The Massachusetts Department of Transportation established a Healthy Transportation Compact in Chapter 25 of the Act of 2009, “An act modernizing the transportation systems of the Commonwealth,” which requires HIAs to assess the effect of transportation projects on public health and vulnerable populations. To our knowledge, this is the only state-level law that requires the routine use of HIA, although several have been proposed. The inter-agency Compact includes the Secretaries of Transportation, Health and Human Services, Energy and Environmental Affairs, the Highway Administrator, the Transit Administrator, and the Commissioner of Public Health. The Compact is designed to facilitate transportation decisions that balance the needs of all transportation users, expand mobility, improve public health, support a cleaner environment, and create stronger communities. It institutes an HIA program for planners, transportation administrators, public health administrators, and developers that strives to achieve positive health outcomes and strengthens cross-sector commitment to forming transportation initiatives that support public health and active living.
In Massachusetts, a working group containing members from each agency met regularly to plan the operations of the program and identify potential HIA targets. The first question the working group discussed was how to define HIA, and whether there needed to be a Massachusetts-specific definition. The agencies then screened a number of pending transportation decisions as potential HIA topics and ultimately selected the McGrath Highway Corridor, which will develop plans to guide the removal of a section of elevated freeway.
The Massachusetts Department of Health is using the McGrath Highway Corridor HIA to pilot the Healthy Transportation Compact HIA Program. Through conducting this HIA, the departments are developing the procedures, collaborative partnerships, data sources and metrics, and analytic approaches needed for a successful HIA partnership on future projects. According to the Massachusetts Department of Health, the work on HIA to date has already contributed to building new partnerships and strengthening others. These include partnerships between public health, transportation, energy and environmental regulators, as well as legislators, local health officials, and the general public.
The cost of HIAs will differ depending upon the questions to be answered, and the magnitude and complexity of the policy or project. Small scale or “desk top” HIAs can be done with existing staff and several weeks of salary ($5,000-$10,000). Larger HIAs requiring complex analyses on multiple issues can exceed $150,000. The Massachusetts Department of Health is using the HIA of the McGrath Highway Corridor as the test case to work out the details of the Healthy Transportation Compact HIA Program and the best funding mechanisms for ongoing HIA activity.