Health Impact Assessments: Get in the Know

Planning, also called urban planning or city and regional planning, is a dynamic profession that works to improve the welfare of people and their communities by creating more convenient, equitable, healthful, efficient, and attractive places for present and future generations.- American Planning Association

Healthy communities; how else can a community survive and thrive, whilst remaining sustainable past generations? Health Impact Assessments are one tool that can be used to “integrate health into the decision-making process and enhance communication between multiple stakeholders, including health and planning practitioners and policymakers.” HIAs examine the health impacts of programs and proposed policies and projects using a systematic six-step framework to promote health equity. Recently, I published a post about the impacts of HIAs in the planning field and how they allow for cross-sector collaborations. Working at APA’s Planning and Community Health Center is giving me more knowledge than I could have ever imagined about health impact assessments, and also the collaborative efforts happening with various coalitions across the U.S. through the Plan4Health project.

For further information on Impact Assessments, visit Human Impact Partner’s site on Health Impact Assessments. To get you started, here’s a neat 2 page HIA-Fact-Sheet! The National Association of County and City Health Officials (NACCHO) and APA collaborated to produce a free Planning for Healthy Places with Health Impact Assessments course, where you can learn how to administer HIAs and use as a future resource. NACCHO also has an extensive toolbox of health materials and projects.

If you’re interested in learning more about Health Impact Assessments, please review the Plan4Health webinar from Monday, July 20th. The session featured work from the American Planning Association’s partnership with The Pew Charitable Trust’s Health Impact Project as well as examples of HIAs conducted in community settings.

Participants will learn about the state of HIAs in planning, including a brief introduction to HIAs for less-experienced listeners, and will have the opportunity to engage with members from three Plan4Health coalitions: Health by Design in Indianapolis, IN; the Inner Core Community Health Improvement Coalition in Metro Boston; and the Chronic Disease Prevention Advisory Board in Columbus, OH.

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The Social and Health Inequities between Water, Sanitation, and People

Entire Collage

As part of my History and Theory course, we were tasked to create a visual project based on what we chose to focus on at the beginning of the semester. After toiling with many ideas, I decided I wanted to make a collage of photos pasted on canvas portraits that I had lying around for almost a year. Below I included the books and websites I used to find my pictures- there’s even an entire digital format with all photographs of the book How the Other Half Lives by Jacob Riis! If you hadn’t read it or at least looked at some of the photographs, do so- you’ll be able to see social mindfulness and visual ethnography at its beginnings and documentation of what it was really like to live during the industrialized period. Two other great books to learn about sanitation and clean water history and cultural implications of dirt history are Filth: Dirt, Disgust, And Modern Life and The Sanitary City.

My intention was to show a contrast of present times with the historical beginnings of sanitation methods involving water and clean cities, along with how human interactions with each other and their environments are dependent on the level of sanitation and access to clean water. The contrast of present day color photos with black and white photos from the past are selectively pieced so that black and white historical photos are in the background, though still always present in today’s times of color photos. Many of the photos show humans reliance on water and sanitation for many purposes, such as for drinking, sewer and waste removal, employment, cleanliness, and enjoyment. We see that humans’ struggles, resilience and forms of success through ingenuity with cleaning water and cities is an issue that is present over time, though manifests and changes according to trends and locations around the world and is often done with the aid of planners. Ultimately, lack of clean water and sanitation is a social inequity that leads to health decline in the environments and its people throughout history, and we see that this dynamic though may seem resolved, still needs much work to be done today in order to reach global, social and health equality.

*If you would like more information about where I got my photos from, and what sources I use, please ask. Also, this looked much better when it was hung up on the wall as part of the gallery walk through, but I forgot to take a picture…Each canvas has its own photo as well as the collective piece in one photo.

   

Top Left Corner20141209_231746

Bottom Left Corner20141209_231723

Bibliography of Pictures

Cohen, W. (2005). Filth: Dirt Disgust and Modern Life. Minneapolis: University of Minnesota Press.

How The Other Half Lives, by Jacob Riis. (2012, July 12). Retrieved November 5, 2014, from http://www.authentichistory.com/1898-1913/2-progressivism/2-riis/index.html

Hoy, S. (1995). Chasing Dirt: The American Pursuit of Happiness. New York: Oxford University Press.

Kostigen, T. (2008, July 10). The World’s Largest Dump: The Great Pacific Garbage Patch. Retrieved November 5, 2014, from http://discovermagazine.com/2008/jul/10-the-worlds-largest-dump

Melosi, M. (2008). The Sanitary City (Abridged ed.). Pittsburgh: University of Pittsburgh Press.

Parker, L. (2014, July 15). First of Its Kind Map Reveals Extent of Ocean Plastic. Retrieved November 5, 2014, from http://news.nationalgeographic.com/news/2014/07/140715-ocean-plastic-debris-trash-pacific-garbage-patch/

Impact Assessments- Are they useful to planners?

To follow up on the last blog post, here I will discuss a tool that I find is very important (though relatively new) to the field of planning: Impact Assessments. I have linked my Prezi here, so you can get a bit of a sense where I am coming from, as well as some of the resources I used.

On the “What is Planning” page of The American Planner’s Association website, the first paragraph states:

Planning, also called urban planning or city and regional planning, is a dynamic profession that works to improve the welfare of people and their communities by creating more convenient, equitable, healthful, efficient, and attractive places for present and future generations.

Healthy communities. How else can a community survive and thrive, whilst remaining sustainable past generations? While this may sound like a bold statement to make, please remember this is my personal opinion, and I do invite you to comment further and provide resources too! In my work over the years I have developed some questions that helped to guide my presentation as well as serve for further research purposes. These main questions are as follows:

  1. Why is healthy planning seen to be mostly a job for public health officials?
  2. If APA and CDC recognize need, why has it not become more of a priority amongst planners and policymakers?
  3. Should planners focus on the health of communities/environment when they develop their analysis and recommendations?
  4. What is being done to set the standards for all planners to make sure that health is a major consideration for every plan they develop and put forth?

The American Planner’s Association website states on its Health Impact Assessments page:

In practice, an HIA is part of a systematic approach to identifying the differential health impacts of proposed and implemented policies, programs, and projects within an equitable, sustainable, and ethical framework…The HIA is a valuable tool that can be used to integrate health into the decision-making process and enhance communication between multiple stakeholders, including health and planning practitioners and policymakers.

Despite this statement, I feel that planners are not being trained adequately to prepare plans that are not only sustainable, but with the health of people and ecology at the forefront. Although APA recommends the use of Health Impact Assessments or HIAs, most planners are not being prepared to use Impact Assessments unless they are also pursuing a policy degree at their accredited university. For further information on Impact Assessments, visit The Different Types of Healthy Assessments, and on Health Impact Assessments you can partake in the CDC free online training course for planners to learn how to administer HIAs! To get you started, here’s a neat 2 page HIA-Fact-Sheet!

Much of planning history has developed because of the responses needed to remedy certain building or health issues that we humans caused. I do believe the tides are turning and the field is beginning its stages of planning for the future, but overall there needs to be more preventive planning rather than reactive. I recently met with a person that works at the Pioneer Valley Planning Commission, who originated in the public policy field but ended up working in educational and policy planning. I asked her about the use of Impact Assessments at PVPC, and she said they have used them before for certain ecological or community health projects. Like me, she believes they could be a greater resource to planners and policy analysts if used consistently; not all planners and policy analysts are using them, and furthermore there is no uniform recipe for how to create an assessment. While there are guidelines, only some factors are strictly enforced (more so for the Environmental Impact Assessments).

One paper published from the Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health writes about Model Curriculum for HIAs that can be introduced to graduate universities. I think this is a great resource that proves officials are seeing more and more the importance of Impact Assessments. PEW Charitable Trusts has an entire site dedicated to upcoming projects and trainings that utilize health impact assessments for both public health officials and community developers, and here you can access many Toolkits and Data Resources. In my research, though I have not dissected its entirety, I have found this paper from the EPA website, A Review of Health Impact Assessments in the US, to offer an analysis of HIAs and their practicality, as well as areas for improvement.

I am positive I will write more on this in the future since it is one of my passions, but for now I hope you find the many resources I posted to be of help! I am happy to see that there are other planners and officials out there that see the value in using Impact Assessments for future policy and planning work, and I hope to see more efforts to make HIAs become part of standard training.