The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, announced seven grants to help bring health considerations into public policy decisions on transportation, education, housing, and other sectors of the economy and U.S. society. The grantees in seven states plan to achieve this goal through use of health impact assessments, or HIAs. These assessments bring together data, community and business input, and public health expertise to help policymakers and communities avoid unintended health risks and improve wellness when making critical policy decisions.
Considering health when making decisions in other fields offers a largely untapped opportunity to address many of the most challenging illnesses facing Americans, says Aaron Wernham, M.D., director of the Health Impact Project. These projects will help ensure that policymakers have the data they need to make choices that improve health in their communities.
Each new grantee will conduct at least two HIAs to inform specific upcoming decisions and will build a self-sustaining HIA program. Working with government, the private sector, and the community, the new programs will create the systems, partnerships, and infrastructure to make health a routine consideration in policy decisions for years to come.
HIAs bring health considerations into decisions in fields such as housing, education, and transportation to produce policies and projects that can enhance people's ability to live healthier lives. To address challenging health problems, an increasing number of communities are turning to HIAs. In 2007, 27 HIAs had been completed in the United States. Now, more than 250 are complete or in progress, according to the Health Impact Project map of HIA activity.
Three additional foundations provided funding to support HIA program grants: The California Endowment, Kaiser Permanente Colorado, and Saint Luke's Foundation of Cleveland. The grantees were chosen from a pool of applicants who responded to a national call for proposals. Selection was based on the opportunity to bring health into policy decisions where it might not otherwise have been considered, the severity of the likely health impacts, and the organizations; ability to conduct robust and balanced assessments.
Here are brief profiles of the new grantees and descriptions of how they will improve the health of communities through use of HIAs.
The Arizona Department of Health Services, in collaboration with the community group Health in Policy and Practice, will conduct two HIAs to inform transportation decisions. The first will address high-capacity transit master plan for public transit in Flagstaff.
The second will be carried out in tandem with an environmental assessment, planned by the regional public transportation authority Valley Metro, for a proposed transit extension into South Phoenix, an underserved neighborhood of the city. Transit projects can affect health by improving access to community resources such as clinics and healthful food, supporting physical activity, and reducing air pollution. Building on experience, the project team will also develop a self-supporting HIA program that will engage state and county agency partners to provide HIA technical assistance resources, support agency policies that require consideration of health in future decisions, and develop an Arizona network of HIA practitioners.
The Los Angeles County Department of Public Health, in partnership with the Los Angeles County School Attendance Task Force, will conduct two HIAs to examine potential options for reducing school truancy by implementing law-enforcement and community-based diversion programs and increasing access to affordable transportation options. Truancy is a risk factor for dropping out of school, resulting in lower literacy, poorer job opportunities, and lower income; all of which place health at risk by making it more difficult to afford safe housing, food, medical care, and other basic needs.
The department will also establish an HIA program that will work across agencies to identify policies that are important to health. The program will respond to emerging policy issues, complete full HIAs, and conduct rapid policy assessments when accurate health information is required for quicker decisions.
This grant is supported through funding from The California Endowment. The Los Angeles County Department of Public Health previously conducted HIAs on menu labeling and a local policy proposal to reduce salt consumption.
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The Tri-County Health Department serving Adams, Arapahoe, and Douglas counties in the Denver metro area will conduct two HIAs. The first will inform an area corridor plan that may affect vehicular and pedestrian safety, air quality, and noise, which poses a health risk through sleep disturbance and stress. The second will inform an agricultural-tourism plan to bring visitors to farms and other destinations. The plan can affect health by expanding access to locally grown healthful foods, creating economic opportunities, and encouraging physical activity through biking and walking.
The HIA program that the department is creating will increase capacity for development of HIAs in local government planning, develop a curriculum and syllabus for two University of Colorado, Denver, classes to educate future land-use and transportation planners, and develop an HIA report framework for local governments and community organizations to inform future HIA work around transportation decisions in the Denver region.
This grant is supported through funding from Kaiser Permanente Colorado. The Tri-County Health Department has previously conducted the Derby District Redevelopment HIA and the Glendale Riverwalk HIA.
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The Ingham County Health Department will conduct an HIA to inform development of a regional Fair and Affordable Housing Plan by the Tri-County Regional Planning Commission in accordance with federal fair housing guidelines. Reducing housing costs for low-income residents in the region can improve health by increasing the money available for food, home heating and cooling, and medical care. The second HIA will be integrated into development of a regional urban and rural services management policy that will guide resource allocation for four Michigan municipalities that may participate in the regional plan. The plan can affect health by encouraging safety and physical activity through development that combines residential and commercial use inside a boundary line while allowing low-density land uses, such as farms and protected natural areas, outside it.
The department will also complete development of a prototype HIA-based checklist and online mapping and visualization tool kit to streamline the incorporation of health into future local land-use, transportation, zoning, and building permit decisions.
The Ingham County Health Department previously completed the Health Impact Assessment of the Non-Motorized Transportation Plan and Climate Sustainability Plan Recommendations and the Ingham County HIA.
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The Minnesota Department of Health will conduct two related HIAs to inform decisions by the Duluth City Council regarding land-use planning. The first HIA will help develop a small area plan for the neighborhood of Gary and New Duluth. The second one will contribute to the master area plan for Duluth Works, a former U.S. Steel Corp. plant that is now a Superfund site.
Both HIAs will provide recommendations to the City Council on how best to consider the potential health impacts of planning decisions and development on the sites. In particular, the HIAs will consider the risks associated with exposure to contaminated soils and water, and lack of access to health care, as well as potential benefits, such as new housing, job creation, and a more interconnected, safer community.
The Minnesota Department of Health also will create a statewide, sustainable HIA program, which will establish a state-level interagency work group and a coalition of local agency and nonprofit partners to support training and technical assistance. The department will create tools and develop state-level policies to help make HIA a routine part of decision-making.
The Minnesota Department of Health has previously conducted four HIAs: the 6th Avenue East Duluth HIA, Divine Mercy Development HIA, Douglas County Comprehensive Plan HIA, and St. Louis Park Comprehensive Plan HIA.
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The Cleveland City Planning Commission, as part of the Healthy Cleveland initiative, will conduct two HIAs in collaboration with the Cuyahoga County Board of Health and agency partners, including Cleveland's Public Health Department. The HIA will help inform a neighborhoods land-use and design decisions, affecting access to affordable housing, green space, healthful foods, and education by examining health outcomes such as diabetes, obesity, and stress, and other relevant health conditions.
The second HIA will inform planning and funding decisions related to establishment of an urban greenway on Clevelands east side. Decisions on neighborhood design and green space can affect a variety of factors important to health, such as housing quality and affordability, access to healthful foods, and availability of safe places for exercise.
The program will develop broad-based, local capacity to conduct HIAs, as well as develop specific criteria for the selection of future HIAs. It will build upon the groundwork laid by the Northeast Ohio HIA Partnership, an initiative coordinated by the planning commission, the County Board of Health and other agency partners, which was launched in July 2011 with funds from The Saint Luke's Foundation of Cleveland.
This grant is supported through funding from Saint Luke’s Foundation. The Cleveland City Planning Commission previously conducted the Urban Agriculture Overlay District HIA.
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The Oregon Health Authority, working with the nonprofit group Upstream Public Health, will conduct two HIAs. The first, in collaboration with the Oregon Department of Transportation, will assess strategies under consideration to reduce traffic congestion and vehicle miles traveled, in preparation for the development of a statewide plan. Relieving traffic congestion can improve health by reducing exposure to air pollution. In some communities, it may also increase opportunities for physical activity and improve access to employment.
The second with the Oregon Department of Energy, will inform the siting of a large wind power facility. This HIA will build on the interagency partnership developed through a previous assessment that more broadly examined health issues associated with wind energy in Oregon. It also will pilot the framework that the states health authority developed in the 2011 Strategic HIA on Wind Energy Development in Oregon. Health effects likely to be considered include the potential for exposure to noise, stress related to changes in the aesthetic character of communities, and benefits from reduced air pollution and economic development.
The Oregon Health Authority will also establish criteria that will enable it to work with these agencies in future decisions and will support a strong network of public- and private-sector HIA partners to continue to build the practice in Oregon.