scope of health effects that will be included in the HIA, the populations affected, the sources of data and the methods to be used Assessment, which is a two step process that first describes the baseline health status and then assesses potential impacts
14. STAGES OF HIA Recommendationssuggest design alternatives that could be implemented to improve health or action that could be taken to manage health effects Reportingpresents findings and recommendations to decision makers and stakeholders Monitoring and evaluation includes monitoring the implementation of HIA recommendations. Evaluation can be of process, impact or outcomes
15. NATIONAL TRENDS IN HIA The field of HIA is growing exponentially In 2008 there were 27 completed HIAs In 2013 there are over 200 completed or in-progress HIAs HIA can, and has been, applied to a wide range of topics
16. Completed HIAs 2007 (N = 27) MN 1 MA 2 NJ 1 CO 1 CA 15 GA 3 FL 1 AK 3 Map Courtesy of A. Dannenberg, A. Wendel, CDC NCEH
17. Completed and In Progress HIAs 2013 (N = 233) WA 9 ME 2 MT 2 MN 12 OR 22 NH 1 WI 8 NY 1 MA 10 MI 7 PA 2 CT 3 NE 3 OH 8 IN 1 NJ 1 IL 4 CO 6 DE 1 CA 59 KS 2 MO 3 VA 1 MD 5 KY 3 NC 6 DC 1 TN 3 AZ 2 NM 3 SC 2 GA 7 TX 5 FL 2 AK 18 Puerto Rico: 1 Map created through a partnership between Health Impact Project and the Centers for Disease Control and Prevention’s Healthy Community Design Initiative HI 1
18. What sectors or topics do HIAs address?
19. HIA Examples Atlanta BeltLine Farmers’ Field Stadium in LA Decatur Community Transportation Plan Transitional Jobs HIA, Wisconsin Casino Legislation, Kansas
20. Completed and Ongoing HIA www.healthimpactproject.org/hia/us
21. Housing HIA
22. HIA Guides
23. Key Values of HIA Democracy Equity Sustainable Development Scientific & Robust Practice Holistic Approach to Health
24. GHPC’s work in HIAP/hia Kansas Missouri Minnesota Vermont Georgia New Hampshire Massachusetts Tennessee Kentucky GHPC conducts an HIA on the proposed zoning plan for Ft. McPherson (2010) Health Impact Project (The Pew Charitable Trusts and Robert Wood Johnson) names GHPC and OPHI Regional Training Centers for HIA (2011) GHPC and OPHI train selected public health institutes on HIA (2011) GHPC is awarded grant from Health Impact Project to conduct an HIA in Galveston, Texas (2011) GHPC is selected by NNPHI to provide technical assistance to federal agencies in the National Prevention Council (2012) Staff provide training and technical assistance to EPA, DOT, and HUD. GHPC staff have provided training and technical assistance to practitioners in
25. HIA of the Georgia Qualified Allocation Plan Administered by the Georgia Department of Community Affairs Criteria for: Low Income Housing Tax Credits 4% Tax Credits HOME Investment Partnership Program Creates: ~ 30 new or renovated affordable housing developments each year At least 30% rural Some special needs designations Some sustainable development
26. Screening Decision point: the 2015 Georgia Qualified Allocation Plan (QAP) for Low Income Housing Tax Credits (LIHTC), State Housing Tax Credits, and HOME Investment Partnership Program Funds Timeline: spring through fall 2014. The new QAP becomes effective on January 1st or when the Governor signs it.
27. How can affordable housing affect health? How: Location, design, and construction Who: Occupants and neighbors What: Physical activity, access to healthy foods, access to jobs, access to health services, stress and mental health, social interaction, injury risk, microclimate exposure, and exposure to environmental hazards.
28. Scoping Preliminary identification of potential areas of impact Communications Plan; Evaluation Plan; Stakeholder Engagement Plan Outreach to stakeholders Convene the Advisory Committee
29. access to jobs, Goods, & Services Proximity Transportation access Household budget Amenities
30. injury risk Crime and its determinants Perceived crime Traffic Other hazards
31. Physical activity Travel distances & barriers Community design Perception of safety or ease Recreational spaces for adults and children
32. Exposures microclimate exposure exposure to environmental hazards
33. social interaction Places to interact Who do you meet? Displacement
34. Accessibility Special population needs: In units In neighborhoods
35. HeAlth Outcomes Injuries Chronic disease Environmental exposure Prevention and treatment Stress and mental health Emotional health
36. QAP Elements Site Selection Eligibility and Population Zoning Access Community and Unit Amenities Building Design Landscape, Parking, Open and Play Space Relocation Strategies Environment
37. Next Steps Advisory Committee meeting Select topics and assessment methods Data collection Scientific literature Additional outreach Conduct the assessment Develop good feasible recommendations with stakeholder input Share the results Follow up
38. Community development HIA evaluation and healthy community development toolkit Convene stakeholders Scope and analyze potential health impacts Collaborate to recommend effective changes Provide training and technical assistance on a similar HIA in Connecticut Evaluate the findings from three simultaneous HIAs (including ours)
39. Objectives In partnership with other Pew-funded community development HIA grantees and Pew, participate in a parallel evaluation that will determine best practices and lessons learned from conducting HIA on decisions related to community development, with particular attention to what parts of the HIA process and findings were useful and what was redundant or peripheral to the developer’s needs, and how the process could be streamlined. The findings from each HIA will be synthesized into a “healthy community development checklist” and related tools to streamline the inclusion of health in community development planning in the future. 
40. Healthy Community Design
41. Healthy Community Design CommunityCharacter Manual Policy document Incorporation of HCD as a general principle, alongside: Sustainability Complete Communities Housing and Neighborhoods Historical Resources Natural Resources Infill Development Mixed Use Centers and Economic Development Transportation Stormwaterand the Transect
42. Physical activity Air quality Injuries Social connections Food systems
43. Conclusion Health impact assessment can: Open door for collaboration Allow time for relationships to develop Prepare practitioners to meet partners where they are Help find win-win solutions