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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Equity at the Center of HIAs: An Emerging Planner’s Perspective

This post will be featured on APA’s Sustaining Places blog, so I wanted to share with my blog community here. Thanks for reading!

Today marks my third official week since beginning an internship with the American Planning Association at their Planning and Community Health (PCH) Center in Washington, D.C. Within these last two weeks I’ve been exposed to quite a whirlwind of information, events, conference calls, and meetings (including a few that had free food!). I have to say that I feel very privileged to have this opportunity to come to “work” where I get to learn about all the things I’m passionate about and research all the topics I’ve always wanted to investigate.

At PCH, there are several projects that I’m involved in, either directly or indirectly, and while there is lots of overlap amongst them, they each have their own unique focus! Many of the projects are still in the developing stages, which have allowed me to see where they have begun while simultaneously jumping in head first to drive them forward. These projects will promote webinars, fact-sheets, and toolkits that APA will share with fellow planners as well as the general public, which is part of their vision in leading research and education in the planning field.

One project, Health Impact Assessment’s Role in Planning, will analyze a targeted list of Health Impact Assessments (HIAs), their presence and effectiveness in the planning and public health fields, and address where they are headed in future planning strategies. Over the last 10 years, planning and public health have begun to collaborate, and there’s acceptance that these fields should in fact be working together. At the Planning and Community Health Center, we are working towards Health in All Policies (HIAP) by promoting public and community health strategies in planning, with HIAs being one tool.

A second project as part of Planning Tools for Health is producing tools to help public health and government officials, along with planners, in support of reaching healthier communities for all. So far, two fact sheets have been produced: Health into the Comprehensive Planning Process and Safe Routes to Parks. Be on the lookout within the next few months for the final fact sheet: Green Infrastructure for Community Health. Another project, Plan4Health, is a joint collaboration with the American Public Health Association and funded by the Centers for Disease Control and Prevention. You can learn more about Plan4Health on their site, but in essence their goal is to foster “creative partnerships to build sustainable, cross-sector coalitions.”

This past week, I was able to attend the 3rd National HIA Meeting here in D.C. with fellow staff, where we could “choose our own adventure” and select sessions that aligned with our personal interests. The major theme throughout this conference was equity as part of all things considered health, and further, health planning. As a learning planning and policy student with a strong background in community organizing, I have always felt strongly towards the importance of effective community engagement as part of the planning and policy processes. For clarity purposes, the CDC Health Equity Guide states that “Health equity means that every person has an opportunity to achieve optimal health regardless of: the color of their skin, level of education, gender identity, sexual orientation, the job they have, the neighborhood they live in, and whether or not they have a disability” (p. 2) Through most of the sessions, equity, how to effectively include equity as a component in HIAs, and how to achieve equity in plans and policies was continuously reinforced.

Standing among so many professionals from various sectors, I was deeply moved by the belief that equity should always be part of the public health and/or planning process, and further mirrored in the policies that stem from these fields. It was a refreshing reminder to hear from the diverse and overwhelmingly dedicated speakers that we should always be striving to effectively engage within our communities that will be affected by the plans and policies produced. Community engagement cannot simply be hosting a public meeting, counting the attendees and checking it off as done.  Equity is about making sure that throughout the planning process—not just the engagement piece, but the entire start to finish—those directly affected by the plan are in “the driver’s seat”, as so eloquently put by Lead Organizer of ISAIAH Phyllis Hill. We all were left reinvigorated to continue our work with more passion and a greater commitment to equity and, though we may be in different sectors, are all still committed to the belief that zip codes should never determine a person’s health.

While at the conference, I was able to meet with many key partners that are working with APA to propel the Health in all Policies movement forward, as well as the use of HIAs in the planning process. Senior Associate Ruth Lindberg of The PEW Charitable Trusts met with members of PCH to discuss the summary report of HIAs that will be released this fall. Rachel Banner, Program Manager at National Recreation and Park Association, was also another collaborator present at the conference, who recently spoke at an APA directed webinar about Safe Routes to Parks. Many coalition members of Plan4Health were present throughout the various breakout sessions, as well as authors of the various HIAs that APA is researching. Besides planners, sessions were filled with leaders from public health, environmental agencies, sustainability departments as well as an array of epidemiologists, policy writers and analysts, elected officials from local, state and federal levels, community organizers, and non-profit leaders.

In closing, wise words were spoken by Robert Wood Johnson Foundation Senior Program Officer Pamela Russo, “Multiple sectors need to work together to make health and well-being a national priority.” Rebecca Morley, Director of Health Impact Project, reminded all of us the importance of engagement, empowerment, and equity, and that we all need to be doing more to support more community-driven HIAs rather just community-engaged HIAs.

All of us at PCH were honored to take part in The National HIA Meeting and we are looking forward to attending next year. If you would like more information about any of the projects mentioned, please visit APA’s Planning and Community Health Center site.

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.