Notwithstanding those considerations, the committee considers the public disclosure of HIAs to be an important ideal of practice but recognizes that it may not be realistic to expect widespread disclosure in the absence of requirements or incentives for it. Presidential/Congressional Commission on Risk Assessment and Risk Management. 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.. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Industrial proponents, government decision-making agencies, local health departments, and independent organizations (such as universities and nongovernment organizations) may all be in a position to implement measures recommended in the HIA. II, Selected Evidence Base Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. Conversely, to have the greatest relevance as an informational and planning document and to ensure judicious use of resources, the HIA should ultimately focus on the health effects of greatest potential importance. Acknowledgments The Association for Community Health ImprovementsCommunity Health Assessment Toolkitoffers a nine-step pathway for conducting a CHA and developing implementation strategies. Fifth, transparent reporting of possible environmental and health impacts has proved in many studies to lead to risk reduction because it motivates changes, such as improved pollution controls, on the part of industry and governments (Wolf 1996; Bennear and Olmstead 2008; Vaccaro and Madsen 2009). By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. Commonly, a core team is responsible for the bulk of writing and analysis. 2007; Harris-Roxas and Harris 2011). However, decision-makers are often overwhelmed by today's proliferation of fragmented indicator sets. Moving to opportunity: An experimental study of neighborhood effects on mental health. The committee selected a six-step framework as a clear way to organize and describe the critical elements of an HIA. The https:// ensures that you are connecting to the Why Complete an Assessment and Improvement Plan? ACTION STEP 1: Assemble the Community Team Representation from diverse sectors is key ACTION STEP 2: Develop Team Strategy Decide whether to complete CHANGE as a whole team or divide into subgroups For those reasons, the committee concludes that HIAs including, to the extent practical, the data used for the analysis, analytic methods, assumptions, findings, uncertainties, data gaps, and recommendations should be made public. This plan is used by health and other governmental education and human service agencies, in collaboration with community partners, to set priorities and coordinate and target resources. The assessment also highlighted several potential benefits, such as funding for infrastructure and health care; increased employment and income; and continued funding of existing infrastructure (BLM 2007, p. 500). An initial brief summary of the pathways through which health could be affected and the health effects to be addressed, including a rationale for how the effects were chosen and an account of any potential health effects that were considered but were not selected and why. Health Impact Assessment: International Best Practice Principles. Literature review provides much of the empiric evidence for most HIAs, and whenever possible, assessors should conduct a systematic review of the literature for any health effects and determinants identified as high-priority issues in scoping. The role of adaptive management as an operational approach for resource management agencies. 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. Environmental, Social and Health Impact Assessment (ESHIA) Process. The committee concludes that the following are the most important factors to consider in determining whether to do an HIA: Ultimately, the HIA report should provide a rational and consistent explanation of how proposals are selected for screening. Metrics are key to providing a more holistic view of a community's health, and ultimately inform and drive action. Society of Petroleum Engineers; 2006. Similarly, HIAs sponsored by private nonprofit organizations may not have requirements for disclosure inasmuch as most U.S. HIAs are not done under a legal mandate that requires disclosure. The committee is referring here to HIAs sponsored or led by private-sector entities that are not part of any formal government process, such as a permitting or regulatory requirement. Because HIA in the United States is often undertaken outside a formal legal mandate, it has not consistently included alternatives assessment. In: Kemm J, Parry J, Palmer S, editors. The decision-maker must ultimately balance health considerations with the many technical, social, political, and economic concerns that bear on the proposal. Bhatia R. A Guide for Health Impact Assessment. Box 3-6 shows how the results of an HIA of proposals to provide paid sick days to employees were presented clearly in a report with appropriate acknowledgement of the strengths and weaknesses of the evidence. Bhatia R, Farhang L, Gaydos M, Gilhuly K, Harris-Roxas B, Heller J, Lee M, McLaughlin J, Orenstein M, Seto E, St Pierre L, Tamburrini AL, Wernham A, Wier M. Bhatia R, Branscomb J, Farhang L, Lee M, Orenstein M, Richardson M. Birley M. Health Impact Assessment in multinationals: A case study of the Royal Dutch/Shell Group. In 2005, an HIA was conducted by a multidisciplinary team. The committee notes that the diversity of approaches and decision contexts imposes challenges for determining the resources required for conducting an HIA. The variability also reflects a lack of clear criteria that define HIA as a distinct field. Petticrew M, Cummins S, Sparks L, Findlay A. Validating health impact assessment: Prediction is difficult (especially about the future). Key Elements of Community Health Improvement Planning: From Assessment to Action Planning Key Elements of Community Health Improvement Planning: From Assessment to Action Planning CHA-CHIP Demonstration Project Improvement www.assesstoolkit.org April 23, 2012 The lines are muted. Characteristics unique to the affected community may not be obvious to HIA practitioners who are outside the community. 2006; World Bank 2010). As described by Ross (2007, p. 9), the Atlanta BeltLine is a transit, trails, parks, and redevelopment project that uses a 22-mile loop of largely abandoned freight rail line that lies between two and four miles (more). Some provide a checklist of factors to consider and often focus on health determinants that might be affected by the proposal. Centers for Disease Control and Prevention. As described by Ross (2007, p. 9), the Atlanta BeltLine is a transit, trails, parks, and redevelopment project that uses a 22-mile loop of largely abandoned freight rail line that lies between two and four miles from the city center and affects about 45 neighborhoods. In selecting the analytic methods that will be used, the HIA practitioner should consider not only technical limitations but what type of information will be most useful to decision-makers. Retrieved fromhttps://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs The HRET's Community Health Assessment and Implementation Pathway is an eight-step approach to guide the CHNA journey. HIAs in the private sector are increasingly common, pursuant to internal corporate guidelines or requirements of lending banks, such as the International Finance Corporation and World Bank (see Appendix A for further discussion) (Birley 2005; IPIECA/OGP 2005; McHugh et al 2006; ICMM 2010; IFC 2007, 2010).3 Few, however, are made public. The nature of the proposal being assessed, including alternatives that were included in the analysis. The report of the Healthy Families Act HIA provides a clear description of the steps in the analytic process. In practice, therefore, the HIA team will be asking a decision-maker to consider the findings and recommendations. A discussion of whether the HIA achieved its initial objectives. Some decisions to conduct HIA may depend on a specific statutory requirement or mandated procedure. Example of a logic framework that maps out the possible causal pathways by which health effects might occur. Describes data sources and analytic methods and methods used to engage stakeholders. A preliminary opinion regarding the potential importance of the proposal for health. An official website of the United States government. Behavioral Risk Factor Surveillance System data were used for the county and the state and stratified by race. 3, Elements of a Health Impact Assessment. 2019 Feb;22(1):25-31. doi: 10.1089/pop.2018.0049. In other cases, all proposals in selected agencies or sectors have been screened by local governments (SFCC 1998; Lester et al. During scoping, the HIA team may produce an initial list, refine it on the basis of stakeholder input, and then make it final through research and analysis in the assessment phase. The opportunity to bring health information into a decision-making process that may otherwise not include this information. The bulleted list below provides examples in which some health impacts or behavioral outcomes have been quantified. The expected resource requirements of the HIA and the ability of the HIA team to meet them. The local North Slope Borough governmentan agency that participated in preparing the EISconducted an HIA, which was integrated into the EIS report. Scoping establishes the boundaries of the HIA and identifies the health effects to be evaluated, the populations affected, the HIA team, sources of data, methods to be used, and any alternatives to be assessed. Improving community health starts with knowing the factors that impact people's health, both inside and outside of the clinic. Mindell J, Boaz A, Joffe M, Curtis S, Birley M. Enhancing the evidence base for health impact assessment. Bethesda, MD 20894, Web Policies Bhatia R, Seto E. Quantitative estimation in Health Impact Assessment: Opportunities and challenges. o Who is ultimate decision maker if the event needs to be cancelled, postponed or similar? Other groups have developed standard approaches to promote and evaluate practice quality, including the quality of analysis (see, for example, Fredsgaard et al. Evaluating health impact assessment. The findings of the HIA were covered by newspapers and Web sites in California, Maine, Massachusetts, and New Hampshire; and the HIA researchers were interviewed on radio. Sources: Adapted from Cook et al. The committee notes that in addition to characterizing effects, HIAs may provide conclusions on the significanceor societal importanceof the effects, although this has been rare in U.S. practice. Scoping identifies appropriate data sources for the analysis and should also identify important data gaps. Although little has been written on the reasons for keeping HIA information confidential, the committee recognizes that there may be reasons for organizations conducting HIAs to decide not to disclose the results. It was not possible to derive mortality rates for demographic subgroups. Lester C, Hayes S, Griffiths S, Lowe G, Hopkins S. Implementing a strategy to address health inequalities: A health authority approach. 2007). For example, in Alaska, one of the adverse impacts of a proposed mine expansion was the feared contamination of water and wildlife, and evidence suggested that a fear of contamination might lead communities to shy away from eating a traditional diet. A community health assessment gives organizations comprehensive information about the communitys current health status, needs, and issues. 1 Upon completing the assessment, hospitals develop implementation strategies to address the significant community health needs identified in the CHA. Action plans have mutually reinforcing activities. It is informed by a review of U.S. and international HIA literature and guidelines (see Appendixes A and E) and by the experience of committee members and others who provided input during the committee process. HIAs can be conducted by a variety of agencies, organizations, or individuals. The phrase desktop HIA has also been used to refer to a rapid HIA that entails little or no public engagement. The Public Health Accreditation board defines community health assessment as a systematic examination of the health status indicators for a given population that is used to identify key problems and assets in a community. It should define the vision for the health of the community through a collaborative process and should address the gamut of strengths, weaknesses, challenges, and opportunities that exist in the community to improve the health status of that community. On the basis of its review, the committee synthesized the information from guidance, practice, and literature to propose criteria that define an HIA and draw several conclusions regarding HIA practice. 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. 2004; Bhatia and Wernham 2008). 2006; Bhatia 2010; ICMM 2010). Recommendations form the core of a health-management plan, but the plan also determines authority for and assigns responsibility for implementing each recommendation, establishes a monitoring plan, and creates or suggests mechanisms to verify that assigned responsibilities are being met. As discussed later in this section, recommendations can also establish a foundation for monitoring, and the results of the monitoring may indicate that the management strategies need to be adapted to respond to the observed outcomesa process known as adaptive management (Johnson 1999). Crossings at 29th St./San Pedro St. Area Health Impact Assessment. Funding Acknowledgement It is critical to arrange the information logically so that readers can navigate easily through the document, to provide a lay summary that accurately describes the main findings and conclusions of the study, and to reference all data and sources accurately (Fredsgaard et al. Failure to disclose HIA results and incomplete disclosure are not restricted to industry. Even when there is substantial uncertainty, an assessment can illuminate potential causal pathways thateven when there appear to be conflicting influences on a specific outcomecan point the way toward a flexible framework for monitoring and managing any impacts that might occur as the proposal is implemented. The committee finds that an HIA report should at least describe the proposal and alternatives that are the subject of the HIA, the data sources and analytic methods used, the groups and individuals that were consulted in the course of the HIA, the process and findings of each step of the HIA, and the overall conclusions and recommendations. Public concerns are a common trigger for a decision to screen, and the degree of concern or controversy about a proposal may be one of the factors weighed in the decision to undertake an HIA. With clear language in mind, partners should come to agreement on the CDC twenty four seven. Public agencies might not disclose or might redact or otherwise limit disclosure of information. 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. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Northeast National Petroleum Reserve-Alaska, Supplemental Integrated Activity Plan, Record of Decision. Evaluation can be thought of in two useful and complementary ways: self-evaluation of the HIA process and impacts and independent external evaluation. In practice, some HIAs have focused on a specific health end point, such as obesity, or health concerns related to a single impact of the proposal, such as the health effects of air pollutants, most likely without using a systematic approach that considered and eliminated other impacts (see, for example, Kuo et al. In many cases, the first course of action is to gather information from published literature, unpublished reports, administrative data gathered for routine monitoring purposes, and other available documents. 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 lack of access to needed goods and services. Please enable it to take advantage of the complete set of features! Identification of apparent data gaps and of data collection that could be undertaken to address the gaps or a rationale for not undertaking data collection. 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. 8600 Rockville Pike These cookies may also be used for advertising purposes by these third parties. A variety of tools and processes may be used to conduct a community health assessment; the essential ingredients are community engagement and collaborative participation. UPH (Upstream Public Health). The committee emphasizes that the effectiveness of recommendations depends not only on the scientific validity of the interventions identified but on their relevance to the affected communitys concerns and their applicability within the regulatory or legislative framework of the proposal being considered. World Bank. Several types of evaluation may be conducted on an HIA, including the following: In practice, most HIAs do not include process, impact, or outcome evaluation; this has been attributed to a lack of interest, time, and resources in the case of process and impact evaluation and to the length of time (often many years) required for observing changes related to implementation. The approaches taken for stakeholder involvement vary widely. Instead, the committee focused its review on the characterization of effects and the use of evidence, although several recommendations to improve the quality of analysis are discussed in Chapter 4.
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