In this report, HIA practitioner refers to the person (or people) involved in conducting an HIA. Jagannathan R, Camasso MJ, Sambamoorthi U. 2010). The discussion recognizes that the practice of HIA varies because it is adapted for use in different decision-making contexts. Community Health Assessment Toolkit. Seventh, disclosure allows people to take voluntary actions to avoid risk (Neidell 2009). It may lack the objectivity and rigor of an external evaluation conducted by an experienced evaluator, but it is important because it contributes to a database that informs other efforts in the field and provides basic information about the applications of HIA, the methods and strategies used by HIA practitioners, and the success of and challenges to its use. Moreover, because there is generally no written record of HIAs that stop at screening, still less is known about the reasons that have led to decisions not to proceed with HIA. In practice, therefore, the HIA team will be asking a decision-maker to consider the findings and recommendations. The recommendations should be provided in the final HIA report and should document available supporting evidence, stakeholder input, and a health-management plan, which should do the following: If no recommendations are made in the HIA report, an explicit rationale should be provided for the decision not to include them. That explanation is particularly important when public funds are to be used for an HIA because the public may want to understand the basis for allocating sparse public resources. Health Impact Assessment on Policies Reducing Vehicle Miles Traveled in Oregon Metropolitan Areas. Northeast National Petroleum Reserve-Alaska (NPR-A) Draft Supplemental Integrated Activity Plan/Environmental Impact Statement (IAP/EIS). Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Any logic models or scoping tables that were completed should also be included. Such programs and projects involve many agencies and entities that have authority over some aspect of planning and implementation. HIA recommendations take various forms, and some examples are provided below. Elliott E, Francis S. Making effective links to decision-making: Key challenges for health impact assessment. The scoping phase was used to identify the parameters of the assessment, the affected and most vulnerable populations, and potential key health effects. Several approaches for scoping are available. For that reason, it is important for the field to define the circumstances under which outcome evaluation may be practicable. The HIA team identified the pathways in which the expansion would affect the lives of the primarily Iupiat residents of the area. National Academies Press (US), Washington (DC). For example, in the Alaskan oil and gas HIA mentioned in Box 3-3, the HIA team drafted recommendations in collaboration with the decision-maker, the Bureau of Land Management, which formally adopted the recommendations as mitigation measures. The bulleted list below provides examples in which some health impacts or behavioral outcomes have been quantified. The committee notes that outcome evaluation of policy experiments is a field independent of HIA, and many large-scale social interventionssuch as Head Start and Moving to Opportunityhave been subject to outcome evaluation that has included consideration of health or health determinants (Leventhal and Brooks-Gunn 2003; Schweinhart et al. Some decisions to conduct HIA may depend on a specific statutory requirement or mandated procedure. Some provide a checklist of factors to consider and often focus on health determinants that might be affected by the proposal. The selection of qualitative and descriptive approaches will be informed by the scale and size of the proposal, the profile of the affected population, and the uses of the resulting information. For example, the chair of the California Assembly Labor Committee referred to the HIA and asked the opposition to the bill if they condoned the spread of disease through restaurant workers.. The opportunity to bring health information into a decision-making process that may otherwise not include this information. For example, the planning of the Atlanta Beltline, as described later in this chapter, involved the regional planning commission, local legislative bodies, state and federal environmental regulators, and private developers. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Given that HIA led by the private sector appears to be a rapidly increasing practice, the issue of availability bears further consideration. Miranda ML, Keating MH, Edwards SE. Screening should also consider whether a proposal conforms with applicable standards, policies, or laws relevant to health inasmuch as there is a wide variety of them that bear directly or indirectly on health. The committee notes that each approach for gathering and interpreting data may be conducted in ways that are more or less participatory, engaging stakeholders in shaping the research questions, interpreting the findings, and developing recommendations on the basis of the findings. A community health assessment gives organizations comprehensive information about the community's current health status, needs, and issues. It is important to note that a matrix does not explain how evidence was used to reach conclusions. 2005; Bhatia and Seto 2011). Some use pertinent screening questions, such as the ones noted, and apply a sequential yes-no query to each (Cole et al. The committee does not intend that the definition and criteria proposed in this chapter be considered rigid requirements but rather that they reflect an ideal of practice, deviation from which may occur but should be based on clear and well-articulated needs and rationale. Community input during the development of recommendations can ensure that they address specific aspects of living conditions and community design that may not be obvious to an outside researcher, and it provides an opportunity to ensure that the recommendations address high-priority issues in a manner that is acceptable to the affected community. A comprehensive profile will include many indicators; those related to selected priorities Another method of scoping is to develop a table that facilitates a systematic and rapid appraisal of all the potential ways in which a proposal might affect health (see Table 3-1). But few data may be available on the geographic scale of some decisions addressed in an HIA, such as decisions related to projects that would affect a rural area or a single neighborhood. The variability also reflects a lack of clear criteria that define HIA as a distinct field. This list can then be used to set priorities. Moving to opportunity: An experimental study of neighborhood effects on mental health. Because any actions taken on the basis of HIA recommendations need to be implemented within a specific legal and policy context, screening needs to establish a clear description of the decision-making process and context. In general, this approach describes effects directly related to the proposal (such as changes in air emissions) and traces them to health determinants (such as air quality) and finally to health outcomes (such as asthma). Risk Assessment in the Federal Government: Managing the Process. However, the committee notes that there are several benefits of disclosure for industry, policy-makers, and the affected communities. The discussion described pathways by which Iupiat health was likely to be affected. It was not possible to derive mortality rates for demographic subgroups. FOIA 2004, 2010). In some cases, the team may draw on outside consultants who have expertise in a specific health issue or method. 2005). BLM later considered amending the EIS to make additional public lands available for oil and gas leasing in the original 4.6-million-acre planning area. That issue is discussed at greater length in Chapter 4. Adopting a position for or against a proposal (for example, support for or opposition to a legislative proposal). Action plans have mutually reinforcing activities. Public-health professionals reviewed the results of the analysis. Castro A, Chen L, Edison B, Huang J, Mitha K, Orkin M, Tejani Z, Tu D, Wells L, Yeh J. Cave B, Curtis S. Developing a practical guide to assess the potential health impact of urban regeneration schemes. From Principles to Consider for the Implementation of a Community Health Needs Assessment Process [PDF 457KB] (June 2013), Sara Rosenbaum, JD, The George Washington University School of Public Health and Health Services, Department of Health Policy. Because the degree to which the proposed action affects public health or safety is one factor considered, this process could be considered the equivalent of the screening step of an HIA. Bennear LS, Olmstead SM. The process of describing pre-existing health issues, health disparities, and influences on health may also begin during scoping, although the full characterization of baseline health status generally takes place during assessment. To receive email updates about this page, enter your email address: We take your privacy seriously. Iteration during scoping and between scoping and assessment often results in additional changes in the final list of issues included in the HIA. Personal (income, employment; can include occupational risk), Revenue or expense to local, state, or tribal government (support for or drain on services, infrastructure), Need for new roads and transit, water, or sanitation systems, New services as a direct result of proposal, Drain on existing services resulting from proposed action. In 2005, an HIA was conducted by a multidisciplinary team. Cole BL, Wilhelm M, Long PV, Fielding JE, Kominski G, Morgenstern H. Prospects for health impact assessment in the United States: New and improved environmental impact assessment or something different? 2006). The Crossings is a proposed housing development in Los Angeles that will provide 450 units in a newly rezoned residential area that needs affordable housing. Epub 2018 Jun 19. Scoping also determines who will be part of the HIA team and establishes a plan for technical oversight and review, stakeholder participation and involvement, and involvement of and interaction with decision-makers. In some cases, recommendations are developed by a decision-maker in response to an HIA report (Quigley et al. Given the volume and breadth of decisions at the local, state, tribal, and federal levels that can potentially affect health in some way, one of the challenges for HIA practice is to determine which proposals to screen. The HIA team was assisted by an advisory committee, but it appears that the committee was not involved in the scoping. The local North Slope Borough governmentan agency that participated in preparing the EISconducted an HIA, which was integrated into the EIS report. A lack of access to needed goods and services. The committee notes that in any assessment, it would be difficult or impossible to quantify all potential health impacts. One of the first steps in identifying the parameters of the assessment was to establish an understanding of the BeltLine, a complex project that had been evolving for several years and was expected to be constructed over a 30-year period. HIAs conducted as part of a formal government process are generally subject to disclosure and freedom-of-information requirements. Thank you also to the ACHI Community Health Assessment Toolkit Workgroup for ongoing insight and contributions. Others have proposed categorizing HIAs as participatory (emphasizing shared governance, public participation, and a focus on socioeconomic and environmental determinants), quantitative or analytic (concentrating on the methods and rigor of the analysis), or procedural (drawing on elements of the other two approaches but emphasizing the procedural steps required and often undertaken within a specified administrative or regulatory context) (Cole and Fielding 2007). The CH Incomplete disclosure may substantially limit access to complete information regarding the process, data sources, methods, and findings of an HIA for those who will be affected by the proposal being assessed (McHugh et al. Clipboard, Search History, and several other advanced features are temporarily unavailable. Given the broad scope of HIA practice settings, applications, and data sources, the committee chose not to develop specific standards or criteria for what constitutes adequate evidence or analysis for HIA. Scholars point to a remarkable consistency in the basic elements that are generally included in descriptions of HIA (Mindell et al. Depending on the nature of the proposal being assessed and the specific impacts, recommendations can take various forms (see Box 3-5), such as the following: HIA Recommendations. Propose a system to verify that measures are being implemented as planned. You can review and change the way we collect information below.
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