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Health Impact Assessments  to Promote  Healthy Neighborhoods History and Overview Nisha Botchwey, Ph.D. University of Virginia  Associate Professor of  Urban + Environmental Planning  and Public Health Sciences MAPP Lilian Peake, MD, MPH Director, Thomas Jefferson Health Department Charlottesville/Albemarle District VAPHA’s Annual Conference Advancing Health Equity from Theory to Practice September 10-11, 2009
HIAs to Promote Healthy Neighborhoods ,[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
What is Health? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Community Design and Health ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Related to land use Related to automobile dependency Related to social processes HIAs    MAPP   Evaluating Sites for FQHC
What is an HIA? ,[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Value of  Health Impact Assessment ,[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
A Vision of  Health Impact Assessment ,[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Steps in Conducting an HIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Scoping:  Health Impacts to Consider in an HIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Voluntary vs. Regulatory Approach to Using an HIA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Environmental Impact Assessments Performed by planners, consultants, environmental scientists, etc. Explores effect of policies, programs and projects on the environment  Began in US in the 1970s   Statutory requirement in many countries to undertake EIA EIA does not typically include assessment of health effects; when it does it may be narrowly focused and solely quantitative in nature.   HIAs    MAPP   Evaluating Sites for FQHC                                                                                                      
HIA Relationship to Environmental Impact Assessment (EIA) ,[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIA Level of Complexity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Review of 38  Health Impact Assessments Conducted in the  United States,  1999-2008 HIAs    MAPP   Evaluating Sites for FQHC
AK 4 CA 16 CO 1 FL 1 MA 2 NJ 1 Completed HIAs in the United States 1999–2008  (N = 38) MN 4 GA 3 WA 3 OR 1 OH 1 PA 1 HIAs    MAPP   Evaluating Sites for FQHC
HIAs in the U.S. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Quantitative and Qualitative Health Indicators in HIAs in U.S.  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIAs in the U.S. (cont’d) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIA Capacity Building Activities ,[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
U.S. HIA Training Materials Available On-line ,[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIA in the United States: Next Steps ,[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
MAPP HIAs    MAPP   Evaluating Sites for FQHC
Charlottesville HIA Framework
America’s Healthiest City “ All residents have access to high-quality health care services.  We have a community-wide commitment to personal fitness and wellness, and all residents enjoy our outstanding recreational facilities, walking trails, and routes to schools.  We have a strong support system in place for families and for the elderly and disabled.  Our emergency response time is among the nation’s best.” -Charlottesville City  Council  Vision Statement HIAs    MAPP   Evaluating Sites for FQHC
Demographics HIAs    MAPP   Evaluating Sites for FQHC
Factors for Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Air Quality ,[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Convenience ,[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Quality of Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Safety ,[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Community Space ,[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
Creating a Framework HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
Framework Applied ,[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
HIAs    MAPP   Evaluating Sites for FQHC
Methods for Identifying Completed HIAs in the U.S. ,[object Object],[object Object],[object Object],[object Object]
HIAs of Projects (N=19) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIAs of Projects continued  (N=19) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIAs of Policies (N=19) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HIAs of Policies  continued (N=19) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Decision-Making Organization for Project or Policy (n=38) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Organizations that Conducted 38 HIAs in the US, 1999-2008 ,[object Object],[object Object],[object Object],[object Object]
Funder of HIA (n=27) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Scoping:  Health Determinants Considered in HIAs in U.S. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Population Affected by Project  or Policy in 27 HIAs in U.S. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Community Involvement in Conduct of 27 HIAs in U.S. ,[object Object],[object Object]
Conduct of HIAs in U.S. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Key Results in HIAs in U.S. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Impact of HIA on Subsequent Decisions in 27 HIAs in U.S.  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Challenges in  Conducting HIAs in the U.S. ,[object Object],[object Object],[object Object],[object Object]

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Health Impact Assessments

  • 1. Health Impact Assessments to Promote Healthy Neighborhoods History and Overview Nisha Botchwey, Ph.D. University of Virginia Associate Professor of Urban + Environmental Planning and Public Health Sciences MAPP Lilian Peake, MD, MPH Director, Thomas Jefferson Health Department Charlottesville/Albemarle District VAPHA’s Annual Conference Advancing Health Equity from Theory to Practice September 10-11, 2009
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  • 11. Environmental Impact Assessments Performed by planners, consultants, environmental scientists, etc. Explores effect of policies, programs and projects on the environment Began in US in the 1970s Statutory requirement in many countries to undertake EIA EIA does not typically include assessment of health effects; when it does it may be narrowly focused and solely quantitative in nature. HIAs MAPP Evaluating Sites for FQHC                                                                                                   
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  • 14. Review of 38 Health Impact Assessments Conducted in the United States, 1999-2008 HIAs MAPP Evaluating Sites for FQHC
  • 15. AK 4 CA 16 CO 1 FL 1 MA 2 NJ 1 Completed HIAs in the United States 1999–2008 (N = 38) MN 4 GA 3 WA 3 OR 1 OH 1 PA 1 HIAs MAPP Evaluating Sites for FQHC
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  • 22. MAPP HIAs MAPP Evaluating Sites for FQHC
  • 24. America’s Healthiest City “ All residents have access to high-quality health care services. We have a community-wide commitment to personal fitness and wellness, and all residents enjoy our outstanding recreational facilities, walking trails, and routes to schools. We have a strong support system in place for families and for the elderly and disabled. Our emergency response time is among the nation’s best.” -Charlottesville City Council Vision Statement HIAs MAPP Evaluating Sites for FQHC
  • 25. Demographics HIAs MAPP Evaluating Sites for FQHC
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  • 32. Creating a Framework HIAs MAPP Evaluating Sites for FQHC
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Editor's Notes

  1. Start with get to know audience Nisha Botchwey, MCP, PhD, Associate Professor of Urban and Environmental Planning and Public Health Sciences, University of VirginiaLillian Peake, MD, MPH, Director, Thomas Jefferson Health District, Charlottesville/Albemarle District Moderator: Ruth Garre Bernheim, J.D., M.P.H Director, Division of Public Health Policy and Practice School of Medicine Department of Public Health Sciences Associate Director, Institute for Practical Ethics University of Virginia; Associate Professor of Public Health Sciences, School of Medicine; Associate Director, Institute for Practical Ethics and Public Life
  2. This session will provide an overview of Health Impact Assessments (HIAs), Why, history and in the US, steps for conducting them present examples from across the nation, and outline steps for completion using Mobilizing for Action through Planning and Partnerships (MAPP) 2008 data from Charlottesville, VA. The session will also engage participants in devising alternative scenarios to development proposals using the HIA tool. At the conclusion of this session, participants will be able to: (1) Describe Health Impact Assessments (2) List three examples of HIAs performed domestically (3) Discuss alternative scenarios resulting from HIA application to development proposals
  3. Having talked a bit about “sprawl,” let’s move to the second concept in the title—health. There is no better definition of health than the World Health Organization’s, set forth over half a century ago.
  4. To summarize, we can identify at least nine ways in which sprawl might affect health.
  5. HIAs are widely used in Europe and have a recent history of use in the United States. They are a tool like zoning. They help planners and other decision-makers better recognize the health consequences of the decisions they make.
  6. Add more here on EIAs
  7. Revise this slide to introduce the framework the class developed
  8. Must consider these things if want to improve air quality when new construction occurs. Materials can emit VOCs which are linked to cancer and liver and kidney damage in addition to inreaseing affects of asthma. Ventilation is key as well, and above all walkability must be facilitated. This means that less cars = less air polution so walking must be encouraged.